Botswana has shown limited progress towards achieving the diet-related non-communicable disease (NCD) targets. In 2016, the World Bank collection of development indicators, compiled from officially recognised sources highlighted that the cause of death by non-communicable diseases (NCDs) in Botswana was reported at 45.7 %. Now, recently, the minister of Health and Wellness, Dr Edwin Dikoloti said NCDs are now estimated to cause 46% of all deaths in Botswana.
The World Health Organisation (WHO) set nine NCD targets to eradicate NCDs by 2025. Some of the targets include halting the rise in diabetes and obesity, a 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years, a 10% relative reduction in prevalence of insufficient physical activity, A 25% relative reduction in the overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases, at least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context.
However a cursory look at data shows that Botswana is nowhere near achieving the bulk of the targets. The increasing trend of NCDs is attributed to more people involved in risky behaviours such as tobacco use, excessive alcohol consumption, unhealthy diets and physical inactivity.
Despite the fact that they are preventable, many of the NCDs can be prevented by tackling associated risk factors. In 2020, the Institute for Health Metrics and Evaluation (IHME) reported that the number of deaths from diabetes in Botswana from 2009 to 2019 increased by 40.1%. IHME is an independent health research centre that provides comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. The IHME research also shows that deaths from diabetes from 2009 to 2019 were higher than other NCDs such as heart disease and stroke which registered a death rate increase of 31% and 18.8% respectively.
Dr Dikoloti also told parliament recently that cancer is estimated to account for 7% of all deaths in Botswana, while heart diseases accounts for 18% of all deaths. The 2030 Agenda for Sustainable Development adopted at the United Nations Summit on Sustainable Development in September 2015, recognises NCDs as a major challenge for sustainable development.
Although Botswana has to some extent reacted by pragmatic measures in its fight against NCDs, there still seems to be inaction with regards to fully enforcing decisions such as promoting healthy diets, improving primary health care for screening and early detection of chronic diseases, controlling alcohol abusers and encouraging physical activity. Progress in implementing comprehensive NCDs strategies and policies has also been hampered by scarce resources.
The minister of Finance and Economic Development Dr Thapelo Matsheka announced that the government will introduce a levy on sweetened beverages related to their sugar content at a rate of two Thebe per gramme of sugar above a content of 4g of sugar per 100 millilitres. Although the sugar tax will not reverse the burden of NCDs alone, they generate revenue and encourage reformulation of high-sugar products in the food system.