COVID-19 and NCDs – a Newly Acknowledged Vulnerability

20 August 2020The 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.

References:

(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

About NCDs+

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

Hooked for life – How big tobacco companies seduce youth – CANSA

Available for download:

CANSA Campaign Logo (jpg): English | Afrikaans

Infographic: Tobacco Companies Target Youth (pdf) English | Afrikaans

Powerpoint: Tobacco Companies Target Youth (pdf) English | Afrikaans

Hooked for Life – How Big Tobacco Companies Seduce Youth

The Cancer Association of South Africa (CANSA) partners with the World Health Organization http://www.who.int/  to highlight risks associated with tobacco use as part of World No Tobacco Day (31 May).  The aim is to advocate for effective policies to lower tobacco use. #WorldNoTobaccoDay

Globally the focus is on the link between tobacco and heart and other cardiovascular diseases including stroke, which combined are the world’s leading causes of death. Says Elize Joubert, CANSA’s CEO, “In South Africa, we’re concerned about the burden of tobacco and especially about the tactics adopted by the tobacco industry to target youth. Research shows tobacco use is often initiated and established during adolescence and young adulthood.”

Smoking remains a major preventable cause of disease and premature death globally http://www.cansa.org.za/avoid-tobacco/ . Annually, the global tobacco epidemic kills over 7 million people.  South Africa’s comprehensive Tobacco Control strategy over the last 20 years has been effective in dropping smoking use per capita – according to the SA National Health and Nutrition Survey 2013.  It showed 32.8% of men had ever smoked compared to 10.1 % of females.

The initial success of legislation of the past 20 years such as the Tobacco Products Control Amendment Act No.12 (1999), hikes in excise duty on cigarettes, and health promotions to educate on risks of tobacco use have led to a 30 % decrease in smoking among school learners.

However, a recent increase in smoking has been noted among youth (particularly girls) in SA from 2008 to 2011, according to the Global Youth Tobacco Surveys.

Partnership

Tobacco companies are engaged in systematic market research generating data on population trends, smoking patterns and attitudes towards smoking. Research revealed that 90% of smokers start the habit by age 18 and 99% start by age 26.

By altering the taste, smell and other sensory attributes of products, tobacco manufacturers entice new users, mostly youth, to start and continue smoking. They maximise the appeal of tobacco products in this age group, by means of introducing the following chemical additives:

  • Levulinic acid to reduce the harshness of nicotine; make smoke feel smoother and less irritating.
  • Flavourings, such as chocolate and liquorice, to boost sweetness of tobacco; mask the harshness of the smoke.
  • Bronchodilators to expand lungs’ airways, making it easier for tobacco smoke to pass into the lungs.
  • Menthol to cool and numb throat, reducing throat irritation; making smoke feel smoother.

“CANSA appeals to young people, be aware of these tactics and understand that these alterations to products while enhancing the experience, do nothing to reduce the long-term negative effects of smoking or the risk for several cancers,” added Joubert. #NoTobacco

Furthermore, CANSA warns against the use of hubbly bubbly, hookah pipes or water pipes http://www.cansa.org.za/hubbly-bubbly-or-hookah-smoking-increases-cancer-risk/. Popular among youth when socialising with friends, it’s important to note that tobacco is no less toxic in a hookah pipe than in other tobacco products. Water in the hookah does not filter out the toxic ingredients in the tobacco smoke. Hookah smokers may actually inhale more tobacco smoke than cigarette smokers do, because of the large volume of smoke inhaled in one smoking session. The sale of hookahs and products is prohibited by law to anyone under the age of 18.

Electronic cigarettes (e-cigarettes) http://www.cansa.org.za/legal-status-e-cigarettes-in-sa/ and similar devices are frequently marketed as aids to quit smoking or as ‘healthier’ alternatives to tobacco.

Joubert states, “However, this has not been proven. They contain nicotine, so they’re addictive and may encourage novice users to later switch to combustible cigarettes. They’re particularly harmful and addictive to people under the age of 25, as their brains are still developing. This makes it easier for them to get addicted to nicotine after using even small amounts of e-cigarettes, which also contain other harmful chemicals. It’s rather recommended to quit smoking by proven treatments.”

CANSA encourages young smokers who have started using any tobacco product to get support to quit. CANSA has a free online eKickButt programme that helps with quitting smoking (www.ekickbutt.org.za). Counselling and medication can more than double the chance of a smoker to succeed when attempting to quit.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556031/

A balanced lifestyle today lowers your cancer risk for tomorrow – CANSA

It is almost mid-year already, and your New Year’s Resolutions for 2018 long forgotten, but it is never a bad thing or too late to take stock of where you are at, with regards to important life goals, possibly the most significant of these being your health goals. After all, the old saying is true, “Health is Wealth”.

CANSA agrees with the World Cancer Research Fund’s findings indicating that if you work towards the three goals below, you will reduce your cancer risk by a third:

  1. Eat Smart (a wholesome, balanced diet, including what you drink)
  2. Maintain a healthy body weight (SA has the highest occurrence of obesity in sub-Saharan Africa, including children and teens)
  3. Be physically active (World Health Organisation has determined that 47 % of SA adults have insufficient levels of physical activity)

Not only will you lower your risk for several cancers, but also your risk for other non-communicable diseases, such as heart disease, stroke, diabetes, etc. Read media release: English | Afrikaans

Exercise outdoors

April 2018: Lorraine Govender (CANSA’s National Advocacy Co-ordinator), was interviewed by Adri Kotze (Africa Editor Centre for Health Journalism – Mail & Guardian).

CANSA was asked to respond to the Cancer Research UK’s latest research, published earlier this year, regarding lifestyle factors which could contribute to an increased cancer risk, and comment on how this pertains to South Africans. Read more…

Balanced Lifestyle Slideshow

Slideshow – How to Live a Balanced Lifestyle

Lifestyle Infographic

Infographic – Tips to Reduce Your Cancer Risk

Smart Lunch
Active Kids

What YOU Can Do:

1.     Life is hectic – avoid making last minute trips to the local ‘fast food’ outlet, by preparing meals in advance where possible. Cook a double portion healthy, balanced meal, eat one and freeze the other.
2.     Reduce your portion sizes – eat three healthy meals a day – don’t starve yourself and wolf down an enormous portion later.
3.     If you didn’t prepare it right, salt will NOT make the meal taste better, only salty! Use alternate herbs to add flavour food, limiting salt to 1 tsp per day (per person…)
4.     Bring ingredients home that won’t tempt you to eat unhealthily. Choose healthy snack options instead, to still the hunger pangs. If you don’t put it in the shopping cart, you’re not likely to start…

Healthy options
 5.     Avoid food high in fat, sugar and low in fibre. Eat less red meat (beef, lamb, pork), replacing it with fish, poultry, beans, lentils and soya products, and avoid processed meats (ham, bacon, salami, etc).
Exercise

6.     Do aim to eat at least 2 ½ cups of veggies / fruit per day, adding wholegrains and pulses where possible
7.     Plan lunch boxes for school and work instead of buying meals at the tuckshop or canteen – find super lunch box tips here in our CANSA Smart Lunch Box Planner, which includes recipes…
8.     What you drink counts too – avoid sugary drinks such as fizzy sodas and alcohol. Drink unsweetened, pure fruit juice (diluted). Increased sugar intake is linked to obesity and alcohol consumption increases your cancer risk.
9.     Teach kids to prepare healthy, balanced meals from the start (instead of giving your toddler a sugary biscuit, opt for a carrot stick…)
10.     Encourage your children to play physical games: hop scotch; skipping; take them to the park, or play areas designed to get them moving and strengthening their muscles. Make exercise a family affair…

Healthy options
11.     Get up, choose to move, use the stairs, stretch, join neighbourhood sport groups or ones that encourage physical activity. You can also find out more about our CANSA Active programme – be active and healthy – having some Feel Good Fun, while raising awareness and funds for CANSA and the fight against cancer in SA.
12.     Limit your screen time, or time on digital devices which encourages less physical activity.
Smart Lunch
 What Your COMMUNITY Can Do:

Community efforts are essential in creating an environment that encourages healthy food choices and physical activity. Community members can make their voices heard in the following ways:

1.     Lobby for healthier food options offered at schools, educational institutions, or in the workplace

Healthy options
2.     Encourage and empower community members to grow their own fruit and vegetables
3.     Community members or service providers can donate healthier food options to organisations supporting poorer community members
4.     Lobby for safe places where community members can walk, run, ride their bicycle, etc
Take part in events

5.     Encourage events that provide the opportunity to be physically active or start or support a club which does so
6.     Provide opportunities for recreation that do not revolve around sedentary, passive behaviour
7.     Community members or service providers can donate play equipment encouraging the development of motor skills, or help local schools (play schools through high schools) to improve sports facilities

It’s ALWAYS time to take stock of your health.
Invest in your health now by living a balanced lifestyle.

A balanced lifestyle today lowers your cancer risk for tomorrow – CANSA

It is almost mid-year already, and your New Year’s Resolutions for 2018 long forgotten, but it is never a bad thing or too late to take stock of where you are at, with regards to important life goals, possibly the most significant of these being your health goals. After all, the old saying is true, “Health is Wealth”.

CANSA agrees with the World Cancer Research Fund’s findings indicating that if you work towards the three goals below, you will reduce your cancer risk by a third:

  1. Eat Smart (a wholesome, balanced diet, including what you drink)
  2. Maintain a healthy body weight (SA has the highest occurrence of obesity in sub-Saharan Africa, including children and teens)
  3. Be physically active (World Health Organisation has determined that 47 % of SA adults have insufficient levels of physical activity)

Not only will you lower your risk for several cancers, but also your risk for other non-communicable diseases, such as heart disease, stroke, diabetes, etc. Read media release: English | Afrikaans

Exercise outdoors

April 2018: Lorraine Govender (CANSA’s National Advocacy Co-ordinator), was interviewed by Adri Kotze (Africa Editor Centre for Health Journalism – Mail & Guardian).

CANSA was asked to respond to the Cancer Research UK’s latest research, published earlier this year, regarding lifestyle factors which could contribute to an increased cancer risk, and comment on how this pertains to South Africans. Read more…

Balanced Lifestyle Slideshow

Slideshow – How to Live a Balanced Lifestyle

Lifestyle Infographic

Infographic – Tips to Reduce Your Cancer Risk

Smart Lunch
Active Kids

What YOU Can Do:

1.     Life is hectic – avoid making last minute trips to the local ‘fast food’ outlet, by preparing meals in advance where possible. Cook a double portion healthy, balanced meal, eat one and freeze the other.
2.     Reduce your portion sizes – eat three healthy meals a day – don’t starve yourself and wolf down an enormous portion later.
3.     If you didn’t prepare it right, salt will NOT make the meal taste better, only salty! Use alternate herbs to add flavour food, limiting salt to 1 tsp per day (per person…)
4.     Bring ingredients home that won’t tempt you to eat unhealthily. Choose healthy snack options instead, to still the hunger pangs. If you don’t put it in the shopping cart, you’re not likely to start…

Healthy options
 5.     Avoid food high in fat, sugar and low in fibre. Eat less red meat (beef, lamb, pork), replacing it with fish, poultry, beans, lentils and soya products, and avoid processed meats (ham, bacon, salami, etc).
Exercise

6.     Do aim to eat at least 2 ½ cups of veggies / fruit per day, adding wholegrains and pulses where possible
7.     Plan lunch boxes for school and work instead of buying meals at the tuckshop or canteen – find super lunch box tips here in our CANSA Smart Lunch Box Planner, which includes recipes…
8.     What you drink counts too – avoid sugary drinks such as fizzy sodas and alcohol. Drink unsweetened, pure fruit juice (diluted). Increased sugar intake is linked to obesity and alcohol consumption increases your cancer risk.
9.     Teach kids to prepare healthy, balanced meals from the start (instead of giving your toddler a sugary biscuit, opt for a carrot stick…)
10.     Encourage your children to play physical games: hop scotch; skipping; take them to the park, or play areas designed to get them moving and strengthening their muscles. Make exercise a family affair…

Healthy options
11.     Get up, choose to move, use the stairs, stretch, join neighbourhood sport groups or ones that encourage physical activity. You can also find out more about our CANSA Active programme – be active and healthy – having some Feel Good Fun, while raising awareness and funds for CANSA and the fight against cancer in SA.
12.     Limit your screen time, or time on digital devices which encourages less physical activity.
Smart Lunch
 What Your COMMUNITY Can Do:

Community efforts are essential in creating an environment that encourages healthy food choices and physical activity. Community members can make their voices heard in the following ways:

1.     Lobby for healthier food options offered at schools, educational institutions, or in the workplace

Healthy options
2.     Encourage and empower community members to grow their own fruit and vegetables
3.     Community members or service providers can donate healthier food options to organisations supporting poorer community members
4.     Lobby for safe places where community members can walk, run, ride their bicycle, etc
Take part in events

5.     Encourage events that provide the opportunity to be physically active or start or support a club which does so
6.     Provide opportunities for recreation that do not revolve around sedentary, passive behaviour
7.     Community members or service providers can donate play equipment encouraging the development of motor skills, or help local schools (play schools through high schools) to improve sports facilities

It’s ALWAYS time to take stock of your health.
Invest in your health now by living a balanced lifestyle.

World Asthma Day 2018 – GINA

May 1: Today is the 20th annual World Asthma Day, an event held each May to raise awareness of Asthma worldwide. World Asthma Day is organized by the Global Initiative for Asthma, or GINA (www.ginasthma.org), a World Health Organization collaborative and 501(c)3 organization founded in 1993.

According to WHO estimates, 235 million people suffer from asthma, which can cause wheezing, breathlessness, chest tightness, and coughing. Although asthma cannot be cured, it is possible to control asthma to reduce and prevent asthma attacks, also called episodes.1 In the United States, approximately half of people with asthma had at least one asthma attack in 2012. More children (55%) than adults (49%) had an attack.

Asthma is the most common chronic disease among children. Asthma is not just a public health problem for high income countries: it occurs in all countries regardless of level of development. Over 80% of asthma deaths occurs in low and lower-middle income countries. Asthma is under-diagnosed and under-treated, creating a substantial burden to individuals and families and possibly restricting individuals’ activities for a lifetime.

Asthma attacks cause adults to miss work and children to miss school. These dangerous and sometimes life-threatening episodes reduce the quality of life for people with asthma. The good news is that we can raise awareness about asthma and how it can be controlled. People with asthma can prevent asthma attacks if they learn how to avoid asthma triggers like tobacco smoke, mold, outdoor air pollution, and colds and flu. Asthma episodes can also be prevented by using inhaled corticosteroids and other prescribed daily long-term control medicines correctly.

This year’s World Asthma Day theme is “NEVER TOO EARLY, NEVER TOO LATE. It’s always the right time to address airways disease.”” The theme provides a call to action for both patients and healthcare providers worldwide to evaluate symptoms regardless of the timepoint in one’s life they may occur and take actions to ensure that the asthma is controlled.

World Asthma Day was first held in 1998, and has grown each year to become one of the most important Asthma events globally. On World Asthma Day, hundreds of awareness-raising activities will take place in countries all over the world. Further information about GINA and World Asthma Day can be found at GINA’s website: www.ginasthma.org. Documents detailing GINA’s global strategy for diagnosis, management, and prevention of COPD are also available at www.ginasthma.org.