12 November 2012

South Africa: Fighting the Scourge of Non-Communicable Diseases

About 500 000 people are expected to benefit from a US$30million global project aimed at addressing non-communicable diseases. The project will be rolled out in four countries, including South Arica, and will have a special focus on diabetes.

This week marked the launch of the South African phase of the Lilly NCD partnership, which will be rolled out over a five year period in four countries, namely, Mexico, Brazil, India and South Africa. The US$30 million project will tackle the scourge of non-communicable diseases (NCDs), paying particular attention to diabetes. The World Health Organisation (WHO) predicts that in the next 15 years the number of people with diabetes in South Africa will triple.

“Over the next ten to 15 years there is an expectation that the incidences of diabetes will double in Sub-Saharan Africa, generally, but in South Africa specifically. Unfortunately, all of the projections around non-communicable diseases are that they will continue to grow at a very rapid pace. Right now the trends are very frightening and we believe firmly that around the world the first and most important step to take is prevention. So, we all have to work hard to reduce these frightening growing trends of non-communicable diseases”, says Tracy Sims, the senior advisor at Eli Lilly.

Non-communicable diseases are chronic diseases, including heart disease and cancers. The WHO points out that non-communicable diseases thrive more in developing countries like South Africa. They are fuelled by tobacco intake, physical inactivity and unhealthy diets. Sims says through this initiative they hope to make direct contact with patients.

“Our work cannot happen at the high level. Our work with our partners must happen at the primary health care clinic level. It must happen at the individual patient level, and that is one of the most important components our work will do...It’s focus on the ground. We have developed a new framework that we hope accelerates immediate impact for patients on the ground level, but also will produce data, recommendations and direction for leaders in city level, provincial level, national level and even global level”, says Sims.

Special focus will also be placed on rural communities, says Denver Webb of the Eastern Cape-based Donald Woods Foundation, a partner in the programme. “We want to have teams of people that will go and visit all of the homesteads in the areas where we are working. We want to start off by registering them... basic screening for diabetes, hypertension, HIV and TB even mother and child ailments. On the basis of what we find we then refer them to the clinic or hospital or, if possible, the community health care workers will come back on a regular basis to bring the medication. We think through this, we will be able to give rural people far better access to an integrated health service than they may currently be having”, he says.

Webb believes that the project provides them with the necessary tools to help people who may not even be aware they have an illness.

“We know through our work that we have a high incidence of HIV and TB in our area and we know that there are people who are getting medication for treatment, but we don’t know how many in the rural area have diabetes but are not diagnosed and not accessing medication. That is why this partnership is important because it will give us the resources to go into homes and test people in a systematic way so that we can identify people who have diabetes or any other chronic disease that they may not even know about”, says Webb.

Meanwhile, the Health Department says many steps have been taken to address the scourge of non-communicable diseases in the country, acknowledging that risk factors such as alcohol abuse and other lifestyle factors can make matters worse. Deputy Director for Chronic Diseases in the department, Anne Croasdale, says figures show that the majority of the population has dietary issues that could bring about the occurrence of non-communicable diseases.

“As a country we face a serious problem of unhealthy diet and we are among the world’s most obese nations of adults and children. According to the national youth risk behaviour survey, 19% of learners were overweight and 9% of learners were obese. In both instances, female learners significantly out number their male counter parts. For adults, if we look at women between the 24 and 34 year age group, 58% are obese or overweight and in the 35 to 44 age group its 72%”.

Croasdale says this can be attributed to peoples’ social economic backgrounds, which means that some cannot afford a healthy diet. She says cheap food tends to be fatty, accessible and very unhealthy while healthy foods are expensive and not always available.

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