Accountability, Corruption and the Right to Health
South Africa’s Constitution promises that everyone has the right to access health care services and that no one may be denied emergency medical treatment. International law reinforces these obligations, requiring that the right to health be realised without discrimination. Yet, as the country continues to confront systemic corruption and weak accountability within the public health sector, a pressing question arises: How can this right be fulfilled when the systems meant to protect it are themselves eroded?
This critical tension formed the focus of a webinar hosted by the Mandela Institute, featuring Ms Sasha Stevenson, Executive Director of SECTION27 and one of South Africa’s leading public interest health lawyers. The session opened with welcoming remarks from Mandela Institute Director Professor Tracy-Lynn Field, who underscored the Institute’s commitment to understanding and addressing the “predatory and parasitic social systems” that undermine human potential — corruption in the health sector being among the most damaging.
Exposing the Human Cost of Corruption
In her compelling presentation, Ms Stevenson detailed SECTION27’s ongoing work to confront the deep-rooted failures in Gauteng’s health system, focusing on two emblematic cases:
- Life Esidimeni: A Decade of Pain Without Accountability. Ten years after the tragedy that claimed 144 lives, families are still waiting for criminal accountability. Ms Stevenson highlighted how the case illustrates a broader institutional culture in which political and administrative leaders evade consequences for decisions that cost lives.
- The Tembisa Hospital SIU Report. Released in September 2025, the report exposed approximately R2 billion in stolen funds, with nearly R122 million flowing directly to Gauteng Department of Health officials. Ms Stevenson described a sophisticated network of “salami-sliced” procurement abuses where tenders are repeatedly broken up to fall below oversight thresholds enabled by deliberate opacity, falsified compliance documents and a culture of impunity.
These losses translate directly into human suffering. As Ms Stevenson noted, billions siphoned from the health budget could have funded thousands of nurses or critical medical supplies. Instead, clinics run out of contraceptives, hospitals lack surgical equipment, and vulnerable patients are turned away after vigilante groups exploit resource shortages.
Why Corruption Persists — and What Must Change
Drawing from SECTION27’s experience in litigation, advocacy and community engagement, Ms Stevenson identified three systemic drivers that allow corruption to thrive:
- Weak systems and poor implementation
Failure to strengthen procurement controls, internal audits, and whistleblower protections leaves health facilities exposed. - Lack of accountability
Even when investigations occur, consequences seldom follow. Officials implicated in wrongdoing reappear in other senior roles, serve in legislatures, or re-enter political structures. - Failures of leadership
Gauteng has cycled through at least 10 MECs and 10 HODs in 15 years — an instability that undermines strategic planning and entrenches dysfunction.
She stressed that addressing corruption requires more than criminal prosecutions. Professional, political and administrative accountability backed by transparent systems and firm leadership is essential if the right to health is to become more than a constitutional promise.
The Path Forward: Rights-Based Health Governance
Ms Stevenson urged participants to reimagine the health system not merely as a service-delivery machine but as a core social institution designed to fulfil constitutional rights. This lens demands people-centred leadership, transparent procurement, stronger oversight mechanisms, and protection for those who expose wrongdoing.
Importantly, she argued that the move toward National Health Insurance (NHI) cannot succeed without addressing governance risks. Centralising all health funds in a single structure may improve equity but also heightens the stakes for corruption if proper safeguards, oversight and transparency are not embedded from the outset.
A Call to Collective Action
In a lively Q&A facilitated by Dr Sanya Samtani, attendees raised concerns about the role of ordinary citizens, health professionals, academics and legal practitioners. Ms Stevenson emphasised that while individuals cannot unilaterally discipline corrupt officials, they can:
- support investigative journalism and civil society organisations;
- demand transparency in procurement processes;
- keep public pressure on political leaders; and
- ensure that scandals do not quietly fade from public consciousness.
“Corruption is not victimless,” she reminded the audience. “Every rand stolen from the health budget represents delayed surgeries, empty shelves and lives placed at risk.”
Ms Sasha Stevenson is a human rights lawyer and the Executive Director of SECTION27, a public interest law organisation in Johannesburg. She holds bachelors, honours and law degrees from Rhodes University and an LLM from the University of Cambridge. She has been working for over a decade to secure systems change that realises health and food rights, including through representing the families of mental health care users who died after their disastrous deinstitutionalisation from Life Esidimeni, securing the re-start of the programme that feeds 9,6 million children at school every day after COVID-19, and work on migrant health, access to abortion and access to medicine, among others.