Diseases such as strokes and diabetes now cause most deaths in South Africa but the health system is still focused on tuberculosis and HIV.
Most deaths in South Africa are now from NCDs, according to the country’s latest mortality report, published in 2018. Tuberculosis is still the leading cause of death, but diabetes is second. Between 2016 and 2018, the proportion of deaths from NCDs increased.
Vicki Pinkney-Atkinson, director of the country’s NCD Alliance explains while HIV diagnosis and treatment has advanced, care for people living with other serious conditions has languished far behind.
“NCDs are neglected in South Africa as the public health system has focused on the communicable diseases,” she says. “People often don’t get treatment for common NCDs. There are long queues to be seen, no easy access to medication, screening, diagnosis and treatment. There are few health statistics for NCDs – it’s all guesswork.” NCDs are not seen as a financial priority for donors and provincial governments in the country, says Pinkney-Atkinson. "...how many people have to die too young from NCDs when they should have had insulin..."
Dr Joe Phaahla, minister of health, wrote: “People in low- and middle-income countries are disproportionately affected by NCDs, and the poorest and most vulnerable communities continue to be at highest risk for NCDs and experience the greatest barriers to accessing essential healthcare.”
“NCDs are a big problem in my community,” says Millicent Magwa, 37, a health worker for Mothers2Mothers who lives in Nomzamo. “Most people are unemployed and can’t afford the right diet. Whenever you tell people they need to reduce the amount of starch and eat more vegetables, they tell you: ‘I eat whatever is inside my house. I can only eat vegetables maybe twice a week and I hardly eat fruit.’ It’s going to get worse because most people don’t have money. Food is expensive; everything has increased in price. It’s really becoming bad.”