Health in South Africa 4: The burden of non-communicable diseases in South Africa

15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urb...

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Bibliographic Details
Published in:The Lancet (British edition) 2009-09, Vol.374 (9693), p.934
Main Authors: Mayosi, Bongani M, Flisher, Alan J, Lalloo, Umesh G, Sitas, Freddy, Tollman, Stephen M, Bradshaw, Debbie
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Antiretroviral agents
Fatalities
Health care
Health services
HIV
Human immunodeficiency virus
Life expectancy
Mortality
Public health
Risk factors
Risk management
Urban areas
Womens health
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Summary:15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases. [PUBLICATION ABSTRACT]
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(09)61087-4