By Phenyo Selinda
South Africa is grappling with a sharp rise in diabetes, particularly among women, making it a leading cause of death. Deputy Health Minister, Dr. Joe Phaahla, raised concerns over this growing epidemic during a roundtable discussion on the Healthy Life Trajectories Initiative (HeLTI), a collaborative effort with national research agencies from Canada, China, India, South Africa, and the World Health Organisation (WHO). Diabetes mellitus has overtaken other illnesses to become the primary underlying cause of female deaths, contributing to 8.2% of all female deaths in 2020, an increase from 7.7% in 2018 .
The rising prevalence of diabetes is alarming, not only for its impact on health but also for its economic burden on individuals and the healthcare system. Diabetes is now the second leading cause of death, following COVID-19, which was first detected in 2020 . As Phaahla emphasized, “non-communicable diseases not only reduce life expectancy but also have a profound economic impact.”
The Alarming Growth of Non-Communicable Diseases (NCDs):
Non-communicable diseases (NCDs), often referred to as lifestyle diseases, are on the rise in South Africa. This category includes diabetes, cardiovascular diseases, and cancers, all exacerbated by modern lifestyle habits. The increase in NCDs is deeply intertwined with social determinants such as unhealthy diets, physical inactivity, excessive alcohol consumption, and smoking. These risk factors are becoming more prevalent across South Africa, which has led to an uptick in diabetes cases, especially among women.
Dr. Phaahla outlined the seriousness of these challenges during his address, where he emphasized the need for “early detection and lifestyle modifications” to reduce the impact of these diseases. The government’s efforts to combat NCDs involve not just treatment but also public education to prevent the further escalation of the epidemic .
Government’s Response and Prevention Strategies:
In response to the rising burden of diabetes and other NCDs, the Department of Health has implemented multiple initiatives aimed at prevention and early detection. Community-based screening campaigns have been rolled out through partnerships with community health workers (CHWs) and traditional health practitioners (THPs), targeting hypertension and diabetes . These programs aim to identify risk factors early and provide education on healthier lifestyles to slow the progression of these diseases.
A significant portion of the government’s focus has been on strengthening primary healthcare (PHC) services to manage chronic conditions effectively. Dr. Phaahla noted that PHC facilities across the country are being equipped with the necessary tools to monitor and treat patients with chronic diseases, ensuring that treatment remains both accessible and affordable to the population .
Collaborations and Public Health Campaigns:
Dr. Phaahla also discussed key collaborations with various sectors to promote healthier living habits. One notable initiative is the memorandum of understanding (MoU) with parkrun South Africa, which encourages communities to engage in regular physical activities like walking, jogging, or running over the weekends. This collaboration aims to combat physical inactivity, one of the leading risk factors for diabetes and other lifestyle diseases .
Beyond physical activity, the government has introduced several regulatory interventions, such as taxes on sugar-sweetened beverages, aimed at reducing excessive consumption of sugar, a known contributor to obesity and diabetes. Additionally, regulations are in place to control trans-fats in food, lower sodium levels in processed foods, and reduce salt intake to mitigate the risk of hypertension, which is closely linked to cardiovascular diseases, another leading cause of death .
Health Promotion Levy and Challenges:
Phaahla acknowledged the need for more proactive use of the Health Promotion Levy (sugar tax), which collects around R2 billion annually. However, only a small fraction of this fund is allocated to the Department of Health. Dr. Phaahla urged for better use of these funds to support the department’s work in tackling NCDs and to assist non-governmental organizations (NGOs) involved in public health efforts .
While progress has been made, there are still areas where improvement is needed. Food safety remains a concern, particularly in small outlets like spaza shops, which serve school children and low-income households. The Department of Health is collaborating with other government agencies to ensure better monitoring of these food outlets and prevent incidents of food poisoning .

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