Department of Health National NCD Summit 12-13 September 2011

In preparation of the UN High-level Meeting on non-communicable diseases (NCDs) held on 19-20 September 2011, the Department of Health held a two-day national NCD Summit on the 12th and 13th of September in Gauteng. The summit was led by the Minister of Health, the Deputy Minister of Health, Provincial Members of the Executive Council (MECs) for Health, UN representatives and leading experts in the field of NCDs. It provided participants, who came from the public and private sector, academia and civil society, an opportunity to collectively agree on strategies and targets to be reached in South Africa to improve the situation regarding NCDs.

NCDs have overtaken infectious diseases as the leading cause of death worldwide, with nearly 80 percent of these deaths occurring in low- and middle-income countries, according to the World Health Organization. South Africa has been grappling with a high HIV prevalence over the past years and like many developing countries it is now also facing the rising tide of chronic diseases. NCDs are among the quadruple burden of disease which this country faces and cardiovascular diseases, diabetes, cancers, chronic respiratory diseases and mental illness are the most common. The management of NCDs has up to now been generally regarded as the problem of the Department of Health. However, the nature of the risk factors for NCDs demands that interventions are aligned to global and national policies which include, but are not exclusive to, health. The Departments of Trade and Industry, Basic Education, Higher Education, Water and Environmental Affairs, Science and Technology, Finance, Agriculture Forestry and Fisheries, Sports and Recreation and Social Development play critical roles in a comprehensive approach to the prevention and control of chronic diseases.

During the Summit, various committees deliberated on the current situation with regard to NCDs in South Africa and proposed solutions on how to reduce the incidence and prevalence through comprehensive and intersectoral interventions. The working groups covered: the role of civil society and social mobilisation in the prevention and control of NCDs; controlling NCDs through health systems strengthening; surveillance and research for the prevention and control of NCDs; dietary risk factor reduction; and intersectoral action on healthy lifestyles and NCD control.

Declaration

A pioneering declaration on NCDs and ten NCD targets for South Africa resulted from the Summit. The latter includes:

1. Reduce the relative premature mortality (under 60 years of age) from NCDs by at least 25% by 2020.
2. Reduce tobacco use by 20% by 2020.
3. Reduce the relative per capita consumption of alcohol by 20% by 2020.
4. Reduce the mean population intake of salt to < 5 grams per day by 2020.
5. Reduce the percentage of people who are obese and/or overweight by 10% by 2020.
6. Reduce the prevalence of people with raised blood pressure by 20% by 2020 (through lifestyle and medication).
7. Screen all adult women at least every 5 years for cervical cancer by 2020.
8. Screen all men above 40 years of age for prostate cancer by 2020.
9. Increase the percentage of people controlled for hypertension, diabetes and asthma by 30% by 2020.
10. Increase the number of people screened and treated for mental health by 30% by 2030.

Challenges

During the Summit the major challenges that were noted included:

• HIV and NCDs are often seen as completely separate and competing challenges, when in fact lessons can be learnt from the HIV scale-up, and responses to HIV and NCDs can take similar approaches, including appointment and medication reminders, transport support, and counselling to support adherence and ongoing behaviour change. Likewise HIV services and cervical cancer screening can be integrated in some settings and people tested for HIV can be screened for hypertension.
• Funding, or lack thereof, however, remains a problem for NCDs especially since there is a lack of funders as well as of the high-profile activist campaigns and celebrities as found in the AIDS sector.
• Social and community mobilization for chronic diseases will be a challenge as they will require much more advocacy and will take more time as the impact of NCDs on families is much more subtle and prolonged as most NCDs are ‘silent killers’ which most of the time do not cause symptoms and go unnoticed.