Civil society organisations are intensifying calls for President Cyril Ramaphosa to declare diabetes a public health emergency, citing the need for urgent government intervention and resources to prevent the growing number of deaths caused by the disease.
Up to 350 stakeholders, including academics, civil society organisations, industry representatives, and government officials, presented a unified front this week at the Diabetes Summit, demanding immediate action on what they describe as a spiralling health crisis.
According to Summit convener and Diabetes Alliance chair Dr Patrick Ngassa Piotie, diabetes is a leading cause of death and poses a heavy burden on the country’s already stretched public health system.
“Currently, the Department of Health has very few people able to dedicate their working time to diabetes. An emergency declaration would mobilise dedicated human and financial resources while putting society on notice that business as usual is no longer acceptable,” he says.
The toll keeps rising
It’s estimated that between 4.2 and 4.6 million people in South Africa have diabetes, and the numbers are expected to rise if there is no intervention. The country is currently seeing an alarming intersection between the disease and other noncommunicable diseases like cardiovascular disease, hypertension and obesity. The rise of diabetes among people living with HIV adds to the complexity of dealing with the disease.
Pholo Ramothwala, founder of Live Life Beyond, a forum supporting people with chronic conditions, went from taking two tablets a day to eight when he was also diagnosed with type 2 diabetes about three years ago.
Ramothwala, who has been living with HIV for 26 years, has developed high cholesterol and hypertension because of long-term medication use.
He explains that his doctor cautioned that one of the side effects of taking both HIV and diabetes medication would be a spike in his cholesterol levels – a reality he still tries to make sense of.
“It is one of the most confusing things. The idea is that once you take medication, you get better. But technically, you get better from one side, and you develop something else,” he says.
After more than two decades of living with HIV, managing diabetes has been more challenging for him because of the blood sugar spikes.
“People need to literally pay attention to everything they are eating, think before they eat, and understand what they are eating. The day before the Diabetes Summit, I woke up feeling dizzy, and it was one of those difficult days where I could literally feel my body reacting to blood sugar spikes,” he tells Health-e News.
Ngassa Piotie explains that Ramothwala’s experience has become a common phenomenon for long-term HIV survivors.
The country’s large population of people who survived the HIV crisis in the 2000s are now in their 40s, 50s, and 60s and are developing diabetes.
“One of the HIV treatments, unfortunately, has a side-effect that can create diabetes in an individual down the line. We also know that even if you are not living with HIV, the more you age, the more your risk of diabetes increases,” says Piotie.
Push for stronger nutrition policy
Nzama Mbalati, Chief Executive Officer of the Healthy Living Alliance (HEALA), says prevention of the rising diabetes and other NCD-related deaths through nutrition has become more urgent than before.
“HEALA has been talking about the cost of inaction for years, and in 10-15 years, if nothing is done, there will be a bigger problem in NCDs. There is a greater need to look at how to support people to eat healthy, driving nutrition literacy and building networks and ecosystems,” says Mbalati.
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Grassroots mobilisation
The Diabetes Alliance intends to adopt a grassroots approach to diabetes management, modelling it after the successful Treatment Action Campaign (TAC) adherence programmes.
Ngassa Piotie argues that grassroots movements, where people are empowered at community level to care for themselves, providing education, peer support, tools and skills to live healthy and long with diabetes, are needed.
Mbalati adds that HEALA will be implementing groundwork in provinces including Limpopo, Eastern Cape, Gauteng, KZN, and Western Cape, piloting mobilisation, treatment literacy, nutrition literacy, and building a large-scale education campaign and social mobilisation.
“We will continue advocating for front-of-pack labelling, the health promotion levy, marketing restrictions to children, and ensuring the National School Nutrition Programme provides nutritious food,” he says.
Ramathwala encourages people to take charge of their health and well-being by screening regularly and paying attention to their diets. “You cannot delegate your health responsibilities to somebody else,” he adds. – Health-e News
