A recent Statistics South Africa analysis of mortality and causes of death 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. These diseases related to unhealthy lifestyles and poor diets represent a growing health and economic burden in South Africa that requires most urgent attention.
Dr Guni Goolab, principal officer: Gems
“This figure is most sobering and highlights the challenge that NCDs pose to our country,” says Dr Guni Goolab, principal officer of the Government Employees Medical Scheme (Gems). “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.”
He 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 Organisation (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.
Goolab attributes 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.”
Legislation leads the way
“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,” says Goolab.
Burden to healthcare
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. So, for the past few years, the scheme realigned 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.
“As our country becomes increasingly urbanised and our population grows, we 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,” Goolab concludes.
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