This is what’s killing South Africans – and future diseases to watch out for

 ·5 Apr 2019

The Institute for Health Metrics and Evaluation (IHME) in association with the World Health Organisation and the Bill and Melinda Gates Foundation has published a new study on the Global Burden of Diseases.

The study is a statistical analysis of the state of global health, tracking life expectancy, deaths and disabilities, causes of death and disability, and various interventions being adopted to combat known health issues.

It uses the latest available global data set, which covers 2017.

“Globally, in 2017, life expectancy was 73 years, but healthy life expectancy was only 63 years. This means on average 10 years of life were spent in poor health in 2017,” the group said.

“Trends in early death and disability, show a 41% decrease in communicable diseases and neonatal disorders, and a 40% increase in non-communicable diseases.”

According to the researchers, the leading causes of death have changed significantly since the 90s, with heart disease surpassing the communicable and neonatal diseases that dominated the top spots near the end of the 20th century.

Between 1990 and 2017, early death from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders dropped, with the greatest declines in the least developed countries.

Progress has also been made in reducing mortality from some common diseases, which have stalled or reversed, primarily for non-communicable diseases such as cardiovascular diseases and cancers.

However, an unintended consequence of greater access to health care globally is increases in mortality from diseases and disorders linked to antibiotic resistance, the researchers noted.

Improvement in healthcare does not necessarily lead to improvement in health either.

“Medications that prevent deaths from cardiovascular diseases, such as those that lower blood pressure and cholesterol, are among the most cost-effective interventions available to health systems.

“Despite this, mortality from cardiovascular diseases has increased since 2007 worldwide,” the researchers said.

Future killers

As part of the report, the IHME also provided a forward projection of what types of diseases are most likely to be the leading causes of death in the next 20 years.

The profile does not change too much, with heart disease and and respiratory infections still seen as the biggest risks – though chronic lung diseases (Chronic Obstructive Pulmonary Disease – COPD) is seen to be a growing problem.

Diabetes, which has already been identified as a growing issue in South Africa and the world is projected to be cemented as a leading killer of the next two decades, with Alzheimers, kidney diseases and cancers also set to climb.

With strides being made in HIV treatments, the disease will likely drop down the list – but the researchers warned that complacency would undo much of this work.

“There is significant risk that the progress made in slowing the HIV epidemic could be reversed without a continued robust investment in health. This could, in turn, threaten recent gains
in life expectancy in eastern and southern Africa,” they said.

“The future is not pre-ordained; the potential is large, in all countries, to alter the trajectory of health through reducing exposure to key risk factors and increasing educational attainment and income per person.”

South Africa’s killer diseases

The latest statistics from South Africa on causes of death was published in 2018, covering 2016 data, and reflects similar patterns.

Overall, the cause of death in South Africa is largely due to what is categorised as natural causes, which account for 88.8% of all deaths. The other 11.2% of deaths were non-natural causes.

For the first time since 1997, diseases of the circulatory system were the top ranking underlying main group of natural causes of death.

Generally, non-communicable diseases accounted for 57.4% of deaths while communicable diseases were responsible for 31.3% of deaths.

Contrary to global trends, where its position has dropped, Tuberculosis maintains its rank as the leading cause of death in South Africa, albeit with declining proportions, while diabetes accounted for 5.5% – up marginally from previous data.

These two big killers were followed by other forms of heart disease and cerebrovascular diseases, which both ranked third place at 5.1% each.

HIV moved up from the sixth position and remained as the fifth biggest killer in the country. Globally, HIV has also climbed up the list since the 90s.

Cause of death Rank Number Percentage
Tuberculosis 1 29 513 6.5%
Diabetes mellitus 2 25 255 5.5%
Other forms of heart disease 3 23 515 5.1%
Cerebrovascular disease 4 23 137 5.1%
Human immunodeficiency virus 5 21 830 4.8%
Hypertensive disease 6 19 960 4.4%
Influenza and pneumonia 7 19 638 4.3%
Other viral diseases 8 16 577 3.6%
Ischaemic heart disease 9 12 883 2.8%
Chronic lower respiratory disease 10 12 659 2.8%
Other natural causes   200 403 43.9%
Non-natural causes   51 242 11.2%
All causes 456 612 100.0%

Read: The 26 diseases that every South African medical scheme has to cover by law

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