Cape Town – Type 2 diabetes has overtaken HIV, tuberculosis and other infectious diseases to become South Africa’s leading natural cause of death.
The latest mortality data from Statistics South Africa show that 27,692 people died from diabetes in 2023, marking the second consecutive year that the disease has topped the country’s list of natural causes of death.
Speaking on 702 Drive with John Perlman, Dr Nomathemba Chandiwana, Chief Scientific Officer at the Desmond Tutu Health Foundation, said the development reflects a long-term shift in South Africa’s disease profile.
“Type 2 diabetes is now a leading cause of death in South Africa. This did not come just suddenly. We’re seeing this more in the media, but this has been a trend that we’ve been seeing in South Africa and all over the world, particularly a lot of African countries, for the last two decades,” Chandiwana said.
She said roughly 100 people are now dying from the disease each day, with the increase driven by several factors.
Chandiwana said South Africa’s ageing population is one contributing factor. Improvements in HIV care have helped increase life expectancy, but ageing also increases the risk of non-communicable diseases such as type 2 diabetes, hypertension and strokes.
However, she said the rise in diabetes cannot be attributed to longer life expectancy alone, pointing to the country’s food environment, obesity and physical inactivity as other major factors.
Chandiwana also raised concerns about the number of people living with undiagnosed diabetes, saying almost half of people with the condition in South Africa may not know they have it.
She described this as a broader public health and healthcare systems challenge, particularly at primary care level, where greater emphasis is needed on prevention, screening and early treatment.
WATCH | Tens of thousands of South Africans die from diabetes each year. According to Stats SA, it is now the leading natural cause of death, claiming more than 27,000 lives annually. Health Minister Dr Aaron Motsoaledi says the development is not surprising at all. pic.twitter.com/AV7HLHaIbK
— SABC News (@SABCNews) August 13, 2026
South Africa already has a national strategy to tackle non-communicable diseases, but Chandiwana said implementation needs to be strengthened.
She identified improving unhealthy food environments, addressing obesity and inactivity, expanding screening and improving treatment as key priorities.
She also highlighted measures outside the healthcare system, including the taxation of sugary drinks, saying a stronger sugar tax could help reduce consumption and ultimately lower the risk of type 2 diabetes.
Chandiwana pointed to countries such as Brazil and Mexico, where increased taxes on sugary beverages have been used to discourage consumption.
Access to newer diabetes treatments also remains a challenge, with cost and availability limiting access to some medicines.
She said South Africa could learn from its response to HIV, which included medicines, pooled procurement, training and political commitment.
“We had a blueprint, we had medications, we had pooled procurement, we had training, and we had drugs available, and political commitment. We need to do the same for type 2 diabetes,” Chandiwana said.
The latest figures underline the growing burden of non-communicable diseases in South Africa and the need for stronger prevention, early diagnosis and long-term management of diabetes.
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Compiled by Glaan Sibuyi
