Over the past decade, the number of deaths in South Africa has increased at an alarming rate
and, facing a quadruple burden of disease, the health system is under severe pressure to meet
the care demands of ill-health that leads to these deaths. Updating knowledge and an on-going
understanding of the country’s burden of disease and injury are fundamental to health
planning and decision-making. Such information should enable government, both at a
national and provincial level, to act in a manner that begins to address and reduce the disease
burden, and allocate resources more appropriately in resource-constrained settings instead of
being reactive to the pressures placed upon the health system. Information about the trends in
mortality provide the first step in comprehensively understanding the burden of disease,
which ideally includes the extent of the loss of health resulting from the non-fatal effects of
illness and injury. Furthermore, reliable and comparable assessments of the impact of
modifiable health risks, as well as information about cost-effectiveness of interventions, are
also needed to identify relevant prevention and health promotion activities.
In South Africa, the first national burden of disease study conducted in 2000 was an important
resource for government, non-governmental organisations (NGOs) and the public for guiding
health and resource priorities (Bradshaw et al, 2003, Bradshaw et al, 2005, Norman et al,
2007). Adopting the burden of disease approach developed by Murray and Lopez (1996), it
has earned wide appreciation among local health researchers and has been used extensively to
inform health sector reviews (e.g. Chopra et al, 2009). To assist national and provincial
governments to pro-actively address and reduce ill-health and its risks, and to assist in
measuring progress towards selected Millennium Development Goals (MDGs), the second
National Burden of Disease Study (SA NBD 2) was performed.