20 August 2020 – The South Africa Non-Communicable Diseases Alliance (SA NCDs Alliance) is raising concern over the systemic neglect of non-communicable conditions (NCDs) like obesity, diabetes, high blood pressure, cancer, asthma and mental health problems due to neglected NCDs prevention and treatment. Download infographics
Dr Vicki Pinkney-Atkinson, Director of SA NCD Alliance says, “People living with NCDs believe it’s a health right to have proper access to care and medicines, especially now during a time of pandemic. Before COVID-19, the NCDs group of conditions killed most South Africans and remained neglected within government policy and budgets. For so long the many millions of people living with NCDs have lamented, ‘it would be better if I had HIV, then I would get access to quality care and medicines.”
NCDs, called underlying conditions during COVID-19, cause most deaths in South Africa. Diabetes kills more women than any other single illness for many years. (1) Government media acknowledge that 90% of those who die following COVID-19 infection had one or more NCD. (2)
Act on NCDs Now – Accountability
The early figures coming out of Wuhan showed that NCDs increased the risk of complications and dying. It was clear that survival depended on well-managed conditions such as diabetes. It immediately exposed the fault lines in NCDs care.
The aim is to get government to implement ongoing care for those living with NCDs by health workers during and beyond COVID-19. This includes ensuring adequate supply of medications that don’t involve travel and visits to facilities and making use of online and tools for consultations to minimise physical interaction and exposure.
The Alliance further proposes performance indicators to assess government’s response to COVID-19 and ongoing NCDs care such as maintenance of food and medicine supply chains, protection and support for vulnerable and neglected people and maintenance of usual health services.
“As South Africans went into lockdown in March, the SA NCDs Alliance initiated online support, counselling and information services to keep people healthy such as the diabetes care line. Those of us living with diabetes soon learned that optimal blood sugar control is the best way to survive a COVID-19 infection. However, getting care and a regular supply of medicines in the public sector involved a stark choice; get your medications or get the virus. Unlike for HIV and TB, a remote non-clinic supply point is a rare option. Insulin, absolutely critical to sustain life in diabetes, is only available at a hospital-level even if there is a clinic next door,” elaborated Pinkney-Atkinson.
Zodwa Sithole, Head of Advocacy for CANSA added, “Patients are feeling frustrated and despondent as they struggle to access vital support services. A cancer patient’s low immunity and high infection risk for COVID-19, results in anxiety and physical distancing and hygiene measures add to a feeling of isolation even as lockdown levels are eased. Part of the response was the launch of our CANSA Tele Counselling service offering free, confidential cancer-related telephonic counselling available in seven languages.”
Nosipho (3) puts the human face on the access issue. In late pregnancy, she always needs insulin and asthma medication. Being a savvy diabetic, she knows she is at risk and tries to avoid the minimum five-hour round trip to get her insulin in central Cape Town during the COVID-19 surge. She knows that the risk of infection is high by using public transport and the long waiting lines at the hospital. When asked, the government sectors were unable to offer a solution.
For other NCDs like cancer, there are implications of delaying any screening that can result in cancers being detected at a later stage and affecting treatment outcomes.
Pinkney-Atkinson concludes, “What works to keep diabetics and other people living with NCDs safe, is not a mystery. There is plenty of evidence, we need action to provide ongoing NCDs care during COVID-19. (4) During the COVID-19 pandemic and beyond, we must go beyond stopping the virus and our right to get our ongoing essential services safely. We need these drugs and supplies (needles and syringes) to stay alive.”
For more information, please contact Dr Vicki Pinkney-Atkinson, Director of SA NCD Alliance at email [email protected]
Call 083 38 38-159. Alternate contact is Lucy Balona, Head: Marketing and Communication at CANSA at email [email protected].
Call 011 616 7662 or mobile 082 459 5230.
(1) Statistics South Africa. Mortality and causes of death in South Africa, 2016: Findings from death notification [Internet]. Pretoria; 2018 [cited 2018 Mar 28]. Available from: http://www.statssa.gov.za/publications/P03093/P030932016.pdf
(2) SA Government News Agency. SA COVID-19 cases rise to 3 034. SANews.gov.za. 2020;2
(3) Not her real name
(4) Young T, Schoonees A, Lachman A, Kalula S, Mabweazara S, Musa E, et al. Taking stock of the evidence. Cape Town: Better Health Programme South Africa; 2020. 50 p
NCDs are a large group of health conditions that are generally not spread from person to person and used to be called chronic illness until 2000 when the Millennium Develop Goals force a new definition. Often the 5 main NCDs groups of conditions are noted: diabetes, circulatory disorders, mental health, cancer, and chronic respiratory illnesses. However, there are many more conditions that do not get a mention. Globally NCDs conditions are responsible for 41 million deaths annually and they are leading cause of death in South Africa since 2013. Diabetes is the leading cause of death of South African women.
However, the NCDs agenda is not just about illness it goes to a whole of society and whole of government response and for this we need an expanded understanding, meaning, NCDs+. The expanded NCDs+ advocacy agenda includes prevention, vulnerable populations, stigma control and disability. NCDs+ has many determinants (social, economic, and commercial) that disproportionately impact poor people. The Sustainable Development Goals (SDGs) address NCDs+ and its inclusion as an equal part of universal health coverage. (National Health Insurance in South Africa).
About the SA NCDs Alliance
The SA NCDs Alliance, established in 7 years ago, is a civil society partnership between three trusted NCDs advocacy organisations: CANSA, Diabetes SA and the Heart & Stroke Foundation SA.
Its mission is for the people of South Africa have equitable access to quality NCDs+ prevention and management within universal health coverage/ NHI.
For this important COVID-19 and NCDs+ advocacy project nearly 90 civil society organisations are collaborating:
Cancer Alliance South Africa
Dementia South Africa
Epilepsy South Africa
Global Mental Health Peer Network
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) SA
National Kidney Foundation SA
Palliative Treatment for Children SA (PatchSA)
South African Disability Alliance
South African Federation for Mental Health
The SA NCDs Alliance’s goal in this programme it to ensure that the policy window of opportunity opened by the COVID-19 pandemic is used to make NCDs a priority in government policy through collaboration with NCDs civil society to put it on a par with HIV & TB. www.sancda.org.za
Diabetes helpline +27-81-578-6636
World Heart Day, which happens every year on 29 September, will see iconic landmarks turned red in honour of the occasion with Table Mountain and the Wheel at the V&A Waterfront in Cape Town being lit up on Friday night.
The day was created and led by the World Heart Federation (WHF) as an event designed to raise awareness of cardiovascular disease (CVD), the world’s biggest killer.
It is seen as a time to promote a heart-healthy lifestyle and improve health globally by encouraging people to make lifestyle changes and be good to their hearts.
The event has the backing of several high-level experts, who are keen to lend their voices to the cause.
Professor Karen Sliwa, Director of the Hatter Institute for Cardiovascular Research in Africa and President-Elect of the World Heart Federation, said “World Heart Day is our chance to shine a light on the world’s biggest killer and work together to improve heart health. This includes highlighting the need for better care of patients with rheumatic heart disease and cardiac disease associated with pregnancy.”
Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa, said “Around the world 1 in 10 people die prematurely from cardiovascular disease but the power to change this is in our hands. Making small lifestyle changes such as eating more fruit and vegetables, keeping active, reducing alcohol consumption and stopping smoking can save lives.”
President of the South African Heart Association, Professor Liesl Zuhlke – who is also Director of the Children’s Heart Disease Research Unit and a paediatric cardiologist, said “We are urging people to ‘share the power’ this World Heart Day by sharing healthy heart tips with friends and family and inspire people everywhere to be healthier. Our focus is on families and communities as children can have heart disease too and a healthy heart starts in childhood.”
Cardiovascular disease is a major cause of death in South Africa. Heart disease, in particular, features prominently among the conditions that contributed to a significant rise in deaths from non-communicable diseases in 2015, according to Statistics South Africa.
All of them agree that neither heart attacks nor death as the result of a heart attack are inevitable and can be avoided by understanding and managing the risk factors involved.
It is possible for a person who suffers a heart attack to regain good health by getting the right treatment fast.
Medical organisations are using World Heart Day to raise awareness and highlight the seriousness of heart disease for all sections of South Africa’s population and help people take heart health into their own hands.
“We want every South African to understand the link between lifestyle and cardiovascular disease,” said Dr Shanil Naidoo, Medical Director of Boehringer Ingelheim. “Healthy lifestyle choices significantly decrease the risk of heart attacks and strokes and have the further benefit of improving an individual’s quality of life.”
Spot the risks and neutralise them
A heart attack occurs when an artery carrying oxygen to the heart becomes blocked. The likelihood of a blockage increases when arteries are narrowed by fatty cholesterol deposits or plaque – a condition referred to as coronary artery disease.
Risk factors for the condition include smoking, an unhealthy diet, obesity, physical inactivity, diabetes, high blood pressure (hypertension), high cholesterol or a family history of heart disease.
Giving up smoking, modifying poor diets and increased exercise are all good solutions along with the critical management of diabetes, blood pressure and high cholesterol under medical supervision.
“Many South Africans have uncontrolled or undiagnosed hypertension, diabetes and high cholesterol,” said Dr Naidoo.
A 2014 study showed that 78% of South Africans over 50 years had hypertension, with less than half of them being diagnosed and less than 7% having it under control.
“These individuals are placing themselves at an even higher risk of having heart attacks or strokes,” cautioned Naidoo.
“While we cannot change our genetics or age, it is important to understand that we need to be disciplined about lifestyles choices which include regular medical check-ups.”
SOME FACT BOXES:
Recognising a heart attack:
Speed of reaction is absolutely critical to surviving a heart attack and regaining good health. In some cases, a heart attack causes virtually instant death. But in many cases survival and recovery are perfectly possible – provided you know what to do and get to work instantly.
What does a heart attack feel like?
- There is heavy pressure, tightness, unusual discomfort or crushing pain in the centre of the chest.
- This may spread to the shoulders, arms, neck or jaw.
- It may last more than 15 minutes and could stop or weaken and then return.
- This may be accompanied by sweating, nausea, faintness or shortness of breath.
- The pulse could be rapid or weak.
Important things to note
- Women may have different symptoms to men, with more pronounced nausea, dizziness and anxiety.
- A heart attack can be silent and produce no signs or symptoms.
- A sharp stabbing pain in the left side of the chest is usually not heart pain.
What to do if you experience or witness a heart attack
- If unexplained chest pain lasts for more than a few minutes, move quickly. Do not try and figure out the cause, rather call an ambulance and state that you are dealing with a suspected heart attack.
- If the ambulance is delayed, access private transport to get to the emergency department of the nearest hospital. On arrival, advise the staff this is a suspected heart attack.
- If you have been trained and you are near a person who loses consciousness due to these symptoms, perform chest compressions at a rate of about 100 per minute.
Professor David Wood
President, CEO, The World Heart Federation.
As you may have read, September 13th in New York City, a new global initiative was launched named the Foundation for a Smoke-Free World. This foundation – whose leadership includes former WHO official Dr Derek Yach – is a tobacco industry-funded initiative, set to receive $80 million of annual funding over the next 12 years from Philip Morris International (PMI).
Alongside our colleagues at the WHO Framework Convention on Tobacco Control (FCTC) and the Union, The World Heart Federation condemns this initiative in the strongest possible terms as an attempt by the tobacco industry to interfere in, and subvert public policy.
Despite funding a foundation that claims its goal is to ‘eliminate smoking’, PMI continues to invest billions of dollars in marketing cigarettes worldwide, focusing many of these efforts in low- and middle-income countries to gain new customers.
Throughout previous decades, the tobacco industry – including PMI – has sought to maintain its profits by sowing misinformation among the public and blocking policies designed to protect public health. PMI’s recent failed attempt to sue the government of Uruguay for implementing anti-smoking legislation is just one recent example of these efforts.
Tobacco use remains the leading cause of premature CVD mortality, in some regions accounting for 25-30% of all cardiovascular deaths. According to current WHO projections, tobacco use will kill one billion people this century.
As the leading global advocacy organization bringing together the CVD community to lead heart-healthy lives, the World Heart Federation will continue to support all legitimate efforts to achieve a smoke-free world.
The best path to tackle this epidemic and achieve a smoke-free world is by implementing policies set out in the WHO FCTC – not by engaging with an industry that has shown repeatedly that it cannot be trusted to defend, let alone promote, public health.
We ask you to share information about this foundation with your colleagues and networks so that they can also be made aware of the false nature of this initiative.
SURVEY: SOUTH AFRICANS’ RELATIONSHIP WITH THEIR HEARTS ‘ON THE ROCKS’
A just-released survey, which was conducted by SA’s leading cardiovascular medicine provider to determine how heart-aware South Africans are in the lead up to Valentine’s Day, revealed that nearly a quarter described their relationship with their hearts as ‘on the rocks’.
The public poll forms part of Pharma Dynamics’ Hug your Heart campaign, which it has launched this February in partnership with the Heart and Stroke Foundation SA (HSFSA), in an effort to create greater awareness about heart disease in South Africa – a condition which claims the second most lives, after HIV/AIDS, in the country.
Of the 2 000 respondents that participated in the poll, almost half (46%) pleaded guilty to activities that put them at risk of heart disease, which includes smoking and drinking too much alcohol, overeating, consuming too much salty, sugary and greasy foods, whilst also living a sedentary lifestyle.
Nicole Jennings, spokesperson for Pharma Dynamics says the findings are telling of the nation’s trivial attitude toward heart-health.
“Unfortunately, it usually takes someone we know to have a heart attack or stroke before we take our own heart-health seriously. The reality is that 215 South Africans die every day from heart disease or stroke – 18% of these deaths occur in women and 13% in men. While certain genetic risk factors for these conditions cannot be prevented, modifiable risk factors that relate to lifestyle account for the majority of heart disease, and a healthy lifestyle can help to prevent 80% of premature deaths from heart disease. With so many South Africans living with cardiovascular disease, it is imperative that people identify their individual risk factors,” she says.
The survey also highlighted another worrying trend among young adults where a staggering 21% are not taking proactive steps to lower their blood pressure. Conversely, older adults seem to be the most proactive in taking care of their hearts with 88% changing their eating habits by cutting back on salt and 69% engaging in regular exercise.
When it comes to men and women’s attitudes towards their hearts, men seem to take a slightly kinder view. Even though the majority of women who reportedly suffer from heart problems indicated that they are taking active steps to improve the health of their hearts, a shocking 19% said they’re not. More female participants also cited cases of high blood pressure than men and only 40% engage in exercise.
Jennings says the reality is that most people only start worrying about their hearts after their 40s, which is almost too late. “Everyone can and should do something to help reduce their future risk of heart disease, even if you don’t think you are at high risk. More women die prematurely from heart disease than breast cancer, therefore it is vital that both men and women of any age lead healthy lifestyles.”
According to Pharma Dynamics’ poll, 74% are planning a romantic night in this Valentine’s Day. However, with love in the air and wine flowing freely, it can be easy to overdo things. Given that Valentine’s Day is all about the heart, there’s no better opportunity to keep yours in top shape.
Jennings suggests the following heart-healthy tips for the big day:
Choose a heart-healthy dinner: Prepare a candlelit-dinner at home or enjoy a picnic using one of our heart-healthy recipes, which were created especially for Valentine’s Day. Visit www.hugyourheart.co.za for a ‘pan-fried chicken strips’ or ‘spicy butter bean pita’ picnic recipe. For the 26% that will be dining out, avoid anything battered, creamy, deep-fried, rich, velvety or sautéed (in butter). Also consider ordering one entrée to share, as many restaurants serve enough for two. Splitting the meal will keep you from overdoing it.
Drink responsibly: Enjoying too much alcohol can raise the levels of some fats in the blood and can lead to high blood pressure and heart failure. Rather enjoy our ‘rooibos and berry mocktail’, which was created especially with Valentine’s Day in mind. One tot of any white spirit such as vodka, gin or rum can be added if preferred or the mixture can be served over 125ml of champagne or Method Cap Classique (MCC). Seewww.hugyourheart.co.za and click on the link to picnic recipes for the ingredients.
Give your sweetheart a box of dark chocolate: Dark chocolate is rich in flavonoids – a nutrient source high in antioxidants, which may reduce the risk of cardiovascular disease.
Spend time with the one(s) you love: Sharing quality time with someone special, whether it be a lover, friend, family or a beloved pet, helps reduce stress on the heart.
Take a romantic walk, hike or dance up a storm with your partner: Aim for at least 30 to 60 minutes of heart-pounding physical activity to gain the maximum benefits.
Play a few romantic tunes: A number of studies have proven the beneficial effects that relaxing music has on blood pressure and heart rate. Based on Pharma Dynamics’ poll, Bryan Adams’ 90s hit song, “Everything I do, I do it for you…” still gets hearts beating and was voted by respondents as the most romantic song of all time.
“South Africans can’t afford to wait until they face a health scare before they take action. We can all take proactive steps now to reduce our future risk of heart disease, so vow to make this Valentine’s Day, a heart-healthy one,” says Jennings.
Pharma Dynamics has also pledged to raise R100 000 for the Heart and Stroke Foundation SA during the month of February as part of the #hugyourheart campaign. For every Facebook post that is shared using #hugyourheart, Pharma Dynamics will donate R5 to the HSFSA. See www.hugyourheart.co.za for more details on how you can play your part in raising vital funds for the non-profit organisation.
Issued by Meropa Communications on behalf of PharmaDynamics. For further information, please contact Brigitte Taim from Meropa on 021 683 6464, 082 410 8960 or [email protected].