The burden of non-communicable diseases in South Africa

Lancet. 2009 Sep 12;374(9693):934-47. doi: 10.1016/S0140-6736(09)61087-4. Epub 2009 Aug 24.

Abstract

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 types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Cardiovascular Diseases / epidemiology
  • Chronic Disease / economics
  • Chronic Disease / epidemiology*
  • Chronic Disease / prevention & control
  • Cost of Illness*
  • Diabetes Mellitus / epidemiology
  • Female
  • Forecasting
  • HIV Infections / epidemiology
  • Health Priorities
  • Health Services Needs and Demand
  • Health Transition*
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Neoplasms / epidemiology
  • Politics
  • Population Surveillance
  • Primary Health Care
  • Primary Prevention
  • Respiratory Tract Diseases / epidemiology
  • Secondary Prevention
  • Socioeconomic Factors
  • South Africa / epidemiology