Capitalism, Mining, and Restorative Justice in Southern Africa

The convergence of capitalism, private enterprise, and public policy provides fascinating and vexing lessons for the practice of global health in the Southern Africa region. Much of the contemporary discourse on health systems focuses on its complex adaptive nature or on building blocks. But while such thinking is relevant to the “what” and the “how” of health systems, it does not explain in depth the “why” of health systems. Yet, it is in the interest of country policy makers and investors at the country and global levels to understand why any particular system is the way it is. Such understanding, which explains — but neither justifies nor excuses — apparent irrationalities and clear injustices in health systems, is a precondition for effective leadership in seemingly impossible situations.This chapter examines a regional challenge: addressing the legacy of unfettered capitalism and state-enforced racism in the mining sector of Southern Africa. It then examines the nascent health financing reforms in one country — the Republic of South Africa itself, with emphasis on the complex social and political dynamics of change and a potential for restorative justice after decades of ruthless exploitation.