'Get healthy - or else'
Health Minister Aaron Motsoaledi has warned South Africans will face harsh health laws if they do not become healthier.
Motsoaledi, in an interview with The Times, cautioned that lifestyle diseases are placing a huge burden on public healthcare.
He said that unless South Africans, and even citizens across the world, change their unhealthy lifestyles, within "a decade or two, global healthcare costs will spiral out of control".
The Council for Medical Schemes has estimated that medical schemes spend at least R8-billion a year - or R670-million per month - treating diseases including hypertension, cardiac failure, type 2 diabetes and hyperlipidaemia (obesity).
Motsoaledi is ready to take on big business to cut down the cost of heart disease, strokes, diabetes and some cancers.
"South Africa is set to overtake the US in terms of obesity," according to Wits School of Public Health professor Karen Hofman, who is conducting a study into the costs of treating lifestyle diseases.
Hofman said chronic diseases are causing the same cycle of poverty as Aids deaths because breadwinners are disabled or die, resulting in families being headed by children.
"People in South Africa are undiagnosed, untreated and dying prematurely from chronic diseases such as high blood pressure, strokes and diabetes."
She said the poor were also contracting lifestyle diseases, with 25% of rural teenagers overweight or obese.
"In South Africa, people are getting lifestyles diseases in their 40s and 50s, instead of getting them in their 60s and 70s, which is happening in the developed world," she said.
But Motsoaledi - who in recent months has drawn the ire of the alcohol industry and smokers with his plans to stop smoking in public spaces and ban alcohol advertising - said South Africans were not serious about their health and the cost implications.
Non-communicable diseases or lifestyle diseases, are expected to "account for 69% of global deaths by 2030", according to a statement issued last year by the Health Department.
In recent months, Motsoaledi has targeted salt content in food, alcohol advertising and tobacco companies. And sugar and junk food are next on his agenda.
But, said Motsoaledi: "The present regulations are a school picnic. We are going to hit smokers hard."
Motsoaledi said he was watching a lawsuit in Australia in which tobacco companies were suing the government and the health minister for passing a law that forces them to sell cigarettes in plain packaging instead of branded covers.
"If [the Australian health minster] wins, I am going to follow her [example]," he vowed.
Two weeks ago South Africa passed a law to force food manufacturers to reduce the amount of salt in processed food including bread, gravy, spices and margarine.
Manufactures have until June 2016 to comply.
The department's head of non-communicable diseases Professor Melvyn Freeman said reducing salt in food was the obvious thing to do.
The department also limited artificial trans fats - linked to heart disease, obesity and some cancers - to 2% in all foods in regulations published last year.
"We are certainly concerned about the food sold in school canteens; we are concerned about the amount of junk food that is being eaten and the sugar intake by South Africans," said Freeman.
According to a study published in the PLoS Medicine journal this month, South Africans consumed 254 cans of Coke per person in 2010, compared with a worldwide average of 89.
Said Hofman: "There are now two million type 2 diabetics in South Africa and the cost of offering primary healthcare to all of them and screening blood glucose levels is R3.5-billion a year before medicine is even dispensed."