Read the Conversation

EF: 2020 was the year of diagnostics, and 2021 was the year of vaccines, what do you think 2022 will be the year of?  

CC: From the perspective of Business Unity South Africa, the aftermath of Covid has a semblance of a new normal returning. Covid has impacted the world of work, and we must all reposition ourselves. We will continue to manage the impact of COVID-19 from an economic standpoint. We will be working with the hardest-hit sectors with economic recovery strategies, including backing and driving the healthcare sector. A critical issue for us in 2022 will be the National Health Insurance discussion. During the pandemic, we built a collaboration platform, particularly with the National Department of Health, which we can use to discuss and engage on NHI. Pre-COVID 19, we had a substantial engagement, but it must be renewed to arrive at some sort of incentivization for universal healthcare. Private healthcare is strong and efficient in South Africa. In contrast, the public sector requires work, so we need to use the strength of the private healthcare sector to build up the public healthcare sector for resources to be more equitable and have a universal healthcare system.  

EF: South Africa showcased very successful collaborations during the pandemic. Is a collaboration between the public and private sectors here to stay?  

CC: I think it is here to stay. Covid was a focused issue, and it was clear that without collaboration and getting the vaccines, people would be significantly impacted. There was no choice; we had to collaborate. During Covid, we had a platform of cooperation; now, the top executives need to collaborate on NHI, which is more complex than COVID-19. The future form of collaboration may differ; we have been talking to the government on bilateral engagement on broader economic recovery issues. There will be ideologies to be bridged and compromise to be reached. But ultimately, I think the collaboration will continue as it was boosted by the pandemic and provided lessons on how to work together.  

EF: How can we leverage the experiences and lessons learned from the pandemic going into the future?

CC: We need to separate the work and the implementation from the politics. BUSA was formed because a project management approach was essential for businesses to support the government. We created the structure with the necessary expertise to make decisions quickly, have fast turnaround times, and not be burdened with mandates and reports. We need to carry this approach in future discussions on NHI. While continuing political negotiation,  identify issues where we need to start making progress, draw on our local and global experience, and drive the project management. Hopefully, this will feed into the more difficult political debates and effectively enable us.  

EF: You spoke at the Confederation of Swedish Enterprise regarding strengthening economic relations between Africa and the European Union. If there was such a project, what strategies would you put in place to get the project going immediately?

CC: We must move beyond the idea that we should not have universal healthcare; we have the resources and the capacity between the private and public sectors in the country to achieve a model that will provide universal healthcare. I would want both private and public to join resources and capacity and identify the trade-offs and compromises needed. The impact on the public sector means that most of the population does not have access to appropriate healthcare. Should this situation persist in the long term, the access of those who have private healthcare would begin to be threatened. When the majority does not see the fruits of democracy, the minority that does will not see them for much longer. In such a scenario, I would consider it reasonable and satisfactory to look to the strengths of the public and private sectors to create a healthcare model for the country with minimal healthcare coverage for the majority of the population. We can enable additional healthcare for those prepared to pay for it.  

EF: Is universal provision the future of access at a global level?

CC: Undoubtedly, globalization has assisted in reducing poverty, but it has also exacerbated inequality, and as inequality grows, those with the resources look after themselves while those without resources cannot do so. In South Africa, those with the means have privatized healthcare, security, and more, while those without means get continuously diminishing returns. The same happens in other aspects of life, so universal access has become a global phenomenon. It is also the result of how we have managed our economic model. Capitalism is the dominant system, but it is under threat. We must reimagine capitalism and apply capital more equitably because inequality has brought up all these broader global issues, such as inequality in healthcare.

EF: Will economic partnerships be based more on self-reliance and independence rather than interconnection?  

CC: No, I do not think so, younger people are beginning to demand more value-based capitalism, they want a better family-work balance, they want businesses to play a value-based role in society, and to achieve this we need to collaborate and not be self-serving. For major corporates to adopt a value space capital in the short term requires compromise and sacrifice, even though companies have improved their bottom line in the medium to long-term through this. Value-based capitalism complements growth and profitability, and younger generations will push for it. I believe there will be more collaboration; countries and firms will collaborate to create an appropriate business environment.  

EF: Could you elaborate on the role of the private sector in the development of South Africa and in reducing issues such as unemployment?  

CC: The private sector in South Africa has resources and capacity, giving us the responsibility to create an environment to do business more sustainably, which means doing business profitably over the long term. The business sector in South Africa has been proactive. For example, at the height of the pandemic, we had 400 professionals in communication, health, legal, and transport, working pro bono for about a year to help manage our project. That value is significant, as with the vaccines and the Solidarity Fund. In the early days of our democracy, we put together a one-billion-rand Business Trust Fund to contribute to the country. We have a history of contributing, and businesses will continue to contribute, but there are significant levers that only the government can pull. The government's responsibility is to reform and deal with corruption - the business cannot act, only support. The government must work with the business sector to address state capacity, and if we can do the structure of reform, we will. The government needs to create the environment for businesses to create jobs, and we are pushing for that. With the appropriate setting, the investment will flow, and growth will occur. We are keen on bilateral engagements because we can discuss what trade-offs and compromises we need to make. We will have to agree on short-term trade-offs and compromises for long-term sustainability. Business needs to appreciate that if we do not work with the government to address the social inequalities in the country in twenty years, we will not be doing business. From a practical standpoint of business sustainability, BUSA is looking to work on universal coverage, using the capacity and expertise of the private and public healthcare sectors, and it is the right thing to do from an ethical and moral view.

EF: What is the role of healthcare in developing the economy?  

CC: Our private healthcare sector is very strong, with world-class companies. With my vice-president at BUSA, Adrian Gore, we have a leadership that believes in this country. We have the capacity, expertise, and the right mindset in the public healthcare sector to benefit the vast majority of the country. The role of the healthcare sector in economic development is to improve people's health and life quality. The private and public healthcare sectors can work together cohesively for better healthcare stability, which must be at the top of the healthcare agenda. Given the discussions, the private healthcare sector must have a clear mindset, and it must not be about protecting the private healthcare sector at all costs. It is about the private healthcare sector continuing to grow sustainably, looking to what complements the industry, and proving that universal health care can be created. This is a critical role over the next few years.  

EF: 90% of multinational pharmaceutical companies set South Africa as their regional headquarters. How do you see South Africa's role as a healthcare hub, and what sort of an example does it set to the rest of the world?  

CC: Lost opportunities for the country need to be addressed. We have a good infrastructure, good skillsets, and an innovative healthcare sector attracting multinational healthcare players to do business in South Africa and the continent, with rudimentary healthcare and significant opportunities to use South Africa as a base. We certainly have the potential to become a healthcare hub for the continent, but we need a message that we are open to investment and create a business environment for investors and players. Kenya and Ethiopia have done this, as have Rwanda, Nigeria, and Ghana. We are competing for investment, we have the infrastructure and the capabilities, and we must rise to the occasion and be very clear that we are open for business; if not, investors will go elsewhere.  

EF: What would be your advice to other business leaders looking for opportunities in South Africa?

CC: For anybody interested in South Africa, there are great opportunities. Business leaders need to express their concerns about the country to the pertinent authorities. Even better, speak directly to the president because the leader of a big multinational wanting to come to South Africa would make a huge impression, especially if that person expressed certain reservations about investing in the country. At BUSA, we would welcome any corporation interested in investing in South Africa, talking to other business organizations, or us. When I speak to people overseas, I am very frank with them, we want them in our country.  

EF: What would make you happy to achieve and celebrate by the end of 2022?  

CC: I would like to celebrate having learned lessons from the pandemic and having a better-prepared healthcare sector in the event of another pandemic. To make progress in manufacturing our own vaccine and work with the government to ensure we are prepared as a country. Finally, I would like to see significant progress in our engagement with NHI; I hope that we will manage to agree on using the strengths and capacities of the public and private sectors.  

April 2022
South Africa