South Africa’s health burden is undergoing a major shift. Non-communicable diseases (NCDs) such as diabetes, hypertension and heart disease are now the leading cause of death, according to the latest global and local data.
While infectious diseases remain a concern, the fastest-growing risks are tied to everyday behaviours, including poor diet, inactivity, smoking and delayed detection.
Health experts say this requires a fundamental rethink of how care is delivered, with greater focus on prevention rather than treatment.
A growing, largely hidden risk
Lifestyle-related conditions are widespread and often undiagnosed.
More than 2.3 million South African adults are living with diabetes, many without knowing it. Hypertension affects roughly one in three adults, yet control rates remain low.
Obesity is a key driver, with around 30% of adults affected, significantly increasing the risk of chronic illness.
Damian McHugh, chief marketing officer at Momentum Health, says much of this risk develops long before people enter the healthcare system.
A “wellness-first” approach, he argues, means identifying risk earlier and supporting healthier daily choices before conditions become clinical problems.
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The economic and public health cost
The rise in chronic disease is also weighing on the economy and healthcare system.
Lost productivity, rising treatment costs and reduced workforce participation are all increasing. However, prevention-led policies are showing results.
South Africa’s salt reduction regulations, for example, have led to measurable declines in sodium intake and improvements in blood pressure levels.
McHugh notes that prevention is not just a health issue but an economic one — with long-term benefits for both individuals and the broader system.
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Why prevention needs to start earlier
Emerging research shows that health risks in early adulthood have lasting consequences.
High blood pressure, excess weight, smoking and inactivity in people’s 30s and 40s are linked not only to heart disease, but also to a higher risk of cognitive decline later in life.
“Prevention isn’t only about avoiding illness now,” McHugh says. “It’s about protecting quality of life over decades — including how people think, work and function as they age.”
Technology is reshaping prevention
Digital health tools are increasingly enabling earlier and more consistent care.
Telemedicine, remote monitoring and data-driven screening are helping identify risk sooner and support ongoing management of chronic conditions.
McHugh says technology allows care to become more proactive, shifting from episodic treatment to continuous support, while still recognising that health journeys differ from person to person.
Closing the gap between awareness and action
While awareness of lifestyle risks is growing, sustained behaviour change remains difficult.
McHugh highlights four practical interventions that can make a measurable difference:
- Know your numbers: Regular screening for blood pressure, glucose and waist circumference
- Move more: At least 150 minutes of moderate activity per week
- Reduce salt: Keep intake below five grams per day
- Avoid tobacco: Quit smoking and limit exposure
“These are small actions, but their cumulative impact is significant,” he says, adding that consistency, supported by incentives and structured programmes, is key.
The bottom line
South Africa’s disease profile has changed and its response must follow.
For McHugh, the solution lies in embedding prevention into everyday life, not treating it as an afterthought.
“Prevention has to fit into how people live,” he says. “If we want to change the future of chronic disease, wellness needs to be part of daily life — not something people only think about when they are already unwell.”
