The leading cause of disablity in South Africa is hardly a surprise, HIV/AIDS. And, the good news is that there is a 10% reduction compared to 2007. But what this image shows is that NCDs (the blue dots) remain the largest group illnesses to cause disability irrespective of age. What is alarming is the for 6/8 NCDs listed, the increases are in double digits.
Disability measure =YLD
Disability is measured as by the amount of time, in years,that people lose to diseases and injuries = years of life lost to disability (YLD). A disabling condition does kill you but takes its personal and societal toll.
Calculating YLD
Mulitipy a disability’s severity by the time it lasts. This means that a short-term, severe health problem and a long-term, relatively mild health problem could both result in the same number of YLDs. For example, someone who needs two months to recover from a car accident but then regains their full health and someone who experiences relatively mild but lifelong back pain could end up losing the same number of years of their lives to disability. YLDs take into account all disabilities, including lower-visibility ones that result in daily pain, lost work time, or an inability for someone to thrive as they otherwise might.
An NCDs concept note, that is set to inform the expired national NCDs policy, is up for comment following a stakeholder consultation in April 2019.
Its purpose is to frame and inform South African NCDs policy for the next 5 years. It is the first policy developed in the Sustainable Development era (2015-2030).
Sustainable development goal (SDG) 3 = health. Target SDG3.t is to reduce early NCDs deaths by 1/3 by 2030
At the stakeholder meeting, NCDs civil society participation was limited at the stakeholder consultation due to 5 days notice. A Zoom connection was supplied but not audible. The link of an audio recording of the meeting is available here. Duration 2 hours.
WHO consultant Melvyn Freeman developed and presented concept noted. He the former Chief Director, NCDs at the South Africa National Department of Health.
“The purpose of the Bill is to build an effective climate change response and ensure the long-term, just transition to a climate resilient and lower carbon economy and society.
“This will be done within the context of sustainable development for South Africa, and will provide for all matters related to climate change,” the Department of EA said in a statement.
The department said the Bill acknowledges that anthropogenic climate change represents an urgent threat to human societies and the environment and requires an effective, progressive and well-coordinated response.
“It further highlights that, amongst others, anticipated domestic climate change impacts have the potential to undermine the country’s development goals, and that responses to climate change raise unique challenges, thus requiring a legislative framework for the implementation of the country’s national climate change response,” the department said.
The National Climate Change Bill addresses issues related to institutional and coordination arrangement across the three spheres of government namely national, provincial and local. It also highlights the need for the spheres of government and entities, sectors as well business to respond to challenges of climate change.
The bill further addresses matters relating to the national adaptation to impacts of climate change, greenhouse gas emissions and removals, and policy alignment and institutional arrangements.
“Section 24 of the Constitution of South Africa states that everyone has a right to an environment that is not harmful to their health and well-being, and that all have the right to have the environment protected for the benefit of present and future generation, while allowing justifiable environmentally sustainable economic and social development,” the department said.
A Series of Provincial Stakeholder Engagement Workshops, where all stakeholders and interested parties will be able to comment on the National Climate Change Bill, will be hosted by the department countrywide.
The objects of the proposed Act are to:
Provide for the coordinated and integrated response to climate change and its impacts by all spheres of government in accordance with the principles of cooperative governance;
Provide for the effective management of inevitable climate change impacts through enhancing adaptive capacity, strengthening resilience and reducing vulnerability to climate change, with a view to building social, economic, and environmental resilience and an adequate national adaptation response in the context of the global climate change response;
and to
Make a fair contribution to the global effort to stabilise greenhouse gas concentrations in the atmosphere at a level that avoids dangerous anthropogenic interference with the climate system within a timeframe and in a manner that enables economic, employment, social and environmental development to proceed in a sustainable manner.
Members of the public are invited to submit to the Minister, by 8 August 2018, written inputs or comments to the following addresses:
By email, By post: The Director-General: Department of EA, Attention: Ms Dineo Ngobeni, Private Bag X447, Pretoria 0001., By hand: Environment House, 473 Steve Biko Street, Arcadia, Pretoria, 0002
Any inquiries in connection with the National Climate Change Bill, 2018, can be directed to Mr Tlou Ramaru at +27-12 399 9252 or Ms Deborah Ramalope at +27 12 399 9160.
In the death stakes #1 is the position to avoid. Stroke and diabetes are the 2nd and 3rd main causes of death in South Africa according to the 2014 figures just released by StatisticsSA. TB remains in unenviable pole position but the number of deaths are dropping each year. Great news.
The ranking looks very different if diabetes and heart/ blood vessel disease are grouped. This makes sense because essentially they kill you in the same way, by cardiovascular diseases (CVD.) So this is what the figures look like done that way around
18.7% CVD (stroke, heart attacks, diabetes and other heart conditions) with <0.2% national budget and NO provincial NCDs budgets
13.2% TB & HIV/AIDS with 39.6% funding (see figure 2 right.)
Deaths from NCDs increase every year while HIV/AIDS and TB deaths have declined each year since 2007. And that is really good news. (See figure above.) However, it is disheartening that NCDs deaths continue upwards.
TB leads the number of deaths in the 15-64 age groups. The between 15-44 years infections are the big killers with HIV/AIDS in 2nd spot. NCDs don’t feature in the top ten but this changes in those over 44 year. NCDs play a much more important part.
How cost effective is screening 8 million people with diabetes and hypertension via the HIV/AIDS Counselling and Testing (HCT) programme? The stats seem to indicate different target age groups for HCT versus NCDs screening which is for at least those older than 45 years. What do you think?
The provincial ranking places the Western Cape in top CVD position followed closely by KwaZulu-Natal.
In 2011 President Jacob Zuma and the South African government committed to NCDs prevention and control in line with global conventions. Since then many more commitments have been undertaken. As part of civil society’s watchdog role the SA NCD Alliance monitors how the government is doing. Today we release our report card covering the years from 2010 to March 2015. Click here to download the report.
March 2005 marks halfway through the national NCDs plan. There is still a lot to be done.
SA is doing fairly well at “population”
measures to prevent NCDs like legislation on smoking, salt reduction and food labeling. The relatively cost effective measures mean a bigger bang for each rand spent. We are all for that. However, there is much more to NCDs prevention and treatment (control.)
There are 6 main areas in the WHO’s NCDs Global Action Plan 2013-2020 are used to benchmark the governments progress. Out of over 25 indicators (see table below): ♦ Less than 1/4 were met:
♦ At least 3/25 critical items were not achieved; and
♦ the bulk (64%) were partially achieved or implemented.
This report was compiled by using official government reports, budgets and transparent interaction with stakeholders. It is a first of its kind in South Africa. Over 600 data sources were used. The Parliamentary Monitoring Group was the major source of government meetings.
None of this is a surprised to the National Department of Health because a year ago, armed with the preliminary findings, a NCDs Network delegation discussed our concerns with the Deputy Minister of Health, Dr Joe Phaahla. Sadly not much has changed since then.
Issues of concern include:
♦ A continuing and alarming trend to make policy and plans without any budgetary allocation;
♦ Minuscule budgetary allocation for NCDs within the Primary Health Care programme budget;
♦ Lack of provincial NCDs plans and budgets – the provinces provided the care but can’t do it without dedicated resources;
♦ Failure to include people living with NCDs in the roll out of “ideal clinics” (also known as Operation Phakisa and “integrated chronic care model”);
♦ Lack of patient-centredness including consultation with patients and those living with the illnesses (nothing for us, without us);
♦ Poor or non-existent monitoring and evaluation.
There is more but we would like you to take look. You be the judge, you use the services.
Below see the 6 areas of the WHO Global Action Plan. Green indicates achievement. Red no progress. Blue no evidence. All the rest partial progress/ implementation.
said in a statement.
