The burden of non-communicable diseases in South Africa
2009 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 374, no 9693, 934-947 p.Article in journal (Refereed) PublishedText
15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases.
Place, publisher, year, edition, pages
New York: Elsevier, 2009. Vol. 374, no 9693, 934-947 p.
middle-income countries, coronary heart disease, Sub-Saharan Africa, human immunodeficiency virus, prevention initiative saspi, risk factors, mental health, black population, Alma-Ata, antiretroviral therapy
IdentifiersURN: urn:nbn:se:umu:diva-115973DOI: 10.1016/S0140-6736(09)61087-4ISI: 000269943100032PubMedID: 19709736OAI: oai:DiVA.org:umu-115973DiVA: diva2:907208