Authored by: Volker von Widdern, The Institute of Risk Management South Africa (IRMSA) Risk Intelligence Committee Member
It is possible that the increasing prevalence of diabetes in South Africa may become an even greater challenge than the HIV epidemic.
The development of anti-retro viral clinical responses to HIV have substantially reduced exposure to HIV, but it does not appear that similar clinical advances can be achieved in the next 10 years to mitigate the impacts of diabetes.
Since human resources are usually the highest priority and cost factor in most organisations, the consequential impact of diabetes on the productivity and development or retention of intellectual property, will face significant risks.
The increasing prevalence of diabetes in South Africa is unfortunately another outcome of the high levels of polarisation in our population. Eating patterns and increasing urbanisation are accelerating the prevalence of diabetes, and these social drivers are a reflection of our high levels of unemployment.
Should employers invest in strategies that reduce employee exposure to diabetes? It can be argued that such investments have no reliable return because employees can easily move to other businesses.
However, it is also true that well aligned and productive employees are by far the most differentiated source of company performance.
What could the scenarios be if no investment is made in reducing the prevalence of diabetes? It is then likely that employee turnover will increase and there will be an artificial demand for employees that have less risk or exposure to diabetes.
There are several research articles that demonstrate the sharp increase and high prevalence of diabetes in SA, and one example from which a short extract is shown below, is:
The prevalence of type 2 diabetes in South Africa: a systematic review protocol
Carmen Pheiffer, Victoria Pillay-van Wyk, Jané D Joubert, Naomi Levitt, Mweete D Nglazi, Debbie Bradshaw
“The prevalence of diabetes is rapidly increasing in South Africa. In 2009, approximately 2 million (9%) people aged 30 years and older had diabetes, increasing almost twofold since 2000 when Bradshaw et al reported a prevalence of 5.5%.
Several factors such as the ageing population, economic transition and urbanisation associated with nutrition transition and obesity have contributed to the increased diabetes prevalence.
In 2000, it was estimated that 87% of diabetes cases in South Africa were attributed to excess body weight.
This is concerning since in 2013 ~38% of men and ~69% of women in South Africa were considered overweight or obese.
In 2015, the global burden of disease study estimated that high body mass index and hyperglycaemia, ranked as the second and third leading risk factors, respectively, after unsafe sex, for early death and disability in South Africa.
Diabetes, due to its association with several microvascular and macrovascular complications, places a significant burden on the South African health system.
In 2009, it was estimated that diabetes caused about 8000 new cases of blindness and 2000 new cases of amputations annually.
A national burden of disease study in 2000 reported that diabetes accounted for approximately 14% of cases of ischaemic heart disease, 10% of stroke, 12% of hypertensive disease and 12% of renal disease.
Furthermore, the indirect costs of diabetes are high. Diabetes in Africa affect mainly working-aged people between 40 and 60 years of age placing an added burden on the economy due to work absenteeism and decreased productivity.
South Africa is battling a quadruple burden of disease due to high rates of infectious diseases, non-communicable disease, maternal and child mortality, and injury-related disorders, thus have limited resources to meet the increased health and economic costs of diabetes.”
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