| by Siyabonga Gema (HST Communications Officer)

As our continent observes African Vaccination Week, which runs from 24 to 30 April, as part of World Immunization Week, the call to action, ''Immunisation for all is humanly possible'', is proving ever more relevant. The COVID-19 epidemic, which wreaked havoc in Africa, claiming around 257 984 lives, shone a glaring light on the need for equity in the provision and acquisition of vaccines, especially when competing with wealthier countries. African Vaccination Week emphasises the need for concerted action to promote regional vaccination systems, including boosting the timely use of vaccines to protect people of all ages from disease. It strives to keep vaccination at the top of national and regional agendas through lobbying and partnerships while encouraging the implementation of other life-saving interventions. The World Health Organisation (WHO) Africa Region states that this year's theme aims to: 1. Reach zero-dose children (those that lack access to or are never reached by routine immunisation services) through accelerated implementation of big catch-up initiatives. 2. Show vaccines' health benefits for children, communities, and Africa. 3. Highlight routine immunisation's role in strong health systems and universal coverage. 4. Continue improving immunisation and address gaps with more investment. According to WHO Africa, immunisation is one of the most impactful and cost-effective public health interventions available, preventing over four million deaths yearly. Apart from its direct effect on population health, vaccination also adds value by lowering the burden of disease on people, families, and communities. This includes lowering medical costs and increasing productivity and educational opportunities. In South Africa, the government prioritises childhood vaccinations to boost children's immunity against diseases like meningitis, polio, measles, hepatitis B, diphtheria, and tuberculosis (TB). State clinics offer free immunisation, with the first shots administered at birth. Although there have been major gains in Africa in terms of immunisation, there is still some cause for concern. WHO Africa states that approximately 1 in 5 African children do not receive all the necessary and basic vaccines. As a result, more than 30 million children under five still suffer from vaccine-preventable diseases (VPDs) every year in Africa. Of these, over half a million children die from VPDs annually – representing approximately 58% of global VPD-related deaths. To sustain strong vaccination programmes that can provide vaccines to everyone in Africa, particularly the most vulnerable, strategic investments to fortify health systems are essential. In addition to improving child health and survival, expanding access to vaccines is essential for establishing the framework for nations to provide all citizens with the fundamental medical care they require to live healthy and prosper. In response, the South African government established the Expanded Programme on Immunisation in South Africa (EPI-SA), a critical public health effort aimed at avoiding childhood diseases through vaccination. Its goal is to lessen the burden of vaccine-preventable diseases by ensuring that children and pregnant women have access to lifesaving vaccines. EPI-SA has made tremendous advances in providing new vaccinations and modifying schedules to meet South Africa's specific needs. Through community involvement, disseminating correct information, and removing obstacles to access, society can play a major role in boosting vaccination and vaccine uptake. This entails collaborating with the government and other health organisations, communicating through a variety of platforms, and ensuring that everyone, particularly underserved populations, has access to immunisations.
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| by Antoinette Stafford Cloete (Health Systems Trust Communications Manager)  
According to the World Health Organization (WHO), there were approximately 263 million cases of malaria in 2023 with 597 000 malaria deaths in 83 countries. The Africa region is most affected by this disease with about 94% of all cases. About 76% of all deaths from malaria in the region were amongst children under five years of age. In 2025, the WHO, with other key partners, is working towards the elimination of the disease through the call that, "Malaria Ends with Us: [to] Reinvest, Reimagine, Reignite". What is Malaria? Malaria is a disease that can be life-threatening. Symptoms can range from feeling fatigued, a fever and chills accompanied by a headache to confusion, seizures and difficulty breathing. Those most at risk of contracting the disease and developing a severe infection are young children, pregnant women and girls, travellers and people who are immuno-compromised such as HIV-positive individuals. If left untreated the disease can progress to severe illness and death within 24 hours. Transmission It is spread to humans by some types of mosquitoes (infected female Anopheles mosquitoes), mainly found in tropical climates and is not spread by human-to-human contact. Contaminated needles and blood transfusion may also transmit malaria. Malaria can also spread through a parasite from the Plasmodium species. Prevention The disease can be prevented by avoiding mosquito bites and with medication. Travellers should always consult their health practitioner before travelling to a high-risk area about prophylactic (precautionary) medication. You can also lower your risk of contracting the disease by: - Using mosquito nets when sleeping in places where malaria is endemic (a place where a disease is generally present in a population year-round).
- Using repellants, especially after sunset when mosquitoes are more prevalent.
- Using coils and vaporisers. There are eco-friendly options available.
- Wearing protective clothing.
- Having screens over your windows.
Preventive Therapies The use of medications, either alone or in combination, to stop malaria infections and their effects is known as preventive chemotherapy. It entails providing susceptible persons, whether or not they are afflicted with malaria, with a complete course of antimalarial medication at specific intervals throughout the peak malarial risk period. Preventive therapies are increasingly being adopted in the fight against the disease as well as drug resistance when already sick with malaria. This strategy is viewed as being more cost-effective when coupled with early diagnosis and treatment of malaria as well as vector control.
Vaccines The WHO has recommended a malaria vaccine, especially for children, since October 2021. The vaccine has shown significant reductions in malaria in the under-five years of age population. Vaccines are now being rolled out as part of routine childhood immunisation programmes across Africa in countries like Nigeria. It is estimated that tens of thousands of children will be saved in this way every year.
The WHO Global Technical Strategy for Malaria 2016-2030 provides a technical framework for countries battling with the disease. It can be used as a guide towards malaria control and elimination. The strategy aims to assist countries with: - Reducing malaria incidence by at least 90% by 2030
- Reducing malaria mortality rates by at least 90% by 2030
- Eliminating malaria in at least 35 countries by 2030
- Preventing a resurgence in countries that are malaria-free.
For this to happen the WHO endeavours to play a leading role in malaria control and elimination by supporting its member states to reach universal health coverage and to achieve the goals of the Global Technical Strategy for Malaria.
The disease is preventable as well as curable and requires the political will of nations, concerted health promotion and education efforts to create awareness and a multi-pronged approach consisting of early detection, treatment and prevention.
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| By Mandisa Dlamini (HST Communications Assistant) and Willemien Jansen (HST Copy and Content Editor)
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How long have you been with HST and which position/s have you occupied? I joined Health Systems Trust (HST) in 2020 as a Clinical Support Officer, where I was responsible for managing office stationery, attending meetings, and providing general administrative support. In 2021, I was promoted to the position of Office Administrator for the uThukela District office, a role I currently hold. Over the years, I've had the opportunity to work closely with various departments across the organisation, gaining valuable experience and insight into different aspects of operations. My journey with HST has not only strengthened my administrative and co-ordination skills but has also deepened my understanding of health systems and community-based work Please share some information about what your current role entails. In my role, I provide comprehensive administrative support to donors, funders, Department of Health (DoH), and HST personnel. I manage and monitor office supplies, keep detailed usage and expenditure reports, and ensure a safe, well-maintained working environment. I co-ordinate office maintenance, implement health and safety policies, and maintain up-to-date records on assets, office equipment, and service providers. I facilitate logistics for meetings, workshops, and travel in line with HST procedures, while also handling monthly expenditure reporting and petty cash reconciliation. Additionally, I manage the district fleet database, track vehicle logbook submissions, and report accidents or non-compliance. I support HR functions by maintaining a district manpower list and assisting with documentation and internal communication. I also handle purchase orders through SAGE, maintain accounts payable records for audits, and ensure accurate financial documentation. Throughout, I prioritise efficiency, compliance, and accurate reporting to support smooth office operations. What influenced your decision to be in the development/NGO sector? My decision to enter the development/NGO sector was influenced by a combination of witnessing inequality up close and realising that I wanted my work to directly affect people's lives. Whether it was through volunteering in college, traveling and observing how various communities live, or being inspired by mentors engaged in grassroots efforts — something resonated with me. I recognised that I didn't want a career focused solely on profit. I sought to be involved in initiatives that empowered communities, advocated for justice, and aimed to create systemic change. How do you spend your time away from work? Outside of work, I enjoy relaxing at home while watching Formula One or cricket, which keeps me both entertained and energised. I also value quality time with my wife — whether it's staying in or going out together, it's those moments that keep me grounded and recharged. What gives you motivation? My family serves as my greatest source of motivation, especially my parents and my wife. Their constant support, belief in me, and the values they've instilled inspire me to keep pushing forward in both my personal growth and professional journey. They remind me daily why I strive for excellence and purpose in everything I do. Also, a big shout out to my HST family for always being there for me and keeping me motivated. From the managers to every single staff member on the ground level—working alongside you all is truly a blessing. What is the best advice you've ever received in your life? (personal or professional) "Listen more than you speak."
In the NGO/development world — and really any field that's people-driven — this is gold. It keeps you grounded, empathetic, and connected. Any future aspirations? I have recently completed my studies in Office Administration and am proudly registered with The Association for Office Professionals of South Africa. Currently, I am furthering my education by working toward completing my studies in Human Resources Administration. My goal is to continue growing in both office management and HR, combining practical experience with a strong academic foundation to support efficient and people-centered workplace environments. What are you reading at the moment? The most recent updates on current events that significantly affect our nation.
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| By Mandisa Dlamini (HST Communications Assistant)

World Health Day is celebrated on 7 April every year. In 2025, the WHO has selected maternal and newborn health as the focus of its campaign, which will have the tagline "Healthy beginnings, hopeful futures". This year-long campaign encourages all governments and health communities to drive action towards an end to all preventable maternal and newborn deaths and ensure that long-term health for women remains a priority. Around the country, events and activities are conducted during the month of April. These include free health check-ups, informational seminars, as well as workshops where local leaders will debate strategies to fight both newly emerging as well as chronic issues. Not only is World Health Day a reminder of the worldwide commitment towards improving health, it is also a time to recognise the incredible advances that have been made over the years. South Africa's rich heritage and resilient spirit continues to drive forward new innovative health policies as well as community-driven initiatives. Health Systems Trust (HST) takes the initiative to advance public health by making healthcare, information, and treatment readily available in communities. Our mobile healthcare services, such as HIV, TB and pap smear test units, extend vital checks to outlying communities. HST also actively promotes the dissemination of health information through pamphlets and community outreach, enabling the public to acquire information on prevention and well-being. HST's commitment to public health shows in our active involvement in national conferences. Recently, we made a presentation at the SAPHEX Conference in Johannesburg on pharmaceutical and healthcare developments. Our communications team is currently attending PHASA 2025 in the Western Cape, advancing our purpose to spread information and promote health initiatives. Through these initiatives, HST remains a key player that contributes to improving the lives of every individual by ensuring they are well-informed, supported, and linked to basic healthcare services. Local communities are encouraged to be actively involved by attending local functions, engaging in talks, and making use of available healthcare services. This collective effort is crucial for promoting a strong healthcare system that benefits everyone regardless of background or condition. World Health Day 2025 is a timely reminder that good health is a basic right everyone is entitled to, and every step made by communities counts towards a bigger picture of global well-being. Let us all lend a helping hand to initiatives that ensure health care is a top priority, leading the way towards a promising, healthier South Africa. For more information and ongoing updates, please visit South African Department of Health and World Health Organization.
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| By Willemien Jansen (HST Copy and Content Editor)

Bipolar disorder remains a significant mental health challenge in South Africa, affecting countless lives and placing a heavy strain on healthcare resources. The burden of disease associated with bipolar disorder is profound, as it not only impacts patients' quality of life but also contributes to broader societal issues, including unemployment and increased healthcare costs. South Africa grapples with a quadruple burden of disease stemming from communicable diseases like HIV/AIDS and tuberculosis; mortality rates among mothers and children; and non-communicable diseases (NCDs), including hypertension and cardiovascular diseases, diabetes, cancer, mental illnesses, chronic lung diseases such as asthma, as well as injury and trauma. Understanding the prevalence and implications of bipolar disorder within the South African context can shed light on the urgent need for better mental health resources and support systems. It is essential to recognise how this condition serves as a major contributor to the overall burden of disease in the country, affecting individuals and families alike. In addressing the nuances of bipolar disorder, this article aims to explore its impact on the South African population, highlighting the importance of awareness, treatment, and support as crucial elements in mitigating its effects on both individuals and society. Impact of Bipolar Disorder on South Africa's Disease Burden Bipolar disorder significantly affects individuals and the wider healthcare system in South Africa. Its prevalence, associated healthcare costs, and impact on quality of life are crucial elements of the disease burden in the country. Prevalence of Bipolar Disorder in South Africa Bipolar disorder affects up to 4% of the South African population. Though underdiagnosed, its visibility is increasing, particularly among younger adults. It often develops between the ages of 15 and 19. Factors contributing to its prevalence include genetic predispositions, environmental triggers, and socioeconomic conditions.
Access to mental health services is limited, particularly in rural areas, further complicating the diagnosis and treatment of bipolar disorder. Healthcare Costs and Resource Utilisation The financial burden of bipolar disorder, and all mental illness, on South Africa's healthcare system is substantial. Direct costs include hospitalisation, outpatient visits, and medication, while indirect costs stem from lost productivity and caregiver burden. In public healthcare, mental health resources are often inadequate. Psychiatric services struggle to meet demand, leading to longer wait times and decreased quality of care. Quality of Life and Mortality Rates Bipolar disorder considerably impairs quality of life. Affected individuals experience fluctuations in mood that can lead to difficulties in personal relationships and employment. Suicidal behaviour is a serious concern, with studies showing that individuals with bipolar disorder have a higher risk of mortality compared to the general population. The stigma surrounding mental illness remains a significant barrier in South Africa and also exacerbates feelings of isolation and hopelessness, further deteriorating mental health. Addressing these challenges, through of example public awareness campaigns, is essential for improving health outcomes in South Africa.
Interventions and Outcomes Effective interventions for bipolar disorder in South Africa can significantly reduce its burden on individuals and the healthcare system. Various treatment options, societal support mechanisms, and policy reforms are crucial for improving patient outcomes. Effectiveness of Bipolar Disorder Treatments Pharmacological treatments, including mood stabilisers and atypical antipsychotics, are standard interventions. Medications like lithium have demonstrated effectiveness in managing manic and depressive episodes. Psychotherapy, particularly cognitive behavioural therapy (CBT), complements medication by helping individuals develop coping strategies. Studies suggest that combining both approaches improves remission rates and enhances patients' quality of life. Access to proper healthcare is critical. Rural regions in South Africa often struggle with limited availability of mental health professionals, affecting the overall effectiveness of treatments. Ensuring treatment accessibility in these areas is vital for achieving positive outcomes. Support Systems and Social Stigma Support systems play a pivotal role in managing bipolar disorder. Establishing family support networks can help individuals navigate their condition more effectively. Communities that foster understanding can reduce isolation and encourage seeking help. Peer support groups also offer invaluable resources. Shared experiences can empower individuals to engage in their treatment actively and maintain connections with others facing similar challenges. Future Directions in Healthcare Policy Future healthcare policies need to prioritise mental health, particularly bipolar disorder. Investment in training healthcare professionals in mental health is essential for enhancing diagnosis and treatment strategies. Improving the integration of mental health services within primary care can provide individuals with seamless access to support. This approach can reduce the stigma associated with seeking specialised mental health treatment. Data collection and research into the specific needs of those with bipolar disorder in South Africa can inform policies. Tailoring interventions to the local context is crucial for improving effectiveness and ensuring successful outcomes. For information on mental health, or assistance please go to: Websites National Department of Health: Mental Health Masiviwe SADAG
SA Federation for Mental Health List of helplines Mental Health Information Line: 0800 567 567 LifeLine National Counselling Line: 0861 322 322 Suicide Crisis Helpline: 0800 567 567 Healthcare Workers Care Network Helpline: 0800 21 21 21, SMS 43001 SADAG: 011 234 4837 List of Whatsapp helplines Cipla Mental Health: 076 882 2775 Maybelline BraveTogether: 087 163 2030 Ke Moja Substance Abuse: 087 163 2025 Have Hope Chat Line: 087 163 2050
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| By Willemien Jansen (HST Copy and Content Editor)
  How long have you been with HST and which position/s have you occupied? I have occupied a number of positions since starting with HST in September 2015. I started as a Research Intern for one year and thereafter I was a Junior Researcher as an independent contractor until April 2017. In April 2017, I filled the position of Fleet Intern for approximately four months, and thereafter I was appointed as Fleet Controller and Team lead up until June 2019. In June 2019, I relocated from Kwa-Zulu Natal to Gauteng to occupy the Administrator position based at the Pretoria Office. I managed and maintained the office upkeep up until the effects of Covid-19 led to the office closure in September 2021. I was primarily responsible for ensuring all office equipment was carefully packaged, labelled and couriered to our head office in Durban. In October 2021, I occupied a dual position of Administrator for the Community Health Worker Think Tank (CHW TT) Secretariat led by the National Department of Health, as well as Office Administrator based at the Midrand Office. In September 2023, I was in a hybrid role filling a third position of Acting Business Development Assistant. In June 2024, I was appointed Business Development Officer and still currently occupy the position. Please share some information about what your current role entails. In my role as Business Development Officer, I engage in regular professional communication with donors, partners, and internal teams, ensuring timely and effective interactions on a daily, weekly, or monthly basis as needed. I support Business Development Unit (BDU) meetings, maintaining up-to-date donor and partner profiles within the CRM database. My professional interaction extends to collaborating with other units within HST, contributing to the development of proposals. I support the proposal budgeting process, including drafting budgets, sourcing quotes, managing budget templates, and updating them as necessary. Additionally, I assist in financial due diligence, ensuring the collection of required documents such as annual financial statements, proof of banking, tax clearance, BEE certificates, and references for completed projects. I play a key role in identifying live and forecast funding opportunities that align with HST's areas of expertise and interests. To ensure timely access to relevant opportunities, I maintain an up-to-date resource list for opportunity research, as well as subscriptions to various platforms that support opportunity identification. My role includes submitting due diligence requirements for each proposal and providing administrative support for business development activities, such as meeting co-ordination, minutes, and travel arrangements. Lastly, I actively seek out relevant training opportunities to enhance the performance of the unit. Administrator for the CHW Expert Working Group (EWG) Secretariat: Under the guidance of the National Department of Health (NDoH) and the EWG Technical Work Stream (TWS) chairpersons, I provided essential support for the EWG's work plan. This included facilitating communication among team members, co-ordinating meetings, and preparing necessary documents such as agendas, attendance registers, minutes, and reports. These tasks were carried out in alignment with the objectives and timelines set forth in the EWG work plan, ensuring smooth and effective operation of the work stream. What influenced your decision to be in the development/NGO sector? NGOs, particularly in the health space, create a feeling of togetherness. People come together with a common goal and work efficiently to reach their goals. This strengthens your ties to the community and provides a sense of fulfilment in seeing a tangible effect on the livelihoods of people. Joining an NGO exposes you to different types of people and helps you develop social skills whilst retaining your authentic personality; its culturally uplifting. How do you spend your time away from work? For the greater part of my life I had spent a lot of my time playing sports and keeping active. During my time in Durban I facilitated an indoor soccer game every Wednesday for the HST colleagues based at the Head office, to encourage team building, trust and strengthen relationships. Since June 2022, my wife and I welcomed our baby daughter into the world and I spend most of my time doing family activities. In the evenings, I enjoy online gaming. What gives you motivation? My greatest motivation is my family. Particularly my parents and my daughter. What is the best advice you've ever received in your life? (personal or professional) Wasted of all days is one without laughter. Any future aspirations? My short term aspiration is to do my Masters in Public Health. Long term I would like to contribute to cancer research. What are you reading at the moment? Mostly health-related publications and the latest news on current affairs.
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| By Siyabonga Gema (HST Communications Officer) and Reu'el McAllister Singh (Communications Intern)

HST's Communications and Multimedia duo, Communications Officer Siyabonga Gema and Communications Intern Reu'el McAllister Singh are shaking things up in the digital space, with a fresh new perspective on engaging content. This continues to elevate HST's work, while ramping up our online presence. Having joined HST almost exactly a year apart, they have made their presence felt through their contributions with expertise. They share their journey with HST thus far, and profile some of their work. Siyabonga Gema Give us a brief background in terms of your work experience I joined HST in June 2023, fresh from the corporate sector where I gained valuable experience in corporate communications in my previous role as Communications Practitioner for the pulp and paper manufacturer Sappi. Before then, I worked in the public health sector as Public Relations Officer at Wentworth Hospital, a position I didn't hold for too long before the corporate bug bit. When I joined HST, I was no stranger to the NGO space as I had acquired some experience during my internship at an NGO called The Association for the Aged (TAFTA) based in Durban central. I hold an Advanced Diploma in Public Relations and Communications Management from the Durban University of Technology, and am a registered Public Relations Practitioner (PRP) with the Public Relations Institute of South Africa (PRISA). What does your current role entail? Some of my duties entail - Writing and distributing content to promote the organisation's brand, activities and products.
- Acting as a liaison between the organisation, the public, and the media.
- Supporting our internal and external communications strategy, writing and disseminating publicity material, responding to inquiries from the public and media, and co-ordinating promotional events, including campaigns such as for CCPAC and 3HP-TPT
- Managing the organisation's social media communications – although this function was taken over by our Communications Assistant, I still play a support and supervisory role.
- Conference co-ordination and upselling HST such as at the World Pharmacy Congress and for PHASA and the G20 summit
What makes your job fulfilling? I am always inspired when I get the chance to join my HST colleagues from our various programmes in the field and seeing first-hand the immense contribution made by our organisation in changing people's lives through the work that we do. It makes me extremely proud of being part of this organisation. It is always exciting to tell the wonderful stories of our colleagues and to shine a light on their dedicated work; this makes my work fulfilling. Who/what had the biggest influence in your decision to choose this career? My grade 3 teacher played a major role in actually making me realise that I have a gift for writing and storytelling. She is the one who encouraged me to write, and even made me enter a school writing competition – which I won! That year I received an award for Literacy which was a big deal for my mother. She even gave me my very first book. So throughout my schooling I always knew that I wanted to pursue a career in communications because that is where my strength lies. What valuable lesson has your work taught you? In my line of work, it is very important to be a good listener; that is the biggest thing I have learnt in my career. We are expected to be a credible source of information, so for us to relay accurate and factual information we must first have a clear understanding of it otherwise we run the risk of misleading our audience, which is a major reputational blow. What are your future aspirations? I have a big passion for strategic communications so I see myself transitioning more into developing compelling business communications strategies for major corporates and organisations. I believe I have gained enough experience in implementing strategies and would like to now get exposure in crafting them. So I see myself as a top executive at a JSE listed company in future, driving and providing its strategic communications direction. Reu'el McAllister Singh When did you join HST and what does your role entail? I joined Health Systems Trust in August 2024 as a Communications Intern, where I contribute to the organisation's media and public engagement efforts. My role involves crafting compelling content, managing digital platforms, and ensuring that HST's communications are clear, engaging, and impactful. A significant part of my work focuses on supporting HST's campaigns and events through photography and videography. Whether capturing key moments at health events, documenting staff at work, or producing visual content that enhances our storytelling, I help bring HST's initiatives to life through dynamic and engaging media. I contribute by: - Writing engaging blog articles to drive awareness and engagement.
- Creating health observance content for social media, ensuring informative and visually appealing posts.
- Managing and optimising social media platforms, including overseeing the Health Systems Trust YouTube channel.
- Designing web banners and visuals for various campaigns.
- Uploading job ads and blog posts to the HST website, ensuring content remains current and accessible.
- Updating and maintaining key contact and media lists to support consistent and timely communication.
- Responding to social media queries, fostering professional and timely engagement with followers.
- Conducting web analytics to track engagement metrics and refine content strategies.
- Maintaining and curating the organisation's image and video library, ensuring high-quality visual assets for future use.
What do you love about your role? I enjoy the creative aspect of the communications unit, transforming health topics into content that resonates with people. Whether it's writing an article, designing a social media post, putting together a web banner, or creating a captivating video that showcases the important work our colleagues at HST are doing in the field, I find fulfilment in making health information accessible and engaging. I also appreciate the dynamic nature of my role. One day, I might be working at the office; the next, we're travelling to a different district to support a campaign or event. This variety keeps me motivated, always learning, and continuously improving my skills. What are your challenges and opportunities for growth? Like any role, working in the communications unit comes with its challenges. Balancing multiple projects at once while ensuring deadlines are met can be demanding. Covering events or managing time-sensitive campaigns requires quick thinking and adaptability. However, these challenges push me to be more creative, resourceful, and strategic in my work. I see myself growing further in the communications and media space, particularly in digital content creation and storytelling. Whether it's expanding my expertise in social media, video production, or exploring audio-visual storytelling, I want to keep evolving. I also hope to merge my passions in a way that allows me to work on creative projects that make a real impact, whether in media, sound, or health communication. The possibilities are endless, and I'm excited to see where this journey takes me.
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| 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 - 6 Tips to Be Water-Wise for Healthy Kidneys.
- NKF Nutrition Coach
- 5 Low-Impact Kidney-Friendly Exercises to Try During National Kidney Month
- Healthy weight
- Diabetes
- High Blood Pressure
- Smoking and Your Health
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| 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: E: webmaster@dipity.co.za
E:
info@worldglaucoma.org
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| 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.11 South 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.14 These 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 _________________________________________________________________________ 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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