Diseases of lifestyle represent an important threat to SA's future

Non-communicable disease ‘epidemic' needs to be addressed by all South Africans

Tuesday, 18 April 2017 

Diseases related to unhealthy lifestyles and poor diets represent a growing health and economic burden in South Africa that requires most urgent attention.

This is the view of the Principal Officer of the Government Employees Medical Scheme (GEMS), Dr Guni Goolab. Dr Goolab points to the recently released Statistics South Africa analysis of mortality and causes of death, which found that non-communicable diseases (NCDs), such as type 2 diabetes, stroke and cardiovascular diseases, were responsible for 55.5% - more than half - of all deaths in this country during 2015.

"This figure is most sobering and highlights the challenge that NCDs pose to our country," adds Dr Goolab. "Millions of South Africans suffer from, and are being treated for, NCDs. Aside from the immense suffering they cause, they represent a significant risk to the local healthcare sector, the successful implementation of National Health Insurance [NHI], as well as the broader economy.

"We as a country need to work together in a determined and coordinated manner while there is still time to do so, if we are to mitigate the massive risk that these diseases pose to the sustainability of our entire healthcare system."

Dr Goolab says that it would be misleading to suggest that all NCDs are related to poor lifestyle choices, as there are a number of factors which can lead to the development of NCDs like cancers, type 2 diabetes and heart diseases. These can include genetic predisposition, family history of a disease and a number of other environmental factors.

"Nevertheless, as pointed out by the World Health Organization [WHO], the increase in the prevalence of NCDs - which the body calls a growing global ‘epidemic' - has been driven primarily by four major risk factors: physical inactivity, unhealthy diets, tobacco use, excessive use of alcohol and unhealthy diets.

"Indeed, WHO suggests that the considerable socioeconomic costs associated with NCDs, make their prevention and control a critical global development imperative for the 21st century.1

Dr Goolab attributed the rise in NCDs in South Africa to the increased consumption of fast and convenience foods high in sugar, carbohydrates, salt and saturated fats; the heavy use of tobacco and alcohol, as well as the increasingly sedentary lifestyles of people, particularly in urban areas. "Poverty also no doubt plays a role in this trend, poorer people finding it considerably more difficult to afford healthy foods."

"The South African Government has been leading the way in addressing these problems through legislation aimed at reducing the content of unhealthy salt and sugars in our food, as well as tobacco use. However, diseases of lifestyle pose a significant challenge that requires a unified approach from all sectors of society including the private and public sectors, and civil society.

"In addition, we are of the view that each and every South African needs to be more aware of the threats that the adoption of an unhealthy lifestyle poses, and be empowered to take greater responsibility for their own health," advises Dr Goolab.

He says that NCDs represent a considerable burden to South Africa's medical schemes, including GEMS, which must cover the huge number of claims received for their treatment. According to Dr Goolab, GEMS has consequently over the last couple of years re-aligned its products, services and benefits to emphasise preventative over curative interventions to reduce the risks to its members.

"We have adopted a number of highly proactive measures in dealing with these healthcare conditions. These include highly innovative managed healthcare programmes, the adoption of selective underwriting measures, public and member educational and awareness campaigns, as well as effective disease management programmes. More than 300 000 of our members are currently enrolled on at least one of our disease management programmes," he adds.

"GEMS has also undertaken an aggressive drive to promote preventative benefits, such as screening tests, and rolled out a substantial workplace exercise and lifestyle programme.

"As our country becomes increasingly urbanised and our population grows, we as South Africans, and South African organisations, must find ways to spread the awareness about very real threat posed by NCDs, as they will pose a significant challenge to our shared future if they are not adequately addressed," Dr Goolab concludes.

References

1. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. (2007) The burden and costs of chronic diseases in low-income and middle-income countries. Lancet; 370(9603):1929-1938. [http://dx.doi.org/10.1016/S0140-6736(07)61696-1].

2.  World Health Organization (WHO), Noncommunicable diseases and their risk factors: http://www.who.int/ncds/introduction/en/.