Undiagnosed and uncontrolled diabetes is a major public health burden in South Africa (SA) and across the world, but new global and South African targets have provided a framework for strengthening the diabetes response in SA.
Dr Patrick Ngassa Piotie, Chairperson of the Diabetes Alliance, says, “With collaboration, implementation and monitoring and evaluation of these targets in health facilities, we may be able to thwart the growing diabetes crisis in SA. Diabetes is the second deadliest condition in SA and some 4.5-million South Africans have diabetes.”
On 28 May 2022, the World Health Organization (WHO) announced five new targets to strengthen and monitor diabetes responses within non-communicable disease (NCD) programmes. South Africa strongly supported the adoption of these targets. A few days later, the SA National Department of Health launched the National Strategic Plan (NSP) for the Prevention and Control of NCDs which includes diabetes targets. Diabetes is an NCD, and high blood pressure often occurs alongside diabetes.
Dr Ngassa Piotie says, “This was a historic week for the global fight against diabetes and a significant moment for the prevention and management of diabetes in SA. Both targets are geared to reducing the risk of diabetes and helping to ensure that those diagnosed with diabetes have access to affordable, quality treatment and care.”
The five new WHO targets for diabetes are that by 2030:
80% of people living with diabetes are diagnosed,
80% have good blood sugar control,
80% of people with diagnosed diabetes have good control of blood pressure,
60% of people with diabetes of 40 years or older receive statins and
100% of people with type 1 diabetes have access to affordable insulin and blood glucose self-monitoring.
“The Diabetes Alliance welcomes South Africa’s support for the WHO targets,” says Dr Ngassa Piotie. “We are also relieved that the National Strategic Plan for NCDs for the period 2022-2027 has finally been launched. The previous NSP lapsed in 2017. NCDs are currently the leading cause of death and disability in South Africa and the consequences of inaction will be catastrophic.”
The NSP for NCDs proposes a 90-60-50 cascade as the first step to improving early detection and treatment of NCDs, namely that:
90% of all people over 18 will know whether or not they have raised blood pressure and/or raised blood glucose,
60% of people with raised blood pressure or blood glucose will receive intervention, and
50% of people receiving interventions are controlled.
“A mammoth task lies ahead to ensure that 90% of all people over 18 know that they have raised blood glucose and/or blood pressure,” explains Dr Ngassa Piotie. “Implementation of the NSP for NCDs in every hospital and clinic across the country will see us take a giant step forward in preventing and managing diabetes. It will also see SA support the WHO target of ensuring that 80% of people living with diabetes in South Africa are diagnosed.”
The provincial departments of health will be responsible for implementation of the NSP for NCDs through the district health system and the National Department of Health will provide oversight.
“The Diabetes Alliance is ready to collaborate with all stakeholders – people living with diabetes and other NCDs, civil society organisations, government departments, the private sector including funders, development partners, and education and research institutions,” says Dr Ngassa Piotie.
“We are also ready to help raise awareness about the risk factors for diabetes, diabetes complications and other NCDs that the NSP outlines. These include tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. We aim to inform South Africans living with diabetes of the importance of the NSP and the role they can play individually to contribute to the achievement of these national targets,” he adds.
“As we work towards implementing the NSP, one key priority will be to establish strong monitoring and evaluation systems that will allow us to track the progress made towards reaching the targets.”
