A silent killer: Why South Africa’s health could crumble under pressure from non-communicable diseases

Cape Town | Non-communicable diseases (NCDs) are the top causes of death and disability worldwide, more than three in five people die from NCDs, which are responsible for more than half of the global burden of disease. The World Health Organization (WHO) estimates that about 41 million people per year die from NCDs, with people from the developing countries suffering the most. 90% of people who die before the age of 60 are from middle and low income countries.

The WHO estimates that without prevention, 52 million people will die from NCDs by 2030. Results from the first Non-Communicable Disease (NCD) Countdown 2030 Report show that South Africa is one of the countries that could fail to reach the United Nation’s goal to lessen non-communicable diseases (NCDs) by 2030.

Each year, NCD Countdown 2030 shows the achievements made by 186 countries to reduce the burden of NCDs. This is also part of the United Nation’s Sustainable Development Goals to reduce premature deaths caused by the four major NCDs: cancers, cardiovascular diseases, chronic respiratory diseases and diabetes.

Although the results of NCD Countdown are based on researchers’ forecast for the next 12 years, existing evidence from previous research shows that South Africa, has the highest rate of people who are overweight and obese in sub-Saharan Africa, with more than 70% of women being overweight. Research has also proven that five out of every 10 adults in South Africa suffer from hypertension.

The four major NCDs share common risk factors: tobacco use, physical inactivity, harmful use of alcohol and an unhealthy diet. Development, industrialisation, urbanisation and aging are also the major drivers of the NCD epidemic in South Africa. A greater focus on political will and regulation of the way in which products such as tobacco and alcohol are promoted has to be monitored in South Africa where 718 people die every day of NCDs.

“The risk of death from NCDs has stagnated or decreased too slowly in most countries and particularly on the African continent between 2010 and 2016,” says Professor Andre Pascal Kengne, NCD Countdown 2030 collaborator and Unit Director at the South African Medical Research Council’s NCD Research Unit. “It is time that we wake up to this cold fact that we need to address the risk factors that contribute to all NCDs as they are fast becoming the leading cause of death now accounting for more than HIV and TB,” says Professor Kengne. 

Although South Africa has introduced the regulation of salt and tobacco products, 260 000 deaths were still associated with NCDs in 2016 alone, meaning that South Africa might have to speed up its implementation of the WHO ‘best buys’ to deal with NCDs. These include strategies such as vaccinating girls to prevent cervical cancer, educating people about the risk of NCDs and effectively implementing and regulating the recently introduced sugar taxes.

Professor Kengne adds that solely referring to NCDs as ‘lifestyle diseases’ may be misleading – particularly in low-to-middle income countries. This label suggests that individuals are unable to control themselves and choose to eat poorly. “This notion ignores the socio-economic contexts that often make it difficult for people to afford healthy food, to resist the marketing of alcohol and tobacco products, or to engage in physical activity,” says Professor Kengne.   

“Low and middle-income countries need to reconfigure their health-systems to address the constant increase of non-communicable diseases,” says SAMRC President and Chairperson of the Global Alliance for Chronic Diseases Professor Glenda Gray.  “We are at a juncture where more has to be done to prevent, diagnose and manage NCDs optimally in our countries and our decisions will determine the extent to which we can take non-communicable diseases interventions to scale and impact on this emerging epidemic,” says Professor Gray.

According to NCD Countdown 2030, women between the ages 30 - 70 in Sierra Leone show the highest likelihood of dying as a result of NCDs at 32.6% while South African women show a 21.2% likelihood of death caused by NCDs. Men between the ages of 30-70 in Sierra Leone and South Africa have a 28.2% likelihood of dying from NCDs and 32.3%, respectively, meaning that their Sustainable Development Goals (SDGs) will only be reached after 2040.

The Democratic Republic of Congo (DRC) and Zambia showed a likelihood to meet their SDG targets for 2030. In 2016, the likelihood of women between the ages of 30 - 70 dying from NCDs was 17.4% in the DRC and 19.8% in Zambia. Men in both the DRC and Zambia showed a 15.9% and an 18.7% chance of death caused by NCDs.

The NCD Countdown 2030 report was published in the Lancet ahead of the third High Level Meeting on NCDs, which took place in New York, USA. The meeting reviewed global and national progress and set out to renew and enhance political commitments towards reducing NCD mortality.

NOTE TO THE EDITOR:

For full access to the article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31992-5/fulltext

For full access to the article - Trends in obesity and diabetes across Africa from 1980 to 2014: an analysis of pooled population-based studies: https://academic.oup.com/ije/article/46/5/1421/3861188

Release date: 
Monday, October 29, 2018 - 14:05
Contact: 
Keletso Ratsela
Contact: Keletso Ratsela

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Tel: +27 71 214 5272
E-mail: keletso.ratsela@mrc.ac.za