It is frequently assumed that people's health is determined primarily by their access to technically-based disease treatment, the standard of which is decided by national health policies that allocate health services. However, evidence suggests that population health is determined more by social status and gradients than by access to clinical care. Moreover, in the present era, there is concern that economic globalisation is exacerbating inequities within countries, thus contributing to greater human insecurity. This paper examines these issues in the context of South Africa since the end of apartheid. It argues that the ANC government's attempts to reduce entrenched inequities in the health system and address the broad social determinants of health have been severely constrained by pressures of economic globalisation, which have induced the government to abandon the objectives of its socially-responsive Reconstruction and Development Programme (RDP) in favour of the neoliberal Growth, Employment and Redistribution Programme (GEAR).