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.


(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:
(2) SA Government News Agency. SA COVID-19 cases rise to 3 034. 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.

Diabetes helpline +27-81-578-6636

Global NCDs target to reduce the harmful use of alcohol

[vc_row][vc_column][vc_column_text]Heart disease and stroke, cancers, diabetes, and chronic respiratory diseases and other noncommunicable diseases (NCDs) cause tens of millions of deaths per year, the majority of which occur during the most productive years of life. NCDs reduce economic output and prevent people around the world of living lives of health and wellbeing.
Creating the conditions that favour sustainable development means taking action to prevent and control NCDs now.

Nine global NCD targets provide a vision for progress by 2025. The WHO Global NCD Action Plan 2013-2020
and other resources provide a roadmap of policies and interventions to realise this vision. When implemented, they will put countries on track to meet the commitments made on NCDs at the United Nations General Assembly in 2011 and 2014, and in the 2030 Agenda for Sustainable Development, including target 3.4 to reduce premature NCD deaths and target 3.5 to strengthen the prevention and treatment of substance abuse, including narcotic drug use and harmful use of alcohol.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_btn title=”Download Now” color=”primary” link=”|||”][/vc_column][/vc_row]

Air pollution another silent killer, it’s about more than the lungs – WHO

9 out of 10 people worldwide breathe polluted air

Air pollution levels remain dangerously high in many parts of the world. New data from the World Health Organization (WHO) shows that 9 out of 10 people breathe air containing high levels of pollutants. Updated estimations reveal the alarming death toll of 7 million people every year caused by ambient (outdoor) and household air pollution. More than 90% of air pollution-related deaths occur in low- and middle-income countries, mainly in Asia and Africa, followed by low- and middle-income countries of the Eastern Mediterranean region, Europe and the Ameri­cas.

“Air pollution threatens us all, but the poorest and most marginalized people bear the brunt of the burden,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “It is unac­ceptable that over 3 billion people – most of them women and children – are still breathing deadly smoke every day from using polluting stoves and fuels in their homes. If we don’t take urgent action on air pollution, we will never come close to achieving sustainable development.”

Click here for the press release; the city database, interactive map, and all the updated health data; frequently asked questions and infographics.

Maximizing health benefits from the sustainable energy transition

Energy is crucial for achieving almost all of the sustainable development goals (SDGs), from eradication of poverty through advancements in health, education, water supply and industriali­zation to combating air pollution and climate change.

New Tracking SDG7: The Energy Progress Report includes updated data from WHO on household air pollution showing that 3 billion people – or more than 40% of the world’s popula­tion – still do not have access to clean cooking fuels and technologies. Household air pollution from burning solid fuels and using kerosene for cooking alone is responsible for some 4 mil­lion deaths a year, with women and children being at greatest risk. The report provides a com­prehensive summary of the world’s progress towards the global energy targets on access to electricity, clean cooking fuels, renewable energy and energy efficiency. The report was launched at the Sustainable Energy for All forum held on 2 May 2018 in Lisbon, Portugal. For the press release click here. For further information, on WHO work on household air pollution click here.

Policy briefs in support of the first SDG7 review at the UN High-Level Political Forum 2018 in­cludes a brief on Achieving universal access to clean and modern cooking fuels, technologies and services (Brief #2), as well as Health and energy linkages – Maximizing health benefits from the sustainable energy transition (Brief #10). The briefs were developed by WHO in collab­oration with Climate and Clean Air Coalition, Global Alliance for Clean Cookstoves, United Na­tions Environment, United Nations Children’s Fund and United for Energy Efficiency. The publi­cation was launched at the UN High-Level Political Forum on 18 April 2018 in New York, the United States of America. For the press release click here.


Experts develop a new roadmap for strengthening workers’ health

With an aim to develop strategic directions for WHO’s future action on health and work, forty experts came together at WHO in Geneva to produce a preliminary roadmap for action by the health sector for implementing the SDGs relevant to workers health. The experts identified cost-effective policy options at national and international levels to achieve SDG targets and pro­posed a set of high priority actions for improving workers’ health and the working environment in the context of global action on health, environment and climate change.

The experts represented ministries of health, international organizations including the Interna­tional Labour Organization, and the network of WHO Collaborating Centres for Occupational Health.

The meeting took place from 9–11 April 2018 at WHO in Geneva. For more information, click here.

Health in All Policies workshop – the case of air pollution, urban health and sustainability

For the first time, a Health in All Policies (HiAP) workshop will address and empower the pub­lic health workforce (public health educators and public and environmental health profession­als) by providing them with skills to advance multisectoral action in health and sustainable development with a focus on air pollution and urban health. Participants of the workshop will identify the skills needed in practice, and examine useful approaches for education to move policy in support of both health and the environment. Collaborative action and HiAP will sup­port reaching the SDGs.

The workshop is being organized in collaboration with the Association of Schools and Pro­grams of Public Health (ASPPH) and the National Environmental Health Association and will take place from 18 to 20 June 2018 in Washington (DC), the United States. For more infor­mation, click here. For more on WHO’s work on HiAP click here.

Chemical releases caused by natural hazards

Natural hazards such as earthquakes, floods and cyclones can cause the release of chemicals from fixed chemical installations, pipelines, transport systems, hospitals and homes. These releases are known as Natech events and they can severely hamper response activities. Risk managers have only recently started studying the causes and consequences of Natech events. It is anticipated that these events triggered especially by floods and cyclones will become more frequent as a consequence of climate change. A new publication, Chemical releases caused by natural hazard events and disasters – information for public health authorities aim to inform the health sector about this issue and provides brief guidance on the role of the health sector in prevention, preparedness, response and recovery. This publication is complemented by three short documents on earthquakes, floods and cyclones.

For more on WHO’s work on chemical safety click here.


#BreatheLife challenge – A marathon for clean air

The BreatheLife challenge is the first in series of campaigns to mobilize citizens to act in their own interests, for better air quality and health. We want to rally people to walk, bike and use public transport to clean the air and to take a pledge to reduce air pollution emissions by partici­pating in ’a marathon a month – the equivalent of 42 kilometres or 26 miles of car use.

This May, WHO released new data on the state of air pollution in the world. The latest air pollu­tion levels and trends from 4,000 cities will be made public. Committing to a marathon for clean air will offer people a way to take action together.

We invite your organization to promote the challenge on different platforms. Use this guide to get

tips, messages and ideas on what your organization can do. For more information, visit

Durban respiratory training and community screening

Help Africa breathe – Siza iAfrika iphefumule

Lung and respiratory disease in children and adult is a major cause of death, disability and morbidity in Africa. The most common illnesses are:
• Infections like pneumonia and TB)
• NCDs like asthma and chronic obstructive pulmonary disease (COPD). TB remains the #1 killer disease in South Africa.

Why Durban?
Two professional groups, that focus on these illnesses, held a joint congress in Durban during April: PATS (Pan African Thoracic Society) and South African Thoracic Society. So, this was the perfect opportunity to discuss the challenges and to improve collaboration for lung health in Africa by strengthening initiatives to improve care, build capacity with research, training and advocacy.

IMPALA research programme for African lung health.
After the congress, 14 partners from 11 African countries continued with a series of education and advocacy events for the IMPALA programme (International Multidisciplinary Programme to Address Lung Health and TB in Africa). This 4-year research collaboration is funded by the UK National Institute for Health Research which established an Africa-focused Global Health Research Unit on Lung Health and TB the Liverpool School of Tropical Medicine (LSTM). It will generate scientific knowledge and implementable solutions for these high burdens, under-funded and under-researched health problems.

Spirometry training in Durban
PATS promotes training to strengthen respiratory health across Africa. So, the Durban event was the perfect time to launch its PATS / IMPALA international standard foundational spirometry training programme. It is available for Africans working in any setting. In 2017 the first courses were piloted in Uganda and Ethiopia.

The training programme lasts at least 2 months with 3 parts:
• Online self-study, the training materials are available for free online here
• Training workshop 3 days of face-to-face training
• Completion of a portfolio of evidence workbook.

Contact [email protected] for training enquiries.

313 Durban people screened for lung health
Alongside the IMPALA meeting, Health Lungs for Life seven-day-long free respiratory screening events were in and around of Durban. Free spirometry testing was provided to 313 people. The data was added to the Paediatric and Adult Spirometry Study which collects lung function information for healthy South Africans for much needed local reference values. These events were funded and supported by the PATS Spirometry program.

Spirometry equipment donates
10 IMPALA partners from Benin, Cameroon, Ethiopia, Ghana, Kenya, Nigeria, South Africa, Sudan, Tanzania and Uganda were presented with ERS / ELF donated spirometry equipment to take back with them for use in their research clinics. Lindsay Zurba, of Spirometry Training Services Africa, said, “This equipment is essential to diagnose asthma, COPD and other conditions that affect breathing. The loaning of this equipment by PATS and LSTM to these in-country partners will have a hugely positive impact on the research and the treatment received by those that visit their clinics.”

Smoking Robs Your Health and Your Wallet – CANSA

Tobacco use is a threat to any person, regardless of gender, age, and race, cultural or educational background that causes over 18 types of cancer, and accounts for over 20% of cancer deaths worldwide. CANSA advocates stopping the use of any and all tobacco products.

Tobacco can be found in many forms, and all tobacco use is harmful. “People only think of cigarette smoking when you talk about tobacco, but it goes beyond that. They need to be aware that hubbly bubbly and e-cigarettes are just as harmful to your health and the health of those around you. It’s not just the smoker who has increased risk of disease, but also people exposed to second-hand smoke,” says CANSA Health Specialist, Prof Michael Herbst.

Tobacco Products Expensive

On top of the health implications, tobacco products are getting more expensive and are creating a huge negative impact on the economy.

“The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on families, communities and countries,” says Dr Oleg Chestnov, World Health Organisation’s (WHO) Assistant Director-General for Non-communicable Diseases (NCDs) and Mental Health.

“There is so much more you can do with an average R30 a day, instead of buying a pack of cigarettes. Have you thought about that? Giving up smoking one pack a day, will free up close to R1 000 a month, which can be used in better ways than harming your health, and the health of those around you. The financial impact is huge,” adds Herbst.

Hookah, or hubbly bubbly use is especially concerning among the youth. The tobacco is no less toxic in a hookah pipe and the 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 they inhale in one smoking session. In South Africa, hubbly and their related tobacco products, fall under the definition of ‘tobacco product’ as indicated in the Tobacco Products Control Amendment Act (2007). This means that its use and sale have to comply with the regulations that apply to a tobacco product in the country. This includes the prohibition of the sale of hookahs and their products to anyone under the age of eighteen.

Electronic cigarettes and similar devices are frequently marketed as aids to quit smoking, or as healthier alternatives to tobacco. This has not been proven, and e-cigarettes are not a better alternative to cigarettes. They still contain harmful chemicals, and it’s rather recommended to quit smoking by proven treatments. CANSA has a e-Kick Butt programme, which assists with quitting smoking (,” continues Herbst.

Know the law – it’s Your Right to a Smoke-free World

CANSA has played a significant role in contributing to tobacco control legislation in South Africa. Every person should be able to breathe tobacco-smoke-free air. Smoke-free laws protect the health of non-smokers. Report offenses here

  • Legislation is very clear about where people may smoke and where smoking is prohibited
  • It’s your right to complain when someone smokes in your presence
  • It’s also your right to take remedial steps if someone smokes in any area where smoking is prohibited
  • Adults may not smoke in a car when a passenger under 12 years is present
  • Smoking is not allowed in premises (including private homes) used for commercial childcare activities, such as crèches, or for schooling or tutoring
  • No person under 18 may be allowed into a designated smoking area
  • No smoking in partially enclosed public places such as balconies, covered patios, verandas, walkways, parking areas, etc.
  • The fine for the owner of a restaurant, pub, bar and workplace that breaks the smoking law is a maximum of R50 000 and for the individual smoker R500
  • The tobacco industry can no longer use ‘viral’ marketing like parties to target young people
  • The sale of tobacco products to and by persons under the age of 18 years is prohibited
  • Cigarette vending machines that sell tobacco products cannot be used to sell other products like crisps, chocolates etc.

Download all the materials and infographics here