For more than 20 years, the Foundation's priorities and programs in South Africa have shifted as political circumstances and the main health challenges in that country have presented new needs and opportunities. But the main goal of our South Africa program has remained the same. Our basic mission is to develop the people, plans and programs to help establish a more equitable national health system and a successful democracy.

The South Africa program was initiated in 1987 during the most repressive period of the apartheid era. From the start the Foundation maintained a hands-on approach, proactively working with South African partners to develop ideas and help implement programs. A central part of the Foundation's strategy has been to develop politically credible and effective institutions to lead the process of health sector transformation. For that reason we have focused our efforts on a relatively small number of key partners, and by doing that, helped build capacity in the South African public health sector.

The Foundation has contributed to the government's efforts in establishing the framework for a more equitable national health system. Over the years, the Foundation has:

• developed a national initiative for reducing the rate of HIV infection among young people, contributing over the past decade to substantial decline in the rate of HIV infection among people under 25 years;
  
• provided the essential information on which government health policy and program plans are based;
• facilitated the decentralization of health management nationally and helped advance primary health care as the foundation of an equitable national health system;
• helped in the training of most top-level health officials in the country;
• established key national resources in reproductive health, child health and health systems development to help inform government policies and programs;
• supported development of a charter of patients' rights which government has adopted.
• raised the profile of health and HIV/AIDS on the national agenda, training a generation of health media reporters and established the first independent health news service which is the major supplier of health content to most major news outlets including the national broadcaster.
  

Over the past two years the Foundation has concentrated its efforts in support of government's plan for restructuring the South African health system. As part of that effort, the Foundation is coordinating an on-going process to strengthen political leadership in health and drawing on international experience to inform broad based health systems reform with the goal of ensuring that implementation of national health insurance results in access to health services for all South Africa and will improve health service delivery and outcomes. 

Examples of key South African institutions initiated and supported by the Foundation include:

The Health Systems Trust: established initially to coordinate and inform planning for the post-apartheid national health system, the Health Systems Trust continues to play a significant role in support of health policy development, research, and evaluation. The Health Systems Trust is best known for its annual Health Review of South African health trends.

The Reproductive Health Research Unit (RHRU) at the University of the Witwatersrand: was founded in 1994 to spearhead the revision of reproductive health policies and programs resulting in implementation of comprehensive reproductive health services in all public clinics and substantial declines in maternal mortality within the first five years after democracy. The RHRU has in more recent years played a pivotal role in expansion HIV/AIDS treatment programs.

The Oliver Tambo Fellowships for Health Management at the University of Cape Town: trains public health managers earmarked for senior management positions through an 18 month program with a major focus of health budgeting and finance. More than 500 managers have graduated from this program over the past 15 years and the program has more recently expanded to include students form other southern African countries.

The Mandela Award for Health and Human Rights: established at the behest of Nelson Mandela shortly after his release from 27 years imprisonment for the purpose of recognizing extraordinary dedication to improving the health and well-being of the marginalized and disadvantaged. Over nearly two decades the Award has been presented to outstanding South Africans and other leaders in public health in South Africa and around the world.

loveLife: South Africa's national HIV prevention program for youth, was launched in September 1999, by a consortium of leading South African public health organizations in partnership with a coalition of more than 100 community-based organizations, the South African government, major South African media groups and private foundations. loveLife combines a highly visible sustained national multimedia HIV education and awareness campaign with countrywide adolescent friendly service development in government clinics, and a national network of outreach and support program for youth.

loveLife is a comprehensive, evidence-based approach to youth behaviour change that implements, on an unprecedented scale, the international experience of the past 20 years – combining well-established public health techniques with innovative marketing approaches to promote healthy AIDS-free living among South African teenagers.