Director’s Foreword: The quest for equity and justice in higher education
The last two years have seen unprecedented mobilisation on higher education campuses across South Africa. While these have taken different forms on each campus, fundamentally they have all been concerned with two issues: a growing crisis of affordability and therefore access to higher education; and, as a new generation of South Africans have asserted their place in the academy, a critique of the knowledge project in universities, which in the words of one commentator ‘remain[s] rooted in colonial, apartheid and Western worldviews and epistemological traditions’.
Over the last decade and a half, government funding to universities has not kept pace with increasing enrolments, and the proportion of university income from student fees has consequently increased: from 24% in 2000 to 33% in 2013, with government’s share declining from 49% to 40%. This is compounded by ongoing inequities between universities along historically racial lines - a three-fold difference in per capita income between the least and most resourced university. For many young people in South Africa, obtaining a higher degree has become an intense battle for survival, and in late 2015, when universities announced above inflation tuition fee increases, a wave of protest action swept across universities under the banner of #FeesMustFall, including at UWC. Campuses became spaces of mobilisation, but also violent confrontation, with weeks of closure and levels of securitisation reminiscent of the apartheid era. Government eventually announced a moratorium on fee increases for 2016, and committed to real increases in year-on-year funding for higher education. Within a few months the student protests had achieved a paradigm shift in policy and public opinion, in which the goal of free higher education was no longer universally portrayed as an impossible pipe dream. Despite the difficulties and disruptions, the events on campuses drew necessary national attention to the ongoing stark realities of South Africa as one of the most unequal societies in the world, where extensive privilege exists alongside severe marginalisation. The protests fundamentally challenged the status quo in higher education, generating new conversations and critical self-examination, and jolting the nation out of a creeping acceptance of inequality in access and resourcing.
As a postgraduate School with a largely distance-based and part-time student population, these struggles have had relatively little direct impact on the delivery of our educational programmes over the last two years. Although the UWC campus was shut for extended periods in 2015 and 2016, we met regularly as staff and found ways of working off campus, thanks in particular to a committed and experienced administrative team. However, the events on campus provoked considerable internal discussion and reflection in the SOPH on our role and position in, at times, a highly conflicted and polarised university environment. We became more focused on the conditions of undergraduate students and ways of engaging their problems and issues, such as food security, and in establishing the SOPH as a space of solidarity on campus. We have also begun to interrogate the meanings of “decoloniality” in relation to our curriculum and the field of public health more generally, and the way our School functions as a collective. The struggles in higher education are far from resolved and will form a powerful backdrop to our endeavours in the years to come.
In this context, our approach to educational programmes, research and public engagement, centred on values of equity and social justice and the promotion of public value in health and health care, remain as relevant as ever. Our postgraduate programmes continue to be popular in South Africa and across the African continent, with demands for places outstripping our capacity to meet them. An advert for doctoral and post-doctoral scholarships in 2016, linked to two health systems research chairs in the SOPH, led to 169 applicants from 25 sub-Saharan African countries. It highlighted the need to build stronger institutional capacity at African universities to train and supervise students who are increasingly demanding doctoral and post-doctoral training opportunities within their geographic and financial reach.
In other developments, our MPH Programme saw the consolidation of the Pharmaceutical Public Health track, designed and run in collaboration with Professor Richard Laing of Boston University. Two new MPH courses (also offered as standalone accredited continuing education courses) were developed and taught, and a third is in preparation. A total of 25 people involved in access to essential medicines in one way or another in South Africa and the region, enrolled in these courses. In 2016 the SOPH began supporting curriculum and materials development for Masters-level training in Supply Chain Management at the Rwandan Centre of Excellence.
Making use of a rapidly changing environment of digital access, we completed the shift of our core diploma and masters courses from paper-based distance learning materials to UWC’s integrated on-line learning management system, iKamva. In the process we also considerably enhanced our capacities in e-learning, and appointed a full time e-learning co-ordinator, Ziyanda Mwanda, who is profiled in this report. Our long-standing experience with distance education has prepared us well for the general shift in higher education towards on-line pedagogies. Following a number of requests from partner institutions to assist in the development of distance learning programmes, we convened and organised a two-part workshop series in 2015. This was attended by 16 public health institutions from Africa and Asia and led to the launch of a guide in 2016 entitled: The process of transitioning from face-to-face to distance teaching and learning in postgraduate public health education for health systems development.
Linked to these developments we collectively designed and launched an integrated social media policy for the SOPH. The platform includes Facebook as an alumni networking and communication portal (with growth of ‘fans’ from 200 in 2014 to over 2,700 in early 2017), active use of twitter (616 followers), launch of a SOPH YouTube channel, and extensive redesign of the SOPH website (to be launched in 2017). SOPH’s Twitter handle (@sophuwc) featured in the Top 10 list of Twitter handles related to during the 4th Global Symposium on Health Systems Research held in Vancouver in November 2016. As is evident in these pages, our research activities and collaborations are as vibrant as ever, addressing a wide range of themes relevant to policy and practice, spanning programmatic (Type 2 Diabetes; HIV/TB; nutrition; maternal, child and reproductive health), health systems (human resources for health, medicines, governance, leadership), social and educational research, and playing a vital role in the training of doctoral and post-doctoral researchers. Drawing on this knowledge base, the SOPH has engaged in national health policy developments, writing submissions on the National Health Insurance White Paper, a proposed tax on sugar sweetened beverages, and the draft Bill on the creation of the National Public Health Institute for South Africa. In 2016, we co-hosted the World Nutrition Congress of the World Public Health Nutrition Association, and participated actively in the Global Symposium on Health Systems Research in Vancouver.
Our external collaborations remain numerous. They include government players at all levels in South Africa, the University of Cape Town and other higher education institutions in South Africa, and a network of collaborators in Africa and Asia. In this report, we specifically profile our exchanges with researchers and health system actors in India with whom we have increasingly come to recognise a common language and set of interests. The Antwerp Institute of Tropical Medicine also continues to be one of our most significant international partners - a partnership generously supported by the Belgian Development Co-operation - which contributes to several of the capacity building initiatives described above.
In 2015 we were awarded a second South African Research Chair (SARChI) in Health Systems Governance. We were also very fortunate to appoint Professor Asha George to our existing SARChI Chair in Health Systems, Complexity and Social Change, replacing Wim van Damme who occupied the position for two years. We welcomed three new core staff members: Di Cooper (professor), Hanani Tabana (senior lecturer) and Carnita Ernest (project manager) — and said goodbye to long-serving senior lecturer Gavin Reagon (who took up a position with the Western Cape Provincial Health Department).
Departmental secretary Lynette Martin and project manager Shun Govender both retired at the end of 2016. We were deeply saddened by the untimely passing of our long-time collaborator and former staff member Kirstie Rendall-Mkosi.
Despite a rapidly changing and often uncertain context, the SOPH remains resilient, continuing to adapt and renew itself in ways that speak to the many realities we are confronting. This has been made possible by an incredible team of academic and administrative staff, acting collectively in support of each other and the SOPH’s mandate. As I wrap up my four-year term as Director, I am deeply grateful to them all.