Why Focus on Chronic Disease when people are dying from AIDS?

Its true, people in South Africa are dying from AIDS. South Africa has the largest number of infected people living with HIV estimated at over 5.7 million. The national prevalence rate is around 12%. Yet there is something else going on in South Africa and across the developing world that is not receiving as much attention as it should and that is the rise of Chronic Diseases. These include diabetes, cardiovascular disease, cancers and chronic respiratory diseases.

Lets look at some numbers to make a comparison. In 2005, over 35 million people worldwide died from chronic diseases.  It is the leading cause of death and disability and currently accounts for almost 60% of deaths and 43% of the global disease burden.  In the same year 2.8 million deaths were from HIV/AIDS worldwide. By 2020, it is estimated that chronic disease will account for 73% of all deaths.  Chronic disease is no longer a “Western problem.”  The reality is that four out of five chronic disease deaths occur in low and middle income countries.

Here are some facts about Diabetes:

- Today 300 million people worldwide have diabetes.
- 10,000 people die everyday from diabetes - that is double the amount of people dying 

   from AIDS
- In sub-Saharan Africa 12.1 million people are estimated to have diabetes, with only 15%

  diagnosed.
- By 2030 23.9 million adults in sub-Saharan Africa will have diabetes - more than the

   number of people that currently have HIV.

In South Africa, an epidemiological transition is taking place with a shift in disease burden from infectious diseases such as HIV and TB to chronic diseases.  With the change in eating patterns, and rural to urban migration, many of the new urban poor are now encountering a “double burden” of disease.  Not only do they continue to be susceptible to infectious disease, but with the availability of nutrient poor but calorically dense food, combined with a sedentary lifestyle, they are at increased risk for obesity and developing chronic diseases.

In South Africa, chronic diseases accounted for 28% of all deaths in 2002.  In 2005, a study showed 51% of men and 77% of women in South Africa were overweight, a major risk factor for chronic disease, predicted to increase over the next 10 years.  Between 1997 and 2004, 195 people died per day because of some form of cardiovascular disease (CVD) in South Africa.  Models suggest that by 2010 there will be over 600 deaths per day in South Africa due to chronic disease. Premature deaths caused by CVD in people of working age (35-64 years) are expected to increase by 41% between 2000 and 2030.  Diabetes in South Africa is an emerging problem particularly when prevention messaging and early detection screenings are very limited.  Many people present themselves at clinics when they are already suffering from a complication of the disease.  Access to insulin and regular blood sugar monitoring is challenging in impoverished areas.

In response to the facts, Project HOPE is taking a leading role in addressing this crisis. Since 1998 Project HOPE realised that this problem was only going to get worse and began addressing it before anyone else in providing training to healthcare professionals in China, India, Mexico, New Mexico, and now South Africa.

The HOPE Centre project, is our response to this crisis in South Africa. Please check back regularly to see how we are getting on.