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Mar 14

Understanding Kidney Health

Reuel Singh on 2025-03-14 02:00 PM

By Mandisa Dlamini (HST Communications Assistant)

The kidneys are vital organs responsible for filtering waste and excess fluid from the bloodstream, excreting them as urine. They play a crucial role in regulating blood pressure, maintaining electrolyte balance, and producing red blood cells. The proper functioning of the kidneys is essential for overall health and well-being.

Risk Factors

There are various reasons why someone might get kidney disease. Common causes are high blood pressure and type 2 diabetes, the major causes of kidney damage. Other contributing factors are family history, obesity and age.

Observable Effects

The symptoms of kidney disease are usually hidden until the disease progresses. In advanced stages, people start showing symptoms like feeling very tired, throwing up, swelling in the legs and for some people, confusion and decreased appetite. These symptoms can indicate various medical problems and so it is important to visit a doctor regularly for check-ups.

A Healthy Lifestyle and Prevention

You can avoid kidney disease by making healthy lifestyle choices. The key activities are:

Drink enough fluids: Adequate fluid intake is good for your kidneys.
Balanced Diet: A healthy balanced diet like the DASH diet can help maintain blood pressure and promote kidney health.
Regular Exercise: Engaging in regular exercise increases circulation and aids in managing body weight, blood pressure and blood glucose levels.
Body Weight: Maintaining a healthy body weight helps reduce the risk of chronic kidney disease and its complications.
Blood sugar control: Diabetes is a major cause of chronic kidney disease; therefore, it is critical for people with diabetes to monitor and control their blood sugar levels.
Control blood pressure: Blood pressure should remain in the normal range to prevent kidney damage.
Smoking cessation: Stopping smoking decreases risk for kidney disease and enhances overall health.

Identification and Treatment

Kidney disease must be identified early in order to be effectively managed. The diagnosis is typically the same: blood tests for anemia, imaging studies like an ultrasound, and urine tests for the functioning of the kidneys. These treatment strategies, either directly or indirectly, aim to manage chronic conditions through medication recommendations and lifestyle adjustments. For example, this may involve dietary changes in cases of hypertension and a reduction in physical activity levels for individuals with diabetes. However, in the late stages, dialysis or kidney transplantation may be necessary.

2025 Campaigns Supporting World Kidney Day

The International Society of Nephrology (ISN) offers an "Are Your Kidneys Healthy?" quiz designed to educate the public on health assessments, promoting both proactive and reactive approaches to raising awareness about kidney health. It is important to have knowledge of kidney health and the implementation of prevention. Regular visits to a physician, active participation in healthy initiatives and other preventive measures can help control the loss of kidney function.

For more information visit: https://www.theisn.org/initiatives/world-kidney-day/

References

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Mar 12

Glaucoma Awareness: Seeing into Your Future

Reuel Singh on 2025-03-12 01:27 PM

By Reu’el McAllister Singh (HST Communications Intern)

Glaucoma is one of the leading causes of blindness worldwide, including in South Africa. Regrettably, many individuals remain unaware of their condition until they experience vision impairment. This progressive disease develops silently, without noticeable symptoms, affecting approximately 80 million people globally.

What is Glaucoma?

Glaucoma refers to a group of eye conditions that cause a build-up of pressure in the eye, which can ultimately damage the optic nerve, leading to permanent vision loss or blindness. While it can develop for various reasons, many cases can be managed with treatment. Staying informed about the risk factors and having routine eye check-ups can help safeguard your vision.

Types of Glaucoma

Various forms of glaucoma exist, which can generally be classified into several distinct categories:

Open-Angle Glaucoma: This represents the most prevalent type. The drainage angle between the iris and cornea remains open, but the drainage system doesn’t work properly, causing fluid build-up and increasing eye pressure over time.
Angle-Closure Glaucoma: In this type, the iris blocks the drainage area, causing a sudden rise in eye pressure. This can lead to severe pain, blurred vision, and requires immediate medical attention.
Secondary Glaucoma: This occurs when another condition, such as an eye injury or certain medications, increases the eye pressure, leading to glaucoma. Conditions like diabetes or inflammation in the eye can also cause secondary glaucoma.
Congenital Glaucoma: A rare form of Glaucoma that babies are born with due to abnormal development in the eye’s drainage system during pregnancy. Early treatment is crucial to prevent permanent vision damage.

Recognising Symptoms and Risk Factors

What to Look Out for:

Gradual loss of peripheral (side) vision is often the first sign.
Blurred or hazy vision.
Eye pain or pressure.
Frequent headaches, particularly around the eyes.
Sudden vision loss (a symptom of angle-closure glaucoma requiring immediate medical attention).
Seeing rainbow-colored halos around lights, particularly when accompanied by nausea or vomiting.

Key Risk Factors to Consider:

Being over 40, with risk increasing over the age of 60.
A family history of glaucoma.
Higher prevalence in people of African or Asian descent.
Elevated eye pressure.
Medical conditions such as diabetes, high blood pressure, and heart disease.
Eye injuries or surgeries.
Long-term use of steroid medications.

Recognising these symptoms and understanding the risk factors are crucial steps toward early diagnosis and treatment. Regular eye exams are key, even if you don’t experience symptoms.

The Importance of Early Detection and Treatment for Glaucoma

Early detection through routine eye examinations are essential, as it helps identify the condition in its earliest stages before irreversible damage occurs. Comprehensive eye examinations can measure eye pressure, assess the optic nerve, and track changes in the visual field, all key factors in diagnosing glaucoma early.

Although the damage from glaucoma cannot be reversed, early diagnosis allows for treatment to slow or prevent further vision loss, helping people maintain their quality of life. Treatment typically focuses on lowering eye pressure to protect the optic nerve, with options including medicated eye drops, oral medications, laser therapy, and, in some cases, surgery. Lifestyle changes, such as maintaining a healthy diet, regular exercise, and managing underlying health conditions like diabetes and high blood pressure, can also help manage the condition effectively.

Resources and Support

The South African Glaucoma Society (SAGS) is dedicated to providing essential information and support to individuals affected by glaucoma. Additionally, SAGS collaborates with international glaucoma organisations, such as the World Glaucoma Association (WGA) and The International Agency for the Prevention of Blindness (IAPB), to raise awareness and promote research aimed at preventing vision loss.

Glaucoma is often called the "silent thief of sight" because it can progress without noticeable symptoms until significant damage has occurred. Early detection through regular eye exams is crucial in preventing irreversible vision loss. Being proactive about eye health, individuals can take the necessary steps to protect their vision and maintain quality of life.

For information on glaucoma or assistance, please visit:

South African Glaucoma Society(SAGS) website: https://www.sags.co.za/

E: webmaster@dipity.co.za

World Glaucoma Association(WGA) website: https://wga.one/

E: info@worldglaucoma.org

The International Agency for the Prevention of Blindness(IAPB) website: https://www.iapb.org/

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Mar 04

THOUGHT LEADERSHIP: This World Obesity Day, let’s advocate for a stronger Health Promotion Levy to promote and protect public health

Reuel Singh on 2025-03-04 12:55 PM

by Judith King (Health Systems Strengthening Copy and Content Editor / PhD candidate: Public Health)

In South Africa ‒ which has the highest prevalence of obesity in Africa ‒ weight-related non-communicable diseases (NCDs) have eclipsed tuberculosis (TB) and HIV as leading causes of morbidity and mortality, and conditions such as diabetes, stroke and heart disease account for three of the top four causes of death nationally.¹ Current rates of obesity in South Africa are 11% among men (with another 20.3% being overweight), and 41% among women (with another 26.6% being overweight).² This is a social and economic risk for the country.

The causal link between sugar consumption and diet-related NCDs

Consumption of the high sugar content in sugar-sweetened beverages (SSBs) ‒ while not the only cause of excess body weight and obesity ‒ is strongly linked to weight gain among adults and children in South Africa.^3,4,5 In a large prospective study conducted in 2019, such consumption was significantly associated with the risk of overall cancer and breast cancer.⁶

Liquid sugar is especially harmful, with data showing that just one sugary drink per day raises an adult's likelihood of being overweight by 27%, and that of a child's by 55%, while increasing anyone's risk of developing type 2 diabetes by 25%.^7,8 The added sugars in these drinks are rapidly absorbed by the body, and pose a significant health risk by raising blood sugar, heightening insulin production, and affecting cholesterol levels and metabolism, which can cause hypertension and inflammation, with a high potential for NCDs such as diabetes, cardiovascular disease, tooth decay, gout, liver disease, and certain cancers.

Describing sugar as a "chronic toxin", Myers, et al.⁹ provide a comprehensive view of the link between sugar consumption and diet-related NCDs, highlighting how this creates a 'poverty spiral' in which "poor health and disability lead to a labour force with diminished capacity" and in turn, slower economic growth.

Yet, as noted by the World Health Organization's Civil Society Working Group on NCDs at the 73rd World Health Assembly in 2020:

"… even in the midst of a public health emergency of international concern, companies that produce harmful products, [including] sugar-sweetened beverages, continue to spread misinformation and deny the link between the harmful effects of their products … to protect their markets."¹⁰

Changing systems for healthier lives

'Changing systems – healthier lives', as the theme for this year's World Obesity Day, signals that to curb the prevailing NCD epidemic, our focus should be trained on where 'behaviour change' begins and ends, and who and what has to change.

This stems from the idea that while individual consumers are exhorted by sugar industry actors to reduce their weight and risk of cardio-metabolic diseases by changing their lifestyle choices, it is also these corporate citizens whose profit-driven stance and aggressive marketing of unhealthy products must change. Moreover, the legal and economic structures enabling corporate profit at the expense of public health should be transformed.

The rationale for the Health Promotion Levy

NCD prevention and control cannot rely solely on public health information and education campaigns, nor on biomedical interventions alone. Obesity is a complex disease brought on and sustained by many factors which are beyond the individual's control.¹¹South Africa was the first country on the continent to recognise this by introducing the Health Promotion Levy (HPL) in 2018 ‒ an anti-obesity measure designed to reduce consumption of sugar-sweetened beverages (SSBs) by instituting a tax of approximately two cents per gram of sugar per litre, payable by the manufacturer.

Similar to the model used for regulating tobacco and alcohol consumption, sugar taxation is endorsed by the World Health Organization, and has been shown in many countries to be successful in facilitating healthier diets and saving on NCD-related healthcare costs, while generating government revenue.¹² In 2020 – apart from the associated burden on our health system – the cost of these NCDs to the South African economy via health expenditure was R33 billion.¹³

Industry opposition to the HPL

However, prior to its promulgation, sugar industry actors and SSB manufacturers formed an alliance to strongly oppose the HPL, and deployed various tactics to "delay, dilute and delegitimise" this policy.¹⁴These strategies included questioning the integrity of scientific evidence supporting the tax; disseminating their own funded studies with findings that refute the link between SSB consumption and obesity; and lobbying to influence government policy-makers with claims of the HPL leading to massive job losses and the decimation of South Africa's cane-growing and sugar milling industry.¹⁵ These corporate responses succeeded in weakening the rate of the Levy from the proposed 20% to 10%.

Data from Statistics South Africa's Quarterly Labour Force Survey do not corroborate the industry's claims that the HPL had resulted in the loss of 16 000 jobs¹⁶, and there is no independently researched and peer-reviewed evidence that the tax has measurably induced the sugar industry's fall in revenue. There are no verifiable data showing that the HPL has generated job losses in the production, distribution and sale of SSBs, nor triggered a decline in SSB producers' profits.

In fact, reliable empirical research findings indicate that the sugar industry's losses and suppressed market demand can be attributed to several operational factors within and around it, such as climate change and COVID-19 affecting production, corruption within some of its companies, cheap sugar imports, and ever-escalating input costs.¹⁷

In 2021, a review of research found that the HPL had led members of urban households – particularly in lower socio-economic settings – to buy almost 30% fewer sugary beverages, thereby almost halving the amount of sugar they consumed from these drinks.¹⁸ The announcement of the HPL also incentivised SSB manufacturers to reformulate their products for lower sugar content (albeit so that they could sustain their profit margins rather than in support of public health goals).

Yet despite these gains, the industry's anti-HPL campaign continues unabated, perpetuating the falsehood that there are no credible studies linking the tax to positive public health outcomes.

The outcome of industry interference in evidence-based health policy

As a result, an increase in the tax announced in February 2022 was postponed to 1 April 2023, and then deferred again in the February 2023 Budget Speech for a further two fiscal years.

In real terms, this signifies a year-on-year reduction in the HPL, which enables greater affordability, and hence greater consumption, of SSBs. This erosion of the Levy's power as a mechanism to address the NCD burden plays directly into the hands of companies that seek only to preserve and increase their profit margins.

On 14 February 2025, the CEO of the South African Sugar Association (SASA) called for "the extension of the two-year sugar tax moratorium to 2030 … in keeping with the lifespan of the Sugarcane Value Chain Master Plan 2030" to enable the industry's diversification and restructuring.¹⁹

Even more concerning is a media report suggesting that – on the grounds of SASA's claim that the HPL has "cost the industry R1.2 billion and threatened the loss of 300 000 jobs" – the 2025 Budget will propose cancelling an increase in the HPL that was due to come into effect on 1 April this year, "to allow the industry time to restructure its response to regional competition".²⁰

How increasing the HPL will support physical and economic health

As our country faces the urgency of deploying domestic financing options to address recent cuts in international aid for health, an increase in the HPL would be an obvious and easy contribution. In the five years since its inception, the HPL has raised more than R10 billion in revenue.^2,21

Here are some key recommendations for a whole-of-society, evidence-based response and the changes in governance of our food system needed to counteract these corporate assaults on public health promotion:

Ø To adjust for inflation and ensure that South Africa's sugar taxation fulfils its intended health-promotion aim, National Treasury should increase the percentage of the HPL to 20% per litre, and lower its 4g/100ml sugar content threshold to 2g/100ml without delay.

Ø Income derived from the HPL should be ring-fenced for financing of robust, properly costed and budgeted NCD responses and chronic disease prevention, rather than having it flow into the National Revenue Fund for ad hoc allocation. From the platform of multisectoral action, prioritised HPL funding could be specifically earmarked for research programmes aimed at improving South Africa's diabetes response, for example.

Ø Widespread awareness of nutrition and understanding of the forces that shape people's health should be catalysed through public health measures such as clear, accessible front-of-package labelling.

The influence of corporate power on the nation's health should be disarmed by making it legally binding for companies to comply with evidence-based policies to counter the commercial determinants of health. Through regulation, legal reform and advocacy, industry actors should be accountable for recalibrating their business models and corporate governance in support of a sustainably healthy populace and planet.

----------------------------------------------------------------------------------------------------------------

The diet-related NCD burden affects all of us, and health as a human right means that we deserve protection from harmful commercial practices.

To change systems for healthier lives:

Ø Related reading:

Goldstein S, Mahomedy S. Commercial determinants of health and cancer prevention in South Africa. In: Moeti T, Padarath A, Parkes J, Singh S, Ruff P, editors. South African Health Review 2023 – Strengthening cancer services. Durban: Health Systems Trust; 2024.

URL: https://sahr.hst.org.za/article/120643-commercial-determinants-of-health-and-cancer-prevention-in-south-africa

Ø The Healthy Living Alliance (HEALA) is running a petition to support a stronger HPL at:

https://awethu.amandla.mobi/petitions/call-on-finance-minister-and-deputies-to-increase-and-expand-sugary-drinks-tax

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References

1. Chandiwana N, Venter WDF. Obesity is South Africa's new HIV epidemic. S Afr Med J, 2024;114, e1927. URL: https://doi.org/10.7196/SAMJ.2024.v114i4.1927

2. Hofman KJ, Goldstein S. Diabetes is South Africa's second biggest killer disease: hiking the sugar tax would help. The Conversation, 20 October 2023.

URL: https://theconversation.com/diabetes-is-south-africas-second-biggest-killer-disease-hiking-the-sugar-tax-would-help-216456

3. Okop KJ, Lambert EV, Alaba O, Levitt NS, Luke A, Dugas L, et al. Sugar-sweetened beverage intake and relative weight gain among South African adults living in resource-poor communities: longitudinal data from the STOP-SA study. Intl J Obes, 2019; 43: 603–614. URL: https://doi.org/10.1038/s41366-018-0216-9

4. Tugendhaft A, Manyema A, Veerman LJ, Chola L, Labadarios D, Hofman KJ. Cost of inaction on sugar-sweetened beverage consumption: Implications for obesity in South Africa. Public Health Nutr, 2015; 19:13, 2296‒2304.

DOI: 10.1017/S1368980015003006

5. Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health. 2007; 97:4, 667‒675. DOI: 10.2105/AJPH.2005.083782

6. Chazelas E, Srour B, Desmetz E, Kesse-Guyot E, Julia C, Deschamps V, et al. Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort. BMJ, 2019; 366. DOI: https://doi.org/10.1136/bmj.l2408

7. University of the Witwatersrand. Facts about SSBs and obesity in South Africa.

URL: https://www.wits.ac.za/news/latest-news/research-news/2016/2016-04/ssb-tax-home/sugar-facts/

8. Morenga LT, Mallard S, Mann J. Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ, 2013; 346:e7492. DOI: 10.1136/bmj.e7492

9. Myers A, Fig D, Tugendhaft A, Mandle K, Myers J, Hofman KJ. Sugar and health in South Africa: Potential challenges to leveraging policy change. Glob Public Health, 2017; 12:1, 98‒115. DOI: http://dx.doi.org/10.1080/17441692.2015.1071419

10. World Health Organization Civil Society Working Group on NCDs. Statement on Item 3. 73rd World Health Assembly (WHA73) COVID-19 Response: Reducing risk of COVID-19, cancer and other NCDs, 18 May 2020.

URL: https://ncdalliance.org/resources/73rd-who-world-health-assembly-statement-on-item-3-covid-19-response-reducing-risk-of-covid-19-cancer-other-ncds

11. Ryan D, Candeias V, Fruergaard Jorgensen L. We need to change the narrative around obesity – here's why. World Economic Forum, 17 May 2018.

URL: https://www.weforum.org/stories/2018/05/we-need-to-change-the-narrative-around-obesity-heres-why/

12. Lee, K, Freudenberg N. Public Health Roles in Addressing Commercial Determinants of Health. Annual Review of Public Health, 2022; 43, 375‒395.

URL: https://doi.org/10.1146/annurev-publhealth-052220-020447

13. Boachie MK, Thsehla E, Immurana M, Kohli-Lynch C, Hofman KJ. Estimating the healthcare cost of overweight and obesity in South Africa. Global Health Action, 2022; 15:1. URL: https://doi.org/10.1080/16549716.2022.2045092

14. López González L. 'Delay, dilute, delegitimise': How the food industry shapes what you eat — and what you weigh. Daily Maverick, 15 October 2021.

URL: https://www.dailymaverick.co.za/article/2021-10-15-delay-dilute-delegitimise-how-the-food-industry-shapes-what-you-eat-and-what-you-weigh/

15. Du M, Tugendhaft A, Erzse A, Hofman KJ. Sugar-sweetened beverage taxes: Industry response and tactics. Yale J Biol Med, 2018; 91:2, 185‒190.

16. Dare C, Boachie MK, Goldstein S, Thsehla E. The association between the Health Promotion Levy and employment in South Africa: an interrupted time series analysis. BMC Nutr, 2025; 11:1, 28. DOI: 10.1186/s40795-025-01012-6

17. Mbalati N. Scrapping of the sugar tax will not save the sugar industry from its own woes. Business Report, 17 October 2024.

URL: https://www.iol.co.za/business-report/economy/scrapping-of-the-sugar-tax-will-not-save-the-sugar-industry-from-its-own-woes-3c805d9d-e24b-478b-adbd-62e71afe38fc

18. Hofman KJ, Stacey N, Swart EC, Popkin BM, Ng, SW. South Africa's Health Promotion Levy: Excise tax findings and equity potential. Obesity Reviews, 2021; 22;9, e13301. URL: https://doi.org/10.1111/obr.13301

19. Pillay Y. Sugar industry unveils diversification plan amid crippling sugar tax crisis.

Business Report, 17 February 2025.

URL: https://www.iol.co.za/business-report/economy/sa-sugar-industry-unveils-bold-diversification-plans-amid-crippling-sugar-tax-crisis-8708eecf-b190-4390-880c-931c76f5f92c

20. Magubane K. Enoch Godongwana's postponed budget cancels sugar tax hikes. TimesLIVE, 20 February 2025.

URL: https://www.businesslive.co.za/bd/national/2025-02-20-enoch-godongwanas-postponed-budget-cancels-sugar-tax-hikes/

21. National Treasury. National Assembly, Parliament of the Republic of South Africa. Question for written reply: Question Number 1300 [NW1493E] and Reply.

URL: https://www.treasury.gov.za/publications/other/MinAnsw/2021/PQ%201300%20-%20Wilson%20-%20NW1493E.pdf

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Feb 21

Understanding Breast Cancer: Incidence, Prevention, and Global Statistics

Reuel Singh on 2025-02-21 12:43 PM

By Mandisa Dlamini (HST Communications Assistant)

Breast cancer is a major health issue affecting many people world-wide.

World Prevalence and Mortality

According World Health Organization (WHO) data, breast cancer was diagnosed in over 2.3 million women, and resulted in the deaths of 670 000 women globally in 2022.

Breast cancer is the most common cancer among women and accounts for one in eight cancer cases. It exceeded other harmful conditions; with 2.26 million new cases in 2020, breast cancer became the leading cancer type surpassing other types. The International Agency for Research on Cancer has predicted that there will be more than three million new breast cancer cases every year from 2040, and more than one million breast cancer-related deaths; a 40-50% increase in the number of these deaths.

Risk Factors

According to WHO, breast cancer risk is increased by a number of factors:

Age and Gender: The two main risk factors are being older and being a woman.
Genetic Predisposition: Although many people with breast cancer have no known family history, a family history can increase the risk.
Lifestyle: Obesity, alcohol consumption, tobacco use, and postmenopausal hormone therapy are risk factors.

Detection and Prevention of Cancer

Lifestyle changes such as maintaining a healthy weight, reducing alcohol consumption and quitting smoking are the cornerstones of preventive interventions. The outcomes of treatment have improved significantly, thanks to the early detection via routine screenings like mammograms and ultrasounds. To enhance access to early detection and treatment, the World Health Organization stresses the significance of including breast cancer control within national health programmes.

The 2023 edition of the South African Health Review (SAHR) explores the pressing challenges, successes, and gaps in cancer care within the South African healthcare system. The edition features three articles on breast cancer. They examine the effectiveness of breast cancer policies in South Africa, the factors influencing uptake of breast cancer screening to inform public health interventions, and the advantages of expanding breast cancer genetic counselling services to outreach clinics. In the editorial, Moeti et al. reiterate that "despite well-intentioned guidelines and policies aimed at facilitating and expediting screening, early diagnosis and treatment, significant delays prevail due to logistical and resource constraints. Articles illustrate the necessity of re-evaluating implementation strategies to better align practice with government policy and highlight gaps in policy regarding the needs of vulnerable populations, inequities in access to timely oncology diagnostic and treatment services and particularly medication, service fragmentation, and communication breakdowns."

The National Department of Health (NDoH) introduced the Breast Cancer Prevention and Control Policy (2017) to raise treatment accessibility and advance early diagnosis capabilities while providing awareness support. Breast cancer prevention policy through national departments uses strategic methods to strengthen screening tests, and secure equal treatment access and add palliative care to healthcare delivery. The results of the SAHR assessment show systemic problems regarding financial constraints combined with inadequate healthcare services and insufficient policy enforcement, which negatively affect these implementation measures. The National Department of Health continuously tries to develop infrastructure in the public health sector, along with stakeholder collaboration and resource allocation improvements to ensure the policy delivers meaningful outcomes to breast cancer patients.

Successfully fighting this illness necessitates broad strategies focusing on defensive procedures as well as rapid diagnosis methods and dependable ongoing treatment methodologies.

For more information visit: South African Health Review 2023

The three articles pertaining to breast cancer in the latest edition of the SAHR are:

In paper 9 of the 2023 SAHR, Peresu et al. explore the factors influencing uptake of breast cancer screening. See an overview of their paper here https://web.facebook.com/watch/?v=2355776991422372&rdid=sg3nkRjcEsTwbXUU

The urgency of ensuring prompt diagnosis and treatment of breast cancer in South Africa remains. Botha et al. explore the effectiveness of breast cancer policies in South Africa. View the overview of their paper here https://web.facebook.com/watch/?v=500751769608209&rdid=QyXvPzVlKDOJ6WYf

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Feb 11

A Day in the Life of Research Associate Zinhle Mtwane

Reuel Singh on 2025-02-11 10:17 AM

By Willemien Jansen (HST Copy and Content Editor)

How long have you been with HST and which position have you occupied?

I recently joined the Health Systems Trust (HST) on 1 July 2024 as a Research Associate under the Research and Implementation Science Unit (RIS).

Please share some information about what your current role entails.

As a Research Associate my role entails being involved in various projects and being assigned to various tasks. I work closely with researchers in implementing research projects and that entails the following duties:

Participant Recruitment: Ensuring ethical guidelines, Good Clinical Practice, and study protocols are followed during the recruitment and informed consent process of study participants. Assist with the development of interview guides and transcription of interviews
Data Collection and Analysis: Conducting interviews and analysing the data using the relevant software.
Training: Assisting with the training of data collectors.
Record Keeping: Maintaining accurate records of data and other research activities.
Report Writing: Helping researchers translate research findings into reports.
Communication: Handling project-related communication as needed.
General Assistance: Supporting researchers with various other research duties as assigned.

What influenced your decision to be in the development/Non-governmental organisation (NGO) sector?

Before joining HST, I worked on projects focused on tuberculosis care within the private sector in the eThekwini district. This experience deepened my dedication to addressing health challenges. Motivated by this, I shifted my academic focus to public health, aspiring to build a career in this field. I also hoped it would open opportunities to work with organisations like HST, which shares my vision of improving South Africa's health outcomes.

How do you spend your time away from work?

Taking time to relax and recharge is important and I love to do so with the loved ones. I love spending time with my family and friends, whether it is a casual hangout or special occasion, or exploring new places on a weekend getaway

What gives you motivation?

My aspiration to learn new skills, knowledge and advance my career

What is the best advice you've ever received in your life? (personal or professional)

The advice that has stuck with me is from my late grandmother, who said "Perseverance is the mother of success". Personally and professionally I grew to learn that indeed perseverance is a key ingredient for achieving success as it teaches us to stay committed to our goals even when faced with challenges and setbacks. This mindset helps build resilience and determination, which I can attest to in my journey as mother and as a professional.

Any future aspirations?

I aim to continuously expand my knowledge and skills through ongoing education, training and professional development opportunities. Thereafter, I hope to progress to a senior research position and continue being part of research opportunities that contribute to improved health outcomes, particularly in resource limited settings, and that lead to publications and presentations. I also aspire to lead my own research team and mentor junior researchers.

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Feb 06

A day in the life of Health System Trust Researcher Dr Thobelani Nompilo Majola

Reuel Singh on 2025-02-06 12:35 PM

By Willemien Jansen (HST Copy and Content Editor)

How long have you been with the Health System Trust (HST) and which position do you occupy?

I have been with HST for close to a year and I am a Researcher in the Research and Implementation Science Unit (RIS).

Please share some information about what your current role entails.

In my current position I lead various projects, which entails protocol development, stakeholder engagements as well as seeking for ethical, district and provincial approvals. I facilitate training workshops with fieldworkers and other Researchers, co-ordinating data collection and analysis. Moreover, I am responsible for writing study related reports, and dissemination of research results through different channels such as feedback sessions with the sub-committee, stakeholders and funders such as National Department of Health (NDoH), as well as attending conferences.

What influenced your decision to be in the development/Non-governmental organisation (NGO) sector?

I have always been passionate about public health on a broader spectrum. I have observed that in the health sector we focus primarily on the symptoms and not the root causes of the problems. As a Researcher, my responsibility is to investigate and identify the various causes of the many health related challenges. Using the data collected, we analyse and formulate technical recommendations that will mitigate the burden of diseases on the healthcare sector. I felt that the best way my abilities and expertise will be utilised effectively is through an NGO such as HST, which is people-centred and focuses immensely on the health and wellbeing of communities.

How do you spend your time away from work?

I am fascinated with nature and as a result, I travel and explore new places. Hiking is also one of the activities that is close to my heart as it brings me close to the mother nature. I enjoy cooking and preparing delicious meals for myself and my family. During my spare time, I also dedicate a portion of my time visiting and helping the vulnerable, particularly children in various charity homes.

What gives you motivation?

I draw strength from strong African women who have walked the path before me, as I perceive myself as a strong African woman who has encountered different adversities that I have conquered. A quote that keeps me going and I live by is one by Maya Angelou: 'I can be changed by what happens to me. But I refuse to be reduced by it'.

What is the best advice you've ever received in your life? (personal or professional)

The best advice that I have received is that we are never granted opportunities that are beyond our capabilities. Therefore, I should always look at a situation that I am facing as a challenge that I need to grow from and conquer.

Any future aspirations?

My future aspiration is to grow professionally and excel in my area of expertise.

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Feb 03

A day in the life of Data Scientist Ntombifuthi Blose

Reuel Singh on 2025-02-03 10:15 AM

By Willemien Jansen (HST Copy and Content Editor)

Ntombifuthi Blose is a passionate data scientist who loves a challenge. We recently sat down with her to get to know her better.

How long have you been with HST and which position/s have you occupied?

I joined Health Systems Trust (HST) on the 1 February 2024 in the position of Data Scientist for the Research and Implementation Sciences (RIS) unit, so it's been one year since I joined the organisation.

Please share some information about what your current role entails.

My role involves capturing, quality-controlling, and analysing national, provincial, and district-level health statistics from various reports and the District Health Information (DHIS) to inform policy, support evidence-based decision-making, and guide priority setting. Specifically, I contribute to the production of the Indicators Chapter of the South African Health Review and the District Health Barometer.

I also lead a project aimed at developing an innovative data communication strategy to enhance evidence-based decision-making in public health. This project focuses on debunking misinformation on HIV and TB using various analytical approaches, with the final product being a user-friendly, public-facing dashboard and website.

Additionally, I provide support for several UNICEF, National Department of Health, and South African Medical Research Council-funded projects, contributing to data-driven insights that shape public health interventions.

What influenced your decision to be in the development/non-governmental organisation sector?

My passion lies in working with real-life data to generate insights that directly impact healthcare resource allocation in South Africa. By analysing health trends and system gaps, I aim to support evidence-based decision-making that strengthens our healthcare system. Being in the development/NGO sector allows me to bridge data with action—ensuring that resources are directed where they are needed most to improve health outcomes, particularly for vulnerable populations. This alignment between data, policy, and impact (in bold, I'm very passionate about this one) is what drives my work.

How do you spend your time away from work?

When I'm not working, I spend my time in two ways—either immersing myself in other research or making memories with my kids. On my own, I love staying up-to-date with the latest in public health and epidemiology news—yes, I'm a typical academic and a bit of a nerd! I also really enjoy going to the gym, though I wish I had more time to go more often.

With my kids, we love being out and about—whether it's a day at the beach or discovering new restaurants. As Durbanites, exploring Cape Town has been such a fun adventure for us, especially visiting different play parks and trying out new spots to eat.

What gives you motivation?

I find motivation in being consistently challenged—whether at work or in other aspects of life. The opportunity to tackle complex problems, learn, and grow keeps me driven and eager to push forward, no matter what. Challenges spark curiosity, resilience, and innovation, and that's what keeps me inspired to keep going.

What is the best advice you've ever received in your life? (personal or professional)

Personal advice: Work can wait, because your children won't remember you as a professional—they'll remember you as an absent parent. Make time for your loved ones; those moments matter the most.

Professional advice: Being an asset isn't just about mastering one thing—it's about knowing a little about everything. A broad understanding across different areas makes you adaptable, resourceful, and invaluable in any field.

Any future aspirations?

Looking ahead, I aspire to continue shaping public health policy through data-driven insights, ensuring that research translates into real-world impact. I want to contribute to building stronger health systems, particularly in how we address HIV and TB.

Academically, I aim to complete my PhD and expand my research on the evolving behavioural factors influencing health outcomes in hyper-endemic rural settings. I also want to engage more in science communication to make public health knowledge more accessible.

On a personal level, I am committed to nurturing both my career and family life, ensuring that I grow professionally while also creating cherished moments with my kids.

What are you reading right now?

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Jan 29

Navigating HPV Vaccines: Protecting Youth Against Preventable Cancers

Reuel Singh on 2025-01-29 11:14 AM

By Mandisa Dlamini (HST Communications Assistant), Phumula Mudau and Willemien Jansen (HST Copy and Content Editor)

Infections caused by the human papillomavirus (HPV) are among the most common sexually transmitted infections (STIs) around the globe. HPV, which comes in more than a dozen strains, can harm both women and men and cause everything from warts to cancer. Cancer often takes years, even decades to develop after a person contracts HPV. It is important to note that genital warts and cancers are caused by different types of HPV. It may be harder for persons with weakened immune systems, including those living with HIV, to fight off HPV. They might also be more likely to have HPV-related health issues. The HPV vaccine remains highly effective in preventing HPV infections and related cancers, including cervical cancer, showing promising results in reducing these risks. To further reduce the number of diseases linked to HPV, South Africa has been actively working to increase HPV vaccination rates.

In 2024, the Department of Health launched a nationwide HPV vaccination programme intending to ensure that girls are and remain protected against cervical cancer later in life. The first round of the Human papillomavirus (HPV) vaccination campaign in South Africa in 2025 is scheduled to take place from 3 February to 28 March. The Cancer Association of South Africa (CANSA), in association with the International Papilloma Virus Society does public awareness campaigns, which features International HPV Awareness Day on 4 March to educate about HPV-related cancer. Private school girls will also benefit from these interventions (single-dose vaccinations) as, just like at school-based clinics serving public school girls.

Vaccination and Prevention

Over 90% of HPV-related cancers as well as premature abnormal cancer cells in the anal, vaginal, cervical, and vulvar regions can be avoided by immunisation against HPV. Girls are advised to have an HPV vaccination when younger (usually between the ages of 9 and 26) in order to prevent infection before sexual activity begins. Age can also affect a person's chance of developing HPV-related health problems because older people may have been exposed to the virus for longer or may have received fewer vaccinations. It is important to utilise both the HPV vaccine and maintain safe sexual practices, such as condom use. Using these preventive methods will improve general sexual health and safety by reducing the chance of HPV infection and its associated effects.

HPV in men

The HPV virus can also harm a man's health. It's critical that men know how to lower their risk of contracting HPV. Although genital cancers are rare, HPV infection can increase a man's risk of developing one. Similar to women, men can also develop genital warts due to HPV. Other health risks include penile cancer and oropharyngeal cancers. Men can contract HPV easily through having vaginal, anal, or oral sex with someone who has the virus. The virus is transmitted through skin to skin contact with an infected area, even if it doesn't look infected. From 2013 to 2017, there were approximately 25 000 cases of HPV-associated cancers in women and 19 000 in men, according to the Centers for Disease Control and Prevention. More than four out of every ten cases of cancer caused by HPV are in men. A Pap test detects early-stage cervical cancer in women, but no such test exists for penile, anal, or head and neck cancers.

The HPV vaccine is just as beneficial for boys as it is for girls. According to the Memorial Sloan Kettering Cancer Center, the HPV vaccine went through years of rigorous safety testing before it was approved in 2006 to prevent cervical cancer in women and in 2009 to prevent HPV-related cancers in males. The school-based HPV vaccination campaign is currently available to girls only, but according to Unicef, boys age 9 and older are also encouraged to get the HPV vaccine and caregivers should approach their healthcare providers to enquire about this.

Call to Action

Protect Yourself and your loved ones with the HPV Vaccine. By getting vaccinated, you're not only protecting yourself but also contributing to a healthier future for everyone. Do not wait—take action today for a cancer-free tomorrow. To prevent HPV and other sexually transmitted diseases, consult your healthcare provider about the HPV vaccine and engage in safe sexual behaviour.

For more information and rsources, visit www.gov.za, Contact Clicks, Dis-Chem, or contact your paediatrician or local pharmacy.

The Health Systems Trust also runs a programme called Cervical Cancer Prevention, Access and Control (CCPAC). For more information go to the website: www.hst.org.za

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Jan 24

A day in the life of HIT Project Manager Braam Steenkamp

Reuel Singh on 2025-01-24 03:15 PM

by Willemien Jansen (HST Copy and Content Editor)

Health Systems Trust's (HST) Braam Steenkamp, based in Pretoria, leads the Health Information Technician (HIT) team. We recently had a chat to get to know him better.

How long have you been with HST and which position/s have you occupied?

I have been directly employed by HST since 2017, but have been working on HST projects since 2014.

From 2017 to 2019, I was Technical Support Officer, and then served for a year as Manager for user acceptance testing (UAT) for project management information systems, which involved providing specialist training in information technology. From 2020 to 2024 I was Technical Manager for HST's health information systems projects, and am now Project Manager in this area.

Please share some information about what your current role entails.

In my current role as a Project Manager, I oversee the implementation and support of health information systems at the national level, except for the Western Cape Province. I lead a highly skilled team of Health Information Technicians, known as the HIT Team, which has extensive experience in the field. Our responsibilities include implementing and supporting national health information systems, as well as conducting training for national, provincial, district and facility Department of Health staff to ensure the sustainability of health information systems for National Health Insurance (NHI). Our project team consists of 41 members, and we are currently supporting approximately 3 500 facilities.

What influenced your decision to be in the development/NGO sector?

The non-governmental organisation (NGO) sector presents a dynamic environment, particularly in relation to the project in which I am currently engaged. The Health Patient Registration System (HPRS), for example, is a tailored solution developed by the Council for Scientific and Industrial Research (CSIR) for the National Department of Health (NDoH). The system is regularly updated, and our team provides valuable input and insights to the development team throughout this process.

How do you spend your time away from work?

Outside of work, I find great joy in spending quality time with my family. Whether we are sharing meals, going on outings, or simply enjoying quiet evenings at home, I believe these moments strengthen our bonds and create lasting memories.

In addition to family time, I am actively involved in community projects that aim to inspire positive change. I find it rewarding to contribute my time and skills to initiatives that help improve our local environment.

My hobbies also reflect my passion for creativity and innovation. I enjoy working on restoration projects and exploring electronics and automation. I design projects that integrate technology to enhance everyday life. Each of these pursuits allows me to express my creativity while continually learning and growing.

What gives you motivation?

Individuals are driven by a diverse array of motivations that influence their behaviours and aspirations. In my case, engaging in reflective practice regarding work activities and experiences that elicit feelings of joy, satisfaction, and a sense of accomplishment serves as a significant catalyst for my personal and professional growth. This thoughtful consideration allows me to identify what is truly important and motivates me to establish and pursue more ambitious goals. By gaining a deeper understanding of the factors that contribute to my happiness and success, I am better positioned to challenge myself and strive for excellence in all endeavours.

What is the best advice you've ever received in your life? (personal or professional)

The phrase 'Aanhouer wen', which translates to 'Never give up', holds a special significance for me. My father imparted these words of wisdom to me after we watched an inspiring boxing match together. In 1983, Gerrie Coetzee made history by becoming the first African to compete for and win the world heavyweight championship. As we witnessed this remarkable achievement, my father emphasised the importance of perseverance and resilience, reminding me that determination can lead to incredible success, no matter the obstacles we face. His encouragement during that moment has stayed with me ever since.

Any future aspirations?

My future aspirations focus on continuous growth and skill development. I am dedicated to keeping up with the latest trends and technologies in our industry.

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Jan 17

New year, same you: How to make changes even if YOU haven’t changed

Reuel Singh on 2025-01-17 11:35 AM

By Willemien Jansen (HST Copy and Content Editor)

The new year arrives and you are rested and ready. THIS year you will get that promotion, lose that weight, get that qualification, get fit. Before long you feel a huge amount of pressure to obtain the lofty goals that you have set for yourself. Self-doubt starts creeping in and you start wondering how you will manage to achieve anything. It is just a matter of time before you start beating yourself up for not achieving what you have set out to do. Once again you feel like a failure. Not achieving what you set out to do can lead to anxiety and even depression.

This cycle is a common one that many of us go through at the beginning of each new year. The fact is that we don't change overnight just because the calendar does. But this also doesn't mean that we are a lost cause. You CAN make changes in your life and you CAN achieve the things you set out to achieve, but you need to have the correct mindset. Meaningful growth can happen at any time and you don't need to wait for the start of a new year to make changes. Here are some ways to relieve the pressure you put on yourself while still making meaningful changes:

1. Shift Focus from "Big Changes" to Small Steps

Every journey starts with the first step. Instead of giving your life a complete overhaul all at once, focus on making small changes, one at a time. Small steps are easier to maintain and can make a huge difference in the end.

2. Set Intentions, Not Resolutions

Resolutions often feel rigid and unattainable. Even the word 'resolutions' makes most of us feel like we won't be able to achieve it. Intentions are more about your mindset or approach, rather than about achieving a specific outcome. Intentions can include things like being kinder to yourself, exploring new hobbies or learning something new.

3. Accept Where You Are

It's okay to not have it all figured out. Don't beat yourself up because you feel like you are lagging behind in certain areas of your life. Embrace where you are and celebrate what you have achieved, instead of focusing on what you haven't.

4. Be Realistic

Setting overly ambitious goals can leave you feeling overwhelmed. If you've never run in your life, it may be unrealistic to think that you will be doing your first marathon in six months. Set goals that are realistic and attainable, and build on small steps.

5. Avoid Social Comparison

The pressure to keep up with our peers can leave us anxious and deflated. Social media easily creates the impression that others are living their best lives while we are left behind. It is not useful to compare yourself to others. Focus on your own path, and remember that social media does not reflect reality.

6. Embrace Progress Over Perfection

Growth is a process. You will often take two steps forward and one step back. Setbacks are a part of life. Celebrate the small successes along the way instead of stressing too much about the end result.

7. Practice Self-Compassion

Be kind to yourself, especially if you don't meet certain expectations. Even if you don't achieve the goal you set out to achieve, you would still have made positive changes in your life. Don't beat yourself up about what you didn't achieve, but celebrate what you did. Self-compassion fosters resilience and helps you bounce back when things don't go as planned.

Change doesn't happen overnight and it doesn't happen just because the calendar changes. Don't be too hard on yourself at the beginning of this new year. Go at your own pace, make small changes, celebrate your successes and remember to look back to see how far you've come.

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