As I write this, I am challenged by the state of South Africa today. Echoing the words of an American President, Gerald Ford, addressing the United States Congress in his 1975 State of the Union Address when he memorably told his nation that, “the state of the Union is not good” I would say that “the state of South Africa is not good”. South Africans are challenged daily by failures of service delivery from local, provincial and national government as well as State-owned entities. As a South African health professional I am particularly concerned by the impact of these failures on the public health service that serves the majority in this…