Epidemic increase in chronic non-communicable diseases (CNCDs) is resulting in immense challenges in developing
countries such as South Africa. Previously misunderstood to affect only high-income countries, 80% deaths due
to CNCDs occur in developing countries. This review article traces the path of health promotion in the Eastern
Cape and South Africa while considering health promotion developments globally. An example is the HealthPromoting
school initiative in 180 schools in the Eastern Cape Province based on the World Health Organization’s
Health-Promoting School Initiative. Alma Ata’s holistic ‘health for all’ ideals, the WHO’s ‘Right to health’ along
with South Africa’s Bill of Rights have remained important paper based progress. However partial implementation
of certain policies and lack of implementation of most broad based health promotion is a major challenge in
South Africa which has to be addressed urgently to reverse the advancing CNCD epidemic. Keeping healthy
population healthy and training them to prevent CNCDs to the maximum possible extent is feasible by strategically
focusing on Health promoting schools in South Africa. Community participation, women’s organizations and
youth participation are critical in implementing Health promoting schools in South Africa while being supported
by the intersect oral cooperation of key stakeholders in the Department of Health, Department of Education and
community engagement services of Universities.