South Africa stands at the threshold of the most consequential health reform in its democratic history: national health insurance (NHI). Its promise? A society where healthcare is not a privilege of the wealthy but a guarantee for all. Yet, what dominates headlines and talk shows is not the vision of equity NHI represents but a stream of narratives steeped in distrust, dysfunction and fear.

The phrase “If it bleeds, it leads” has long held sway in media circles, and when applied to NHI, it has too often bled perspective dry.

Coverage tends to centre on stories of mismanagement, fears of a collapsing private healthcare system, and projected costs. These deserve attention. But they cannot be the whole story. What is equally, if not more, newsworthy is this: millions of South Africans live without consistent access to primary care, quality hospitals or affordable medication. That inequity should lead to action, not fearmongering.

NHI is not just a bureaucratic policy — it is a moral reckoning. It seeks to right the deep structural injustices in our health system, many of which still mirror apartheid-era geography and class divides. The child in Mthatha should have the same chance at survival as the child in Sandton. That is the essence of NHI.

As we approach the Finance for Development Conference in Sevilla, Spain, this Monday and the Brics Leaders Summit in Brazil shortly after, there will be high expectations of our health financing narrative as the Group of 20 presidency. In the wake of the dramatic withdrawals in official development assistance, leading policymakers have emphasised the need to sustain the gains towards the Sustainable Development Goals (SDG) 3 target — universal health coverage — through state-led health financing as guided by the evidence-based policies of normative bodies such as the World Bank and the World Health Organisation. The world will be looking to us to lead by example: not just rhetoric.

We are not naive about the challenges ahead — governance, financing and implementation must be watertight. But scepticism must not become sabotage. South Africa has defied the odds before. We built the world's largest HIV/Aids treatment programme when many said it could not be done. We led globally on Covid-19 vaccine equity. We know how to turn a national crisis into a national triumph — when the narrative fuels solutions, not cynicism.

That is where the media comes in.

You are not just storytellers. You are story shapers. You can hold policymakers accountable while also giving voice to the underserved, platforming progress, and illuminating the moral argument behind reform. You can ask: “What’s broken?” — but also, “What’s possible?”

NHI will not succeed without the public’s understanding and engagement. And the public cannot engage with what they do not hear or see. So, I invite you — editors, journalists, broadcasters, producers — to reposition and reclaim its role. Tell the truth, but tell the whole truth — frame narratives, which can either build trust or fuel scepticism, amplify voices, especially those often excluded — such as marginalised communities. In essence, your role isn’t just to report on reforms like NHI — you can influence whether society embraces or resists them.

In the end, what will define us is not how loudly we argue but how we see our common humanity — and whether we act on it.