The South African elections are over, and it is back to business. It needs to be business as unusual in the case of NCDs prevention and management. Business as unusual? Einstein characterised insanity as doing the same thing over and over again and expecting different results.

When advocates argue, politicians vote, and organizations campaign, they say they are trying to shape or respond to political will. Political will is the ghost in the machine of politics, the motive force that generates political action. Charney Research

Business unusual

NCDs policy is a case in point with the now expired South African NCDs strategic plan (2013-2017) failing dismally even to scratch the surface of the epidemic. Similar to much of SA health policy, it was purely window dressing, with implementation and budgets unmeasurable. For the last decade, communicable disease (like HIV and TB) is the only health concern of politicians. Jacob Zuma and his ilk came to power on that ticket with a policy emphasising “universal access” for people living with HIV. And so national health insurance (NHI) and its identical twin, HIV treatment access, were born. Politicians and deployed officials don’t differentiate between the two. When you add “health systems strengthening” and the “Ideal Clinic” to the HIV/NHI package, it equals the current broken and siloed healthcare system.

Policy consistency as art

Let us not pretend otherwise as we head for the 2nd State of the Nation Address in 2019 with a raft of fledgeling MPs for 6th Parliament. There is zero political will deal with NCDs. Oops, there are two exceptions: fiscal measures and cancers linked to HIV (cervix and breast at a stretch). In the health bit of the 2019 ANC election manifesto, NHI and HIV remain the only priority. The same goes for the 2019 health budget. Policy consistency as an art form, only Einstein says it is insanity

So, business as unusual for people living with NCDs means acknowledging that NCDs like diabetes, stroke, heart disease and chronic lung problems are the biggest killers in South Africa. It means giving NCDs an equivalent priority alongside HIV and TB and putting the missing money where its collective mouth is.

Political will is the missing ingredient in the SDG era. It is going to take more than cheap words and a dawn walk in the name of NCDs prevention.