Common use of Increasing Life Expectancy Clause in Contracts

Increasing Life Expectancy. South Africa’s life expectancy is affected by communicable diseases such as HIV, TB, malaria, respiratory infections and diarrhoeal diseases; high maternal and child mortality; increasing levels of non-communicable diseases such as hypertension, diabetes, cancer and cardio vascular diseases; as well as trauma related injuries. Maternal and child health and HIV and TB will be covered by outputs 2 and 3 and this section will address outputs on increasing life expectancy through non- communicable diseases, trauma related injuries and communicable diseases that are not part of HIV, AIDS and TB. Malaria has contributed to reduction in life expectancy and more than 1 million deaths per annum associated with malaria occur in Africa and most are children under 5 years of age. Malaria constitutes a major barrier to social and economic development in the region and is mainly transmitted along the border areas of South Africa. Three of the nine provinces of South Africa, namely: Limpopo, Mpumalanga and KwaZulu-Natal are endemic for malaria and 10% of the population (approximately 4.9 million persons) is at risk of contracting the disease. Malaria cases in South Africa have been steadily declining over the past 9 years. Between 2000 and 2008, morbidity was reduced by 88% (64,622 and 7796 cases respectively) and mortality by 90% (458 and 46 deaths respectively). Both morbidity and mortality as a result of malaria can be reduced further over the next few years. The country has the capacity to move towards malaria elimination. Globalisation has contributed to increased international travel and trade, and the emergence and re-emergence of international communicable disease threats. These threats call for epidemic preparedness and the effective implementation of the International Health Regulations (IHRs). In terms of the IHRs, South Africa is required to develop minimum core public health capacities, and to develop, strengthen and maintain these by July 2012. Non-communicable diseases contributed 28% of the total burden of disease measured by disability-adjusted life years in 2004. Cardiovascular diseases, diabetes mellitus, respiratory diseases and cancers contributed 12% of the overall burden while around 20% of all mortality is due to non-communicable diseases. The prevalence of mental disorders has been found to be 17%. The burden from Non- Communicable Diseases (NCDs) is two to three times higher than that in developed countries. According to Statistics South Africa, non-natural deaths accounted for 9% of all deaths and 44% of deaths in the 15-19 year age group in 2007. More than half of women and three quarters of men requiring some intervention for hypertension and diabetes do not even know that they are suffering from these conditions (NIDS 2009). Only 14% of cases of high blood pressure reflect good management of the condition. Late detection results in increased costs and unnecessary suffering and possible death. Prevention, screening and early detection and effective management will improve life expectancy. The contribution of violence and injuries to the burden of diseases declined from 17% in 1997 to 9% in 2005. However, this drop may be related to an increase in natural causes rather than drop in injuries. Intersectoral interventions to address the violence and injuries will be developed and implemented.

Increasing Life Expectancy. South Africa’s life expectancy is adversely affected by communicable diseases such as HIV, TB, malaria, respiratory infections and diarrhoeal diseases; high maternal and child mortality; increasing levels of non-communicable diseases such as hypertension, diabetes, cancer and cardio vascular diseases; as well as violence and trauma related injuries. Maternal and child health and HIV and TB will be covered by outputs 2 and 3 and this section will address outputs on increasing life expectancy through non- non-communicable diseases, trauma related injuries and communicable diseases that are not part of HIV, AIDS and TB. Malaria has contributed continues to contribute to reduction in life expectancy and more than 1 million deaths per annum associated with malaria occur in Africa and most are Africa. Most of these deaths occur among children under 5 years of age. Malaria In Sub-Saharan Africa, malaria constitutes a major barrier to social and economic development in the region and development. In South Africa, malaria is mainly transmitted along the border areas of South Africashared with Mozambique, Swaziland and Zimbabwe. Three of the nine provinces of South Africa, namely: Limpopo, Mpumalanga and KwaZulu-Natal are endemic for malaria and 10% of the population (approximately 4.9 million persons) is are at risk of contracting the disease. Malaria cases in South Africa have been steadily declining over the past 9 years. Between 2000 and 2008, malaria-related morbidity was reduced by 88% (from 64,622 and 7796 to 7,796 cases respectivelyfor the respective years) and mortality by 90% (from 458 and to 46 deaths respectively). Both morbidity and mortality as a result of malaria can be reduced further over the next few years. The country has the capacity to move towards complete malaria eliminationeradication. Globalisation has contributed to increased international travel and trade, and the emergence and re-emergence of international communicable disease threats. These threats call for epidemic preparedness and the effective implementation of the International Health Regulations (IHRs). In terms of the IHRs, South Africa is required to develop minimum core public health capacities, and to develop, strengthen and maintain these by July 2012. Non-communicable diseases contributed 28% of the total burden of disease measured by disability-adjusted life years in 2004. Cardiovascular diseases, diabetes mellitus, respiratory diseases and cancers contributed 12% of the overall burden while around 20% of all mortality is due to non-communicable diseases. The prevalence of mental disorders has been found to be 17%. The burden from Non- Communicable Diseases (NCDs) is two to three times higher than that in developed countries. According to Statistics South Africa, non-natural deaths accounted for 9% of all deaths and 44% of deaths in the 15-15 – 19 year age group in 2007. More than half of women and three quarters of men requiring some intervention for hypertension and diabetes do not even know that they are suffering from these conditions (NIDS 2009). Only 14% of cases of high blood pressure reflect good management of the condition. Late detection results in increased costs and unnecessary suffering and possible increased risk of death. PreventionTo redress this, the Department of Health will direct greater effort and resources towards prevention, screening and early detection and effective management will to improve life expectancyexpectancy and quality of life. The contribution of violence and injuries to the burden of diseases declined from 17% in 1997 to 9% in 2005. However, this drop may be related to an increase in natural causes rather than drop in injuries. Intersectoral interventions to address the violence and injuries will be developed and implemented.