RAPID urbanisation in low- and middle-income countries like South Africa is having a significant impact on health and wellbeing. By 2050, it is estimated that 70% of the world’s population will be living in towns and cities. One effect of rapid urbanisation is the growth of non-communicable diseases (NCDs). Healthcare services in growing cities are struggling, and are already swamped with ongoing challenges like infectious diseases, leaving limited time or resources to tackle NCDs like high blood pressure.

The Novartis Foundation seeks to lead the way in helping address these challenges, advocating a multidisciplinary approach to finding holistic solutions for healthy cities and communities. One way it is doing so is by convening experts for brainstorming sessions such as the recent Urban Health in Africa Dialogue event in Cape Town, hosted by the Novartis Foundation in partnership with the International Society for Urban health (ISUH), InterAcademy Partnership (IAP) – Health (IAP), International Council for Science (ICSU), Academy of Science of South Africa (ASSAf), and the University of Basel.

Delegates at the Dialogue event noted that for the first time in history, more than 50% of the world’s population lives in an urban area. In Africa in particular, the unprecedented scale and pace of urbanisation have impacted disease patterns and exacerbated critical health inequities, while posing challenges for sustainability in housing, infrastructure, basic services, food security, education, employment, safety, and natural resources, among others. In addition, they said health literacy levels may also be lower than in high-income countries, so populations are less likely to engage in health seeking behaviours.

Preventable and controllable conditions are among the world’s biggest killers, reports the World Health Organization (WHO).1 NCDs such as heart disease, diabetes and cancer are among the leading causes of death around the world – yet these diseases can be effectively treated or possibly avoided altogether. According to the WHO1, ischaemic heart disease and stroke have remained the leading causes of death globally for the past 15 years, and together, accounted for a combined 15 million deaths in 2015.

Chronic obstructive pulmonary disease claimed 3.2 million lives worldwide in 2015, while lung cancer (along with trachea and bronchus cancers) caused 1.7 million deaths. Diabetes killed 1.6 million people in 2015, up from less than 1 million in 20001.

In South Africa, NCDs are among the top ten natural causes of death, accounting for tens of thousands of deaths annually2 p29-30. According to Stats SA cerebrovascular diseases were the second leading underlying cause of death in South Africa after TB, causing 5.1% of deaths in 2014. Diabetes mellitus was next causing 5% of all deaths. Other forms of heart disease caused 4.7% of all natural deaths and hypertensive diseases accounted for 3.9% of all natural deaths.

“Greater awareness, healthier lifestyles, early intervention and effective treatment and compliance could significantly reduce the number of deaths due to NCDs,” says Dr Thomas Kowallik, CEO and Country President of Novartis South Africa.

In line with the WHO Global action plan for the prevention and control of NCDs3, Novartis notes that measures that can contribute to a longer, healthier life3 include:
1. Eat a healthy, balanced diet. Reduce your intake of salt, sugar, processed foods and unhealthy fats such as saturated fatty acids and partially hydrogenated vegetable oils, and increase your consumption of fresh fruit and vegetables – aim for more than five total servings (400 grams) of fruit and vegetables per day.
2. Maintain a healthy weight. Overweight and obesity is associated with many diet-related chronic diseases including diabetes, cardiovascular disease, stroke, hypertension and certain cancers.
3. Limit your alcohol intake. Worldwide, 3.3 million deaths every year result from harmful use of alcohol4 and alcohol is a causal factor in more than 200 disease and injury conditions, including NCDs such as cardiovascular disease and cancer.
4. Quit smoking, or don’t start smoking at all. Tobacco use, along with an unhealthy diet, physical inactivity and the harmful use of alcohol are major contributors to NCDs.
5. Exercise regularly. Aim for 30 minutes of moderate to vigorous activity a day.
6. Consult your doctor about any symptoms that do not disappear in a week, and go for regular health screenings.
7. Follow your doctor’s orders. If you are diagnosed with an NCD, carefully follow the treatment regimen and guidelines given to you by your doctor.

As part of global efforts to fight key chronic NCDs, Novartis proactively identifies partnership opportunities that will increase access to medicines addressing cardiovascular diseases, type 2 diabetes, breast cancer and respiratory illnesses to lower-middle-income countries as defined by the WHO.