Non-communicable diseases (NCDs) of lifestyle are becoming the leading cause of death in most regions of the world.
South Africa faces a quadruple burden of disease: the HIV/AIDS epidemic paired with a high burden of TB, high rates of maternal and child mortality, high levels of violence and injuries, and a growing burden of NCDs. NCDs are disproportionately affecting poor people living in urban settings. The NCDs drive a rising demand for chronic-disease care and pose an increasing burden on the health system.
The Gauteng Office of the Premier’s Planning Division contracted Genesis Analytics to determine the health and financial effects of NCDs on Gauteng’s health system for 2017-2030 and to recommend policies and best practices to address the growing burden in Gauteng.
Genesis developed a model to project the size and profile of the Gauteng population, prevalence of the selected risk factors and NCDs, and costs borne by the Gauteng public health system.
Our projections show that by 2030 the number of NCD cases in Gauteng will increase by 42% to 4.5 million. There will be high levels of morbidity (2.1 million disability-adjusted life years) and mortality (65 700 deaths) because of NCDs.
This high burden has significant associated costs. NCDs account for nearly 40% of healthcare spending in Gauteng. This spending will lead to a 39% increase over 13 years to R19.2 billion in 2030, without adjusting for inflation. The projected NCD costs are expected to outpace Gauteng Department of Health budget increases.
Genesis prioritised a number of “best buys” (according to the World Health Organisation) to address the health and financial burden in Gauteng, which would bolster the efforts of the National Department of Health. Specifically the province should invest in mass-media campaigns to promote behaviour change and awareness of a healthy diet and physical activity.
This is a cost-effective intervention and the upfront investment will ultimately result in long-term savings and benefits for the province. For NCDs Gauteng needs to develop well-prioritised, efficient and effective treatment and rehabilitation services for chronic-disease care.