South Africa and Non-Communicable Diseases
August 30, 2011
A delegation from the Center for Strategic and International Studies (CSIS) Global Health Policy Center will be traveling to South Africa in August, 2011 to look at the major efforts underway to renew the United States’ bilateral relationship with South Africa, with a particular focus on creating sustainable partnerships in health and other areas of U.S. foreign assistance. South Africa is a leading strategic partner on development, health, and other critical issues. U.S. investments in South Africa are the single largest bilateral health account in the world. The CSIS staff will look specifcally at: The U.S.-South Africa Strategic Dialogue; South Africa's shift toward greater country ownership in the health sphere; and turning the tide on the HIV epidemic.
At the bottom of this page you can find other posts on South Africa relating to HIV/AIDS, Tuberculosis, and Maternal Child Health. Please let us know if you questions on any of these topics that you would like our experts to answer.
The emergence of non-communicable diseases in South Africa poses a great threat to its urbanizing population. About 61% of South Africans live in urban areas (The World Bank 2009) and the urban poor bear the heaviest burden of NCDs as well as other diseases. Most chronic diseases that South Africans suffer from are diseases of lifestyle such as cardiovascular disease, type 2 diabetes, cancer and chronic lung disease. Men are more heavily affected by NCDs because they are more prone to smoking, alcohol use, high salt-intake and lack of physical exercise. However, women are significantly more likely to develop hypertension which then increases the risk of maternal death. Alcohol use, tobacco smoking and excessive weight are responsible for 13.9% of total disability adjusted life years (DALYs). In 2010, the burden of NCDs was a third of the burden of HIV by the number of deaths. In the case that the South African AIDS strategy goals are met - 50% reduction in incidence and 50% coverage for ARTs - the ratio decreases to 6 NCD deaths per 10 HIV deaths.
Although NCDs are a growing concern, there is a lack of emphasis on their prevention and treatment. The South African Medical Research Council writes, “when competing with the more acute and urgent conditions, it is clear that provision for chronic diseases of lifestyle services are less likely to be adequate,” because chronic diseases of lifestyle lack urgency. The South African Medical Research Council recommends that the government adopt an integrated and comprehensive intervention programs to target NCDs. Many people have multiple conditions that require an integrated approach and increasing the capacity to treat these conditions is vital.
Nutrition is a major factor in the epidemic. The South African diet is high in sodium. An average person consumes up to 9.8 grams each day. Fat consumption, including saturated fat, increases as one moves up the economic ladder. A study found that upper class black males receive 30.6% of daily energy from fat. The percentage decreases to 24.3% for black males in informal settlement and to 22.9% for rural black males. Obesity among school children rose from 17.2% in 2002 to 19.7% in 2008. Nationally, 60% of women and 31% of men are either obese or overweight.
Smoking kills three times more people than motor car accidents, an estimated 44,000 each year. South Africa adopted a set of strong legislations that ban smoking in public areas and where children are present. The government also regulates tobacco companies to be frank about health risks. The Tobacco Products Control Act of 1993 and 1998 imposes high tobacco tax rates. Minister Motsoaledi is a strong advocate for a ban on advertisements for tobacco and alcohol products.