Resource allocation during COVID-19: A focus on vulnerable populations

Abstract

South Africa is a country of contrasts, with abundant resources, hard won civil rights and a diverse population. Woven into the fabric of our society is a large divide between its poorest and wealthiest members. In this article we highlight the vulnerabilities in our society which have been amplified by the COVID-19 crisis. Based on recent projections, it is very likely that the healthcare system will be overwhelmed. We acknowledge the recognition by government and civil society of these vulnerabilities and note that difficult decisions will need to be made with regard to resource allocation. Our plea however is to ensure that human dignity and the principle of distributive justice are maintained, and that when difficult decisions are made, vulnerable people do not suffer disproportionately. Furthermore, it is of great concern that there is no national directive guiding resource allocation, prioritisation and triage decisions in both public and private hospitals. The HPCSA should, as a matter of urgency, issue guidance on priority setting and triage decisions in the context of COVID-19, based on distributive justice principles.