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NCDs now killing more South Africans than TB in major public health shift

For many years tuberculosis was the number one killer in South Africa, but there is now a new highway taking many people to their graves – non-communicable diseases (NCDs), such as diabetes and cancer.

According to TimesLIVE, a new report by the World Health Organisation (WHO), released this week, said NCDs including strokes, cancer, diabetes and respiratory disease, along with mental health, now overtake infectious diseases as the top killers globally, responsible for three-quarters of total deaths (killing 41m people a year).

The report, “Invisible numbers: The true extent of non-communicable diseases and what to do about them”, said every two seconds, one person under 70 dies of NCDs. About 86% of those deaths are taking place in low and middle income countries (LMICs).

It notes that this major shift in public health over the past decades “has gone largely unnoticed”. Major risk factors that lead to NCDs are tobacco use, unhealthy diets, harmful use of alcohol, physical inactivity and air pollution.

The report indicated that 51% of the total deaths in SA in 2019 were due to NCDs. Cancer was responsible for 134 deaths per 100 000 population, killing mostly males at 171 per 100 000 people, compared with 114 for women. Cardiovascular diseases killed more people, with a total of 226 deaths per 100 000 people. Men accounted for the most cardiovascular deaths (mainly heart disease, hypertension, strokes) with 253 deaths per 100 000, compared with 202 women killed by this condition in SA.

About 85 per 100 000 people died of diabetes, with men leading at 89 compared with 81 women per 100 000. Many South Africans are also drinking themselves into early graves, with a total of nine litres of alcohol per capita consumption in 2019. Men remain the heavier drinkers, drinking five times more than women.

Chronic respiratory diseases also took their toll, mostly affecting men at 68 per 100 000, compared with 37 women. Almost 40% of the country’s population is inactive, with about 28% of men inactive compared with women, who make almost half (47%) of the inactive population.

More than half, or 54%, of SA’s population is either overweight or obese, with women ranking first at about 65%.

Authors of the report also noted that only a handful of countries are on track to meet the 2030 millennium development goal (MDG) targets to reduce premature NCD deaths by a third.

National Health Department spokesperson Foster Mohale said SA is one of the countries that will not meet its 2030 targets to reduce premature mortality.

“Yes, mortality due to NCDs exceeds communicable diseases (even though) … our government fails to acknowledge. We are not on track to meeting 2030 targets.”

The report, which acknowledges that NCDs are “one of the greatest health and development challenges of this century”, has cautioned that if governments are serious about health and sustainable development, they must address NCDs domestically and internationally, and adopt cost-effective policies and interventions that can save lives.

Many of these early deaths are not inevitable

Addressing major risk factors such as tobacco use, unhealthy diet, alcohol abuse, physical inactivity and air pollution, could prevent or delay significant ill health and a large number of deaths.

The data paint a clear picture. The problem is that the world isn’t looking at it.

A lack of awareness of the data means that not enough action is being taken. Millions of people, especially in lower-income settings, cannot access the prevention, treatment and care that could delay the consequences.

Katie Dain, CEO of the NCD Alliance, said the report “confirms what we've long suspected, that chronic diseases are now beginning to outstrip infectious diseases as the main driver of mainly preventable ill health and death in lower and middle income countries.

“We urgently need a major financial and public health reset by national governments and the global health community before it is too late. Families in sub-Saharan African countries are becoming just as concerned about both the health and economic costs of diseases like diabetes and hypertension as they are about HIV, tuberculosis or malaria.”

“The imperative for action is clear and urgent. NCDs will cost more suffering and lives this decade than any other health issue, and will undermine any efforts to ensure the world is better prepared for future pandemics after COVID-19. Inaction and paralysis is not a viable option,” she said.

Commenting on the WHO report, Vicki Pinkney-Atkinson, NCD activist and director of the SA NCD Alliance, said the SA government is still not taking NCDs seriously, and poor funding towards these killer diseases is testament to this neglect.

“All of these statistics are exactly what we’ve been saying about SA … that it is hopelessly behind because there is no funding for NCDs. We have a new strategic plan, but there are no budgets for NCDs at provincial level, even though they are many of the biggest killers.

“In a recent meeting one of the acting directors-general said there was no funding for NCDs and we just have to get creative. He said do more with less. Actually he meant … do more with nothing.”


TimesLIVE: noncommunicable-disease-deaths-now-outstrip-tb-hiv-but-sa-looks-the-other-way/


See more from MedicalBrief archives:


WHO: Non-communicable diseases increase risk of dying from COVID-19 in Africa


South Africans shunning life-saving treatments out of fear of COVID-19 infection


SA healthcare on collision course with staffing crisis and growing disease burden


Lockdown must go or else non-coronavirus mortality will outstrip COVID-19 deaths


Multi-billion rand strategy from WHO to eradicate Africa’s meningitis by 2030




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