Revisiting the most recently published death stats. Using death stats is not our choice. There aren’t NCDs indicators.
Vicki Pinkney-Atkinson takes full responsibility for this graphic which was carefully researched using the
StatisticsSA Cause of death statistics 2018
Celebration time. It’s happening on 31 May 2022 in Somerset East, Eastern Cape, as part of a World No Tobacco Day event. At last, the NCDs+ civil society can breathe a collective sigh of relief. IT is the long-awaited National Department of Health’s (NDOH) NCDs+ policy for 5 years until 2027. The about-to-launched plan is a compromise, but it is way better than the early drafts. As Churchill may have said, “we are at the end of the beginning”.
If the SANCDA+ had left the NDoH decision makers to their own devices, the 3rd NCDs+ National Strategic Plan (NSP) would have been done and dusted in 2019 without credible transparency and authored mainly by a WHO Country Office appointed contractor. And that version looked remarkably similar to the previous failed 2nd NCDs plan 2013-2017. That plan wasn’t funded, implemented and only externally reviewed/evaluated in 2021.
Yes, it is the SANCDA+ activism that put a spanner in the works. Our early enthusiastic cooperation soured as it became clear that the plan would never be implemented or funded. It moved the SANCDA+ from advocacy to activism using similar tactics as HIV activists in the early part of this century. Memories are short but what is good for the goose is good for the gander.
What is different about the 3rd NCDs+ NSP? (more…)
11 April 2022 Minister in the Presidency, Mondli Gungubele, says a key issue commissioners appointed to the National Planning Commission (NPC) will be expected to address is the slow progress in the implementation of the National Development Plan (NDP) and to identify solutions to make sure that the country fast tracks its route to the NDP goals.
The Minister, who serves as chairperson of the NPC, was speaking during a first media briefing of the third NPC which was appointed in December last year. “One of the shortcomings that [the NPC] has identified…was the incapacity of the state to implement the proposals of the NDP. This often combined with poor leadership that pay lip-service to the NDP without understanding its goals has acted as an obstacle to implementation of developmental objectives.
“As government, we are clear that the greatest challenge has been around implementation and in the discussions held to date, this was my emphasis to guide the discussions,” Gungubele said.
The National Development Plan – which was adopted ten years ago – was created as an action plan for government to tackle several challenges facing the country including unemployment, poverty, inequality, safety and healthcare. “The NDP was designed to change the lives of all South Africans by taking a comprehensive approach where the reality of 2012 [would] become a different one by 2030. We must recognise that we have not met the goals as we intended 10 years ago, that is true.
“Recognising this is the first step to asking: how do we do things differently to change the trajectory that we are on. This is where [the commission] will assist us as we tackle this challenge where implementation of our plans has not met the targets,” he said.
NPC Deputy Chairperson, Professor Tinyiko Maluleke, said the third NPC begins its term at a precarious moment in our country’s history and the “tall order” it faces in bringing the country closer to what the NDP envisioned. “There is, of course, a reason why we are called the NPC…and not the National Implementation Commission. But if implementation is slow or non-existent, planning alone, is clearly insufficient. Given that ours is a tenure that is closest to the finish line of 2030, we cannot afford to be dismissive, smug or philosophical about implementation.
“We have to probe why it is, why it has been so hard to coordinate, to cohere, to cascade down, to streamline and pinpoint down the necessary catalytic interventions which will embed and institutionalise the NDP within the departmental, provincial and municipal plans,” he said.
Professor Maluleke said the NPC will also give attention to identifying catalytic areas for government to pursue. “Countries which have successfully achieved their national developmental goals and targets are those at the heart of whose plans are clear catalytic priorities around which the whole state machinery is mobilized.
“The third NPC will help to enhance the ability of the state to identify and pursue catalytic priorities which will expedite the attainment of NDP goals,” he said. According to Maluleke, another focus area for the NPC will be mobilizing the country’s support for the NDP and its goals.
“Although the NDP is a plan for the whole country, it has not been sufficiently adopted by all sectors at all times. As we mark its tenth anniversary in September, the NPC is urging all South Africans to rally behind the NDP to ensure its implementation and to call government to account on the basis of the promise contained in the NDP. “To that end, the NPC is committed to building partnerships broadly across society and to pursing engagements that should ensure active citizenry and strong leadership for development,” he said.
Today is the health budget speech at 14:00, and in the interests of transparency and inclusivity, it would be great if we, the people, had a look at it beforehand. The budget speech is a version of the Annual Performance Plan (APP) for the financial year to 31 March 2023.
So we are already into the financial year, and the APP23 s already in progress. Having asked for said APP23 PDF, and scouring government and parliamentary websites, we are still in the dark. The closest we came to is a presentation from the health portfolio committee.
The most positive aspect for NCDs+ is that NCDs+ are still in stream, branch or programme 3 along with communicable diseases. At least it hasn’t be shoved back in Programme 4 Primary Health Care where it languished without food or water.
Mind you it is unlikely to change much since the Medium Term Strategic Framework 2019-2024 (MTSEF24) does not prioritise NCDs+ or allocate funding. Except in the most peripheral way. I call this the legacy of 3M era: MDGs, Motsoaledi and Mkhize. Too bad that we are in SDG times and need different action to achieve universal health coverage (UHC target 3.8) and there is more than the target 3.4to achieve action on NCDs.
Joy there is a change to the number of outcomes and outputs covering NCDs+ in the APP23. That means a lot without a programme budget and an implementation plan.
Early in the COVID-19 pandemic WHO’s @DrTedros highlighted the problems of access to health services by millions of people living with NCDs+ in his tweet. His tweet certainly mirrors what the SA NCDs Alliance and our allies have been saying since 2007 when the SA Human Rights Commission (SAHRC) held its first public hearings into the right access to health services.
COVID-19 changed the parameters of vulnerability to include NCDs+, mental health, and reemphasised disability in all its shapes and forms.
SAHRC report 2007
15 years ago the primary focus was understandably on access to HIV/AIDS and TB services. It was the height of the communicable disease epidemic. And amidst our homegrown “AIDS-denialism”. It was also the midpoint of the Millenium Development Goals (MDGs) where vast amounts of funding were channelled into communicable diseases and maternal-child services. That pattern of expenditure and funding remains in place today.
The report’s executive summary is salutary: it fits today’s health service access issues in the COVID-19 pandemic. Just substitute NCDs+ for communicable diseases. And, we have a similar complaint today.
The report’s opening quote is ironically, but not surprisingly, from The AIDS Law Project, the early version of Section 27:
“We don’t yet have a definition of essential health services. This means we don’t have a base line for the right to health and it is impossible to cost the health service and thereby determine objectively what can be
We still don’t have the definition. But HIV unlike NCDs+ is a National Development Plan priority. As for the rest of the conclusions, they mostly are unmet PLWNCDs+ The main change to health services is that HIV/TB services dominate primary health care. We beg for evidence-based inclusion of NCDs + throughout the life-course. And, more not just a tack on to HIV, TB and STI services.
The date of the review is August 2018. This is the first version. Later, in November 2018, a second version was circulated.
The NCDs National Strategic Plan 2013-2017 is also known as the 2nd NCDs NSP. It was reviewed in 2018 by a WHO country office contracted consultant on behalf of the NDoH.
It is grandiosely called The “Implementation Review of the NCDs NSP 2013-2017” The title is a farce since this plan was never implemented and unfunded. The review is supposed to imply an authentic evaluation of the plan, processes and outcomes. It does nothing of the sort
The WHO consultant Mel Freeman was also the NDoH official responsible for the development and implementation of the 2nd NCDs NSP during his tenure as Chief Director, NCDs
A workshop for civil society and community groups in Eastern & Southern Africa
EANNASO with the Civil Society Engagement Mechanism for UHC2030 (CSEM) and partners in the region invites all civil society and community representatives interested in achieving health for all to an advocacy workshop on universal health coverage (UHC) on 23 November 2021.
The online session will be an opportunity to explore the Health for All Advocacy Toolkit, a new resource for civil society and community advocates, and connect with others engaged in this space in the Asia Pacific.
This session will bring together advocates from across issue areas in the Eastern and Southern Africa region to learn more about the state of UHC, discuss the role of civil society and community engagement, and explore how they can meaningfully integrate their work in support of the global movement for UHC.
This Global Week for Action on NCDs (6 – 12 September 2021), the South African Non-Communicable Diseases Alliance (SANCDA), of which the Cancer Association of South Africa (CANSA) is a founding partner, celebrate the progress made in raising the profile of people living with non-communicable diseases (NCDs) in SA. Together with other civil society members, the Global Week of Action on NCDs hails the power and potential of people to act together on and drive NCDs change. The aim is to ensure that commitments made by government to improve health for people living with NCDs, will become a reality. The challenges presented by COVID-19 will not compromise action to help relieve the NCDs burden.
Dr Vicki Pinkney-Atkinson, Director of the SANCDA says, “In SA, the people’s NCDs movement struggles to make the government recognise and meaningfully involve diverse groups, including people living with NCDs to reduce the NCDs burden. Government and other stakeholders committed to global targets to prevent and control NCDs and improve the health of the nation. Now we need to these commitments translate into meeting the UN Sustainable Development Goals.”
Many NCDs are preventable, yet they remain the number one cause of death and disability globally and in SA. Diabetes is still the leading cause of death in SA women. NCDs are mainly driven by five preventable risk factors: tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol and air pollution. Weak health systems, under-investment and lack of accountability by government contributes to increasing the NCDs burden. NCDs include health conditions which usually don’t spread from person to person. Examples are cancers, diabetes and cardiovascular diseases (such as heart attacks and stroke), chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and mental health conditions.
“If every person exercises the right to participate in decision making about their health we would have more accountability for NCDs prevention and care. The SANCDA and our many partners urge the people, including those living with NCDs, to join us in our quest to accelerate action on NCDs. Together we will hold the authorities to account for meeting our needs. What we demand is understanding community needs better, helping to identify gaps, developing options in response to challenges, understand the impact of decisions on different people, and balance input, perspectives and interests,” adds Pinkney-Atkinson, herself living with more than 20 NCDs.
By working together, civil society and the SANCDA highlights the actions undertaken to close the NCDs gap. Achievements include:
Teaming up with the Dullah Omar Institute with its expertise in constitutional law and human rights to explore how law and treaties advance the NCDs agenda. Legal measures against government for its failure to meet commitments to rights and equity are part of this.
Working with the National Department of Health to craft the national NCDs policy (due for publication soon).
Joining forces with local and global social movements representing people left behind, including those focussed on stigmatised NCDs conditions like disability, mental health and obesity.
Coordinating consistent civil society policy action across all Sustainable Development Goals (SDGs) linked to NCDs prevention and control such as poverty, hunger, and emergency-disaster preparedness and responses to COVID-19.
Calls for inclusive NCD governance mechanisms to secure the role of people living with NCDs and civil society in health policy at national, regional and international levels, since 2013. SANCDA endorses the Global Charter on Meaningful Involvement of People Living with NCDs. As a tool this will ensure meaningful involvement and transparency.
Consistently communicating by leveraging outrage, rebuking injustice, translating evidence, sharing personal stories, celebrating successes, and campaigning collaboratively for the annual Global Week of Action on NCDs and other milestone days, weeks and political campaigns. It includes using traditional social media to make noise, demand change, and put issues, insights, and possible solutions in front of policymakers based on human rights and dignity..
Pinkney-Atkinson states, “During COVID-19, we experienced the devastating effects of neglect of NCDs and failure to invest in our health systems. Role players can prevent a repetition of this and can help close gaps and deliver progress on NCDs.”
#ActOnNCDs through social media
People affected by NCDs can be a voice of change by sharing their own messages of support by going to the Global Week for Action on NCDs Map of Impact on https://actonncds.org/take-action/be-a-voice-change . The Voices of Change online picture generator will quickly and easily upload a message and picture and share it on social media.
The SANCDA encourages all to get involved and share messages of support on social media platforms using the hashtags: #ActOnNCDs #NCDvoices. Or mobilise action and be an agent of change – https://actonncds.org/take-action/go-extra-mile
(For more information, please contact Vicki Pinkney-Atkinson, Director SANCDA email: [email protected] or mobile +27-83-38-38-159
Lucy Balona, Head: Marketing and Communication at CANSA at email [email protected]. Call 011 616 7662 or mobile 082 459 5230.