This article will talk about the problem of non-communicable disease (NCD’s) in developing countries in general and in South Africa. As my Master thesis was dealing mainly with the topic of NCDs and nutrition I was able to gain some valuable insights into this area and would like to share some facts and thoughts.

NCDs – What are they again?

First, let me start with some facts. Non-communicable diseases, or chronic diseases, are best described as not be able to spread from one person to another. Cancer, diabetes, pulmonary diseases, and cardio vascular conditions count under this category. They also share the same risk factors mostly related to an unhealthy lifestyle.

So if you think about the mentioned chronic diseases you might associate those with overweighed Westerners who live a luxury life and can therefore afford an unhealthy lifestyle. However, deaths from NCD’s are most prevalent in developing countries. As the WHO states in its report on NCDs from 2014 “Almost three quarters of all NCD deaths (28 million), and 82% of the 16 million premature deaths, occur in low- and middle-income countries”. 1

For me when I learned about this number I was astonished. I knew that NCDs are on the raise in developing countries but I did not expect such a high number. Though, it is not surprising that there is little public awareness about this issue, as NCD’s are still standing in the shadow of the big infectious or communicable diseases – HIV, Malaria and Tuberculosis. Yet deaths due to infectious diseases are slowly but surely being overtaken by those related to NCD’s. 2

South Africa, an upper middle income country with a poor population

Latest since the Fifa World Cup took place in South Africa in 2010 the country is seen as a flourishing and growing country which attracts a lot of tourists. However, even though nowadays South Africa is categorized as an upper middle income country, the gap between rich and poor is constantly growing. 3 As a consequence poor people in the country are still facing the same issues that occur in low income countries, which also means they are facing a raising prevalence of NCDs. 4

NCD’s in the Western Cape region of South Africa – a highly complex issue

It is estimated that NCDs are responsible for 38% of all deaths in South Africa. 5 One of the provinces of South Africa where NCDs account for a substantial proportion of deaths is the Western Cape (WC) region. Here, even 58% of deaths are attributed to NCDs.

Modifiable behavioural risk factors, such as an unhealthy diet, physical inactivity as well as alcohol and tobacco use are causing most NCDs and were found to be a highly relevant health problem in the Western Cape region. One of these risk factors is malnutrition which is a very complex issue. On the one hand a lack of food security has resulted in underweight of mainly young children. 6, on the other hand obesity is prevalent in older children and adults as energy dense diets are increasingly available and often accompanied by an inactive lifestyle.

During my research I tried to develop educational programmes related to a healthy lifestyle for adolescence and adults, whereas my colleagues tackled the topic of children’s undernutrition. But looking at the scale of the NCD epidemic much more work, willingness and resources are needed to overcome avoidable deaths from NCD’s.

  2. The World Bank (2013). South Africa. Retrieved 20th of June 2013, from
  3. World Health Organisation. (2010). Global status report on noncommunicable diseases. Geneva.
  4. Bradshaw D, Nannan N, Laubscher R, Groenewald P, Joubert J, Nojilana B, …, Schneider M (2006). South African National Burden of Disease Study 2000. Estimates of provincial mortality. Cape Town: MRC
  5. Kahn K (2011). Population health in South Africa: Dynamics over the past two decades. Journal of Public Health Policy, 32(Suppl. 1): 30-36.
  6. Kimani-Murage EW, Kahn K, Pettifor JM, Tollman SM, Dunger DB, Gómez-Olivé XF & Norris SA (2010) The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children. BMC Public Health, 10:158.