Well, she was 100% correct. Not only because you really don’t want to face long term treatment for HIV or diabetes, or experience any sort of violence or trauma or have problems as a result of being pregnant or being born, but because the costs of treatment and care takes money away from other priorities such as food, work, and shelter.
There are four main disease burdens in South Africa which can cause death but all can be reduced by prevention. These are infectious diseases such as HIV and tuberculosis; non-communicable diseases, such as cancer, hypertension and diabetes; violence and trauma; and mother and childhood conditions including those that occur during pregnancy and childbirth.
The National Health Insurance (NHI) policy is a new plan that government is putting in place to make healthcare and treatment easier to get and affordable to everyone in South Africa. But, for the NHI to be successful, we need to reduce the amount of disease.
To reduce the massive financial burden, we need to do more to prevent people from getting sick in the first place. We must ask questions such as: “Is it better to treat lung cancer or to reduce the numbers of people smoking?” or “Does it make sense to vaccinate young girls against Human Papilloma Virus (HPV) rather than treat the cervical cancer that it causes in later life?” The answer is better to prevent disease than to cure or treat it.
So what can we do to stop ourselves and others from getting sick? Exercising and changing the way we eat, drink sugary beverages and consume too much alcohol is critical to preventing non-communicable diseases such as heart attacks, strokes, diabetes, obesity and hypertension.
But this is often hard to do in the face of relentless marketing and persuasive advertising campaigns by tobacco, sugary beverages, alcohol and fast food industries who push us into consuming their products. In addition, social and economic realities can make it difficult to eat healthier food or exercise more. We need to set channels to facilitate ways in which people can make healthier choices.
Putting in place measures to keep people healthy and prevent them from getting sick is known as health promotion.
According to the World Health Organisation, health promotion is “the process of enabling people to increase control over, and to improve, their health”. In addition, “it moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions” to address the root causes. These include poverty, poor education, lack of electricity, unemployment, gender issues, violence and limited access to water, healthy food and safe spaces to exercise.
An example of successful health promotion initiatives in South Africa are the banning of tobacco advertising, promotion and sponsorship and increasing the price of tobacco. Together, these initiatives have reduced the percentage of smokers by 50% over two decades and is decreasing the number of people affected by tobacco-related diseases such as lung cancer.
Health promotion focuses on all these issues to educate the public to think differently about health and to change their behaviour to make healthier choices. But people cannot do this alone. Government needs to put in place health promotion policies which support the prevention of disease.
* Simmonds is the programme manager at the National Council Against Smoking, a member of the Health Promotion Development Foundation.