Non-communicable diseases (NCDs) contribute significantly to the global burden of disease,
particularly in low to middle income countries where almost three-quarters of all NCD deaths
and the majority of premature NCD deaths occur.
1 NCDs include any medical condition or
disease that is non-infectious, however four groups of NCDs account for 82% of all NCD
deaths globally. These four groups are cardiovascular diseases (including cerebrovascular
disease), cancers, chronic respiratory diseases and diabetes. The terms NCD and chronic
disease are often used interchangeably, however in some instances reference to a chronic
disease may include HIV. Other NCDs include mental health and injuries, however for the
purposes of this report, only the four major NCD groups will be discussed. Mental health has
been addressed in a previous edition and an update of the burden of disease relating to
injuries will form part of future work.
In 2007, the Western Cape Burden of Disease Reduction project was undertaken.2 The overall
aim of the project was to advise on how to reduce the burden of disease and promote
equity in health in the Western Cape Province. Expert groups were identified for five major
disease categories. Of these expert groups, the cardiovascular workgroup conducted a
review of cardiovascular disease mortality. At the time, it was appreciated that NCDs
accounted for a much larger proportion of deaths in the Western Cape than nationally. This
trend has persisted over the years with current estimates indicating that NCDs account for
38.9% of all deaths nationally 3 and 61% in the Western Cape.
4
The function of the cardiovascular workgroup was an initial review of epidemiological data
pertaining to cardiovascular disease morbidity and mortality including the contribution of
cardiovascular risk factors. This was followed by a review of existing interventions targeting
cardiovascular disease and the compilation of a number of recommendations to reduce
cardiovascular disease burden in the province. The specific focus was on upstream
interventions, addressing lifestyle factors such as diet, physical activity and alcohol and
tobacco use. While the workgroup concentrated their efforts on cardiovascular disease, the
risk factors addressed are common to the four major NCD groups.
This report forms part of the work of the Epidemiology and Surveillance sub-directorate of the
Health Impact Assessment Unit to provide an update on NCD burden in the Western Cape.
Aim
The overall aim of the project is to provide an update on the burden of NCDs in the Western
Cape using the 2007 Burden of Disease Reduction Project as a reference point.
2
Objectives
The specific objectives are:
 To present current epidemiological data pertaining to NCDs and their risk factors in
the Western Cape
 To summarise the recommendations made by the cardiovascular workgroup of the
Burden of Disease Reduction Project in 2007 and evaluate the extent to which they
have been actioned
 To highlight current interventions including upstream and service-level or downstream
interventions not specifically recommended by the cardiovascular workgroup aimed
at reducing NCD burden of disease
 To propose recommendations for future intervention
Methods
The project was carried out by multiple iterations of desktop document review and key
informant discussions. Epidemiological data was obtained from provincial reports, research
reports, national surveys with provincial-level profiles and routine data. Information about
interventions was obtained from discussions with key informants.