Wednesday, 17 July 2024
South Africa has a long-standing health challenge with communicable and non-communicable diseases. As we may all be aware, communicable diseases are categorized as diseases which are infectious and can be transmitted from one person to another like tuberculosis (TB), COVID-19 and HIV. On the other hand, non-communicable diseases are noninfectious diseases that are informed by factors such as genetics, lifestyle choices and environmental factors. These diseases include cancer, diabetes, heart disease and mental health.
The high burden of communicable and non-communicable diseases has negatively impacted the health outcomes of millions of South Africans and as such has been a high priority for the department. To this end, program 3 of the department’s 2024/25 annual performance plan is dedicated to communicable and non-communicable diseases and finding strategies to mitigate their impact on health outcomes.
For many years, the leading health threats have been communicable diseases such as HIV. As noted in the National Strategic Plan for HIV, TB and STIs (2023 – 2028) despite the notable progress in the fight against HIV over the past decades, the HIV prevalence rate remains extremely high, with the prevalence rate estimated to affecting about 13,9% of the South African population. As of 2022, it was estimated that about 8.45 million people living with HIV in the country. Of the infected population, it is reported that about 5,7 million people are on treatment, creating a gap of about 5.7 which accounts for about over 2 million people who should be on treatment but are not. This group of people poses huge challenges for both themselves through a high risk of deteriorating health and a high change of infecting other people, thus increasing the infection rate.
However, more recently the World Health Organisation has observed that “noncommunicable – mainly cardiovascular diseases, diabetes, cancers and chronic respiratory diseases – are the leading cause of death worldwide. They represent 7 out of 10 main causes of death, equivalent to 74% of all deaths globally. This includes more than 15 million people who die prematurely every year from a major NCD between the ages of 30 and 69 years; 85% of these premature deaths occur in low and middle-income countries”.
In a report Statistics South Africa (Stats SA) report published last year on 17 October 2023 titled ‘Noncommunicable diseases: findings from death notifications (2008 – 2018)’, it is reported that non-communicable deaths are on the rise in South Africa with, ‘diabetes-related deaths, increasing from 10 846 (Ten thousand eight hundred forty-six ) in 1997 to 26 880 (Twenty-six thousand eight hundred eighty) in 2018. They were followed by cancer-related deaths, which increased by 60%, from 27,052 (Twenty-seven thousand fifty-two) in 1997 to 43,613 (Forty-three thousand six hundred thirteen) in 2018. Deaths due to cardiovascular diseases increased by 46,5%, from 54,701 (Fifty-four thousand seven hundred one) in 1997 to 80 133 (Eighty thousand one hundred thirty-three) in 2018.
In further breaking down these findings, Stats SA reported that ‘In 2018, females accounted for 54,6% (65 845) of deaths due the three noncommunicable diseases, while males accounted for 45,2% (54 556).’ In addition, it is noted that ‘In terms of the burden of noncommunicable diseases and mortality rates KwaZulu-Natal, Gauteng, Western Cape and Eastern Cape provinces have some of the highest numbers of deaths due to noncommunicable diseases.’
The rise of communicable and noncommunicable is a direct threat to the prosperity of our nation and to our health system. It overburdens our financial resources, and infrastructure and increases the strain on our health professionals. Fortunately, communicable and noncommunicable are preventable. The budget vote supports health interventions that can benefit both citizens’ health outcomes to a point where program 3 of the health budget on communicable and noncommunicable diseases accounts for the largest allocation out of the national budget amounting to R25.2 billion out of the R62.2 billion budget allocation.
Through the phased implementation of the NHI, we will improve our health infrastructure, increase support and recruitment of health professionals and access to medicines and other essential resources. Having quality and reliable systems in place, we can drive impactful awareness campaigns, and promote active living and healthy lifestyle choices. We can improve the care provided at primary health facilities to improve early diagnosis and promptly get people on treatment. Under the NHI, we will improve our tracking systems to ensure that people who start treatments, stay on treatment. Through awareness campaigns and public health interventions, people will also be encouraged to have regular check up’s which is instrumental in the prevention and early detection focus area.
The realisation of these aspirations cannot be realized in isolation without addressing socioeconomic determinants which play a tremendous role in informing health outcomes. We know very well that people with good financial standing tend to have better access to health care and nutrition, thus positively impacting their health outcomes. On the other hand, the majority of South Africans live in poverty and unfavourable conditions which cause them stress, and mental health challenges, making them susceptible to abuse, lack access to proper nutrition and are often exposed to detrimental external environmental factors such as pollution. Poor access to quality health care coupled with the abovementioned challenges fuel the inequality gap between rich and poor South Africans. This goes against the Constitution of our republic and our developmental aspirations.
Therefore, as health is a cross-cutting issue which affects all of us regardless of race, class or financial standing as evident during the COVID-19 pandemic, it is in our collective interest to actively take shared responsibility in improving the health outcomes of this country and challenging socioeconomic factors which negatively inform people’s health outcomes such as unemployment, education, housing, and water and sanitation. The surge of communicable and non-communicable diseases is not merely a health issue but is intricately linked to the country’s socioeconomic and political reality.
Let us collectively rally support to achieve the targets of the department including striving for the UNAIDS HIV 95-95-95 target aimed at ensuring that by 2030, 95% of all people living with HIV know their HIV status; 95% of all people with diagnosed HIV infection, receive sustained treatment; and 95% of all people receiving treatment must have viral load suppression
We must invest in research to find better treatment options and address issues of medical treatment costs, different ways of administering medicine, and treatment fatigue. We must take advantage of technological advancement and social media to package messaging and reach high-risk target groups such as the youth.
Therefore, for us to make meaningful strides to rid our society of the burden of communicable and non-communicable diseases, we must collectively join hands with government in its priority to drive campaigns geared at promoting awareness and setting up mechanisms for prevention and early detection. As alluded to in my earlier remarks, communicable and noncommunicable are preventable. We can realise an HIV-free society. We can have healthy and active communities. We owe it to ourselves, our fellow South Africans and future generations.
Thank you.