Health Gains Arising from Reduced Risk Consumption: South Africa's PRIME Example

Non-communicable diseases (NCDs) represent at least 30 percent of disability adjusted life years in South Africa. Many of the risks associated with NCDs are related to diet, tobacco and alcohol. In South Africa, diets are not diverse enough and often contain too much salt, while tobacco and alcohol consumption remain too high. Thus, NCD risks will continue to expand, unless those behaviours can be altered. In this research, we offer an estimate of the potential reduction in NCD incidence that would arise from an improvement in diet, combined with a reduction in both tobacco and alcohol consumption. We apply the PRIME model, which simulates the effect of risk reduction on NCD incidence. The model inputs baseline data related to the population, risky consumption behaviour and NCD incidence. The model allows for counterfactual scenarios altering the risky consumption behaviour to yield revised NCD incidence. We find that reducing salt, tobacco and alcohol, along with improved fruit, vegetable and fiber consumption would yield a 10 percent reduction in NCDs, from the 2018 baseline. NCD incidence reductions arise primarily from ischemic heart disease (49 percent), cerebrovascular diseases (33 percent) and bronchus and lung disease (11 percent). South Africa's NCD incidence is high, because of relatively poor behavioural choices, despite plans and policies meant to change that behaviour and reduce the incidence. South Africa should increase their efforts to reach NCD goals. If the government is able to reduce harmful behaviour, with respect to a number of the underlying consumption choices, NCD incidence will fall precipitously.