Monday, 15 September 2014
Non-communicable diseases - non-infectious medical conditions such as diabetes and heart disease - are a "growing global epidemic", and will have a negative impact on the development of countries such as South Africa if they are not urgently addressed.
So said Professor Melvyn Freeman, Chief Director of Non-Communicable Diseases at the Department of Health, in a presentation delivered at the seventh annual Government Employees Medical Scheme (GEMS) Symposium, which was held in Durban from 11 to 12 September. "Developing countries should not look back in 10 years time and say we should have started tackling this problem when we had more of a chance to reverse these trends," he warned.
Prof Freeman noted that it was sometimes believed that NCDs were largely a problem of the developed world. In fact, it is anticipated that the greatest growth of these types of medical conditions will be in developing countries.
Dr Timothy Armstrong of the World Health Organization (WHO), who gave an international perspective on NCDs at the Symposium, confirmed this, observing that 85% of premature deaths from NCDs in people between the ages of 30 and 70 years of age occurred in developing countries. This amounted to no fewer than 11.8 million deaths.
Dr Armstrong strongly reaffirmed the need for action against this growing problem in developing countries. He said that if the NCD challenge is not tackled in developing countries, the cumulative cost in lost output would be an estimated US$7 trillion by 2025. On the other hand, the overall cost to implement appropriate interventions would be US$170 billion.
The annual GEMS Symposium, which is attended by more than 400 delegates, addressed the most critical issues facing the healthcare sector and is attended by policy makers, academics, business leaders, funders, healthcare providers, healthcare scientists and various other stakeholders. The theme for the 2014 GEMS Symposium was: "Affordable healthcare through the adoption of a healthy lifestyle and improved outcomes".
GEMS Executive Lizwe Nkonyana said the theme for the Symposium this year was chosen precisely because NCDs are, as a number of speakers highlighted at the meeting, posing an important risk not only to the healthcare funding sector but also the future sustainability of the country. She emphasised that it was critical to find ways to effectively address this challenge.
Dr Armstrong said that WHO was taking the burden posed by NCDs extremely seriously and its Global Action Plan 2013-2020 seeks to: "Reduce the preventable and avoidable burden of morbidity, mortality and disability due to NCDs by means of multi-sectoral collaboration and cooperation at national, regional and global levels."
To emphasise the need for coordinated action against NCDs, a high-level United Nations (UN) meeting of health ministers was held in July 2014 and countries agreed to implement a set of priority actions. Included among these were the objectives of raising the priority accorded to the prevention and control of NCDs, and to reduce the modifiable risk factors for NCDs through the creation of health promoting environments.
Prof Freeman pointed out that the South African National Development Plan (NDP) 2030 rightly recognises NCDs as a major potential risk to the development of the country over the next 20 to 30 years. "The NDP says that the promotion of health and wellness is critical to the prevention and management of lifestyle diseases, particularly the major non-communicable diseases among the poor, such as diabetes, heart disease and high cholesterol," he noted.
Prof Freeman said that leading up to the UN meeting, a national summit was hosted by the Minister of Health and the Deputy Minister of Health. This was attended by government representatives, non-governmental-organisations, professional organisations and academics and adopted a declaration of ten targets to be reached by 2020. A Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2013-2017 has also been developed from this process.
Among the targets set by the summit to achieve by 2020 are the following:
"It has been recognised that the prevention of NCDs requires a ‘whole of government' and a ‘whole of society' approach," added Prof Freeman. "Plans are being developed to establish a National Health Commission to be chaired by the Deputy President which will have representation from all relevant government departments and other organisations within the industry. The deputy chair will be an expert from outside of government."
Nkonyana, who spoke about the GEMS approach to getting members to buy into a healthier lifestyle, said that there was a need for the healthcare system to move from the mentality of treating the sick to rather focusing on keeping members healthy. The early identification of potential health threats is also an important part of this, as early intervention and treatment can assist in preventing certain medical conditions from deteriorating, and keep members strong and productive.
Speaking after the meeting Nkonyana said that she believed the 2014 GEMS Symposium had been an important milestone in the fight against NCDs in South Africa. "It is critical that the dangers of NCDs be highlighted not only to the public, but also the healthcare sector itself. Only once we fully understand what we are facing, can we take steps to effectively tackle this scourge," she added.
"It has certainly become clear from a number of experts who have spoken at this meeting that joint action by all of the roleplayers is going to be an important aspect of our efforts to combat NCDs. GEMS has for a long time noted the burden imposed by NCDs and is fully supportive of all initiatives that seek to mitigate this threat into the future."
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