This opinion piece is excerpted from remarks made by Zoleka Mandela at the United Nations General Assembly.
Although we may value our health more than anything else, we continue to sleepwalk into a future riddled by sickness. At this rate, the 21st century may well be remembered for failing to confront a preventable, treatable, and an often man-made epidemic that continues to destroy our health and lives and that of our children.
Noncommunicable diseases, which include various cancers, cardiovascular diseases, chronic respiratory diseases, diabetes, to name a few, consist of these killers. Even though these are often linked to old age, 15 million people between the ages of 30-69 will die from an NCD this year alone. Last week, the United Nations hosted a High-Level Meeting on NCDs and governments across the world must commit to action.
At last week's high-level NCD meeting, everyone was geared up to get governments to step up their commitment to reduce premature deaths from cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases. But this does not address the full weight of the problem.
NCDs do not discriminate. More than 85 percent of those premature deaths will occur in low- and middle-income countries for two reasons: Failure to address the causes, and failure to provide access to universal health care in order to give everyone a fighting chance at life.
I have had my own life threatened twice by an NCD. I have beaten breast cancer twice, yet I am aware that so many of my brothers and sisters across Africa suffer each and every day because they are denied access to health care. We have the solutions to these 21st century epidemics at our fingertips, yet we fail to ensure they are in place.
I believe that those of us who have survived must tell our stories if we are going to effect change. I remember the moment I realized that there was a possibility that my own life would be cut short by cancer. I was sitting in the car and directly opposite a medical center after my breast biopsy. I had asked the doctor if she thought it was cancer. She didn’t confirm it, but she paused before she said she needed to run more tests. I can never forget the look she gave me that said everything; like I was her own daughter, confronting a terrible reality.
I was scared, and it took me a long time to find my own strength after my diagnosis. I have to say that even at the time that I lost my daughter Zenani to the biggest epidemic that our young people face — road traffic injury, my strength came from my loved ones. My family gave me strength with the recurrence of breast cancer in 2016. My grandfather once said that, “the greatest glory of living lies not in never falling but in rising every time you fall." The strength and resilience of both my grandparents has been a tremendous inspiration for me that continues to be the driving force helping me survive my own experiences.
Having fallen and struggled in my own life, as have many, it is important to keep in mind that my story is not typical. In my country, and in many developing countries, most people don’t even get the chance to fight. Sadly, health care is so difficult to access and often people don’t even know why they are sick — just a third of low-income countries have facilities to provide a cancer diagnosis, while even fewer have the facilities to cure or alleviate pain.
Not only are these diseases treatable, many are preventable. Dirty and dangerous environments, especially in developing urban areas, create chronic health issues. These harm our children and put them at risk from a number of NCDs, which will, in turn, shorten and reduce the quality of their lives.
Equally, while treatment is more readily accessible in developed countries, there are various factors that make it harder to be healthy: Poor city planning, environments, the production of fast foods — these influence choices and behaviors leading to reduced activity and obesity.
If the harmful use of alcohol were also tackled with smart policies, it could efficiently reduce both NCDs such as cancer and alcohol-related road traffic incidents and violence. It is unbelievable that despite all the knowledge, all the evidence of what works, many countries in Africa still aren’t doing enough to make it easier for people to be healthy and safe and less likely to need to enter the health system in the first place — why is that?
This same unsafe environment encourages the road traffic injury crisis. Very much like NCDs, this is an avoidable killer, a cruel health burden that continues to infringe on the basic human rights of our vulnerable children.
The risk of dying as a result of a road traffic injury is highest in the African continent. Each year, a quarter of a million Africans are killed on our roads and I know the pain that goes with such a statistic. My daughter, Zenani, was a teenager for barely 48 hours before she was killed by a drunk driver. It was as if my life was plunged into absolute darkness.
I will never forget the words my grandfather shared with me shortly after her passing: “You are not the only one who has lost a child. I have lost a child and many people have but for you, it is so that you can bring hope to many.”
His words made me more determined to use my life to affect change in that of others and that they should not suffer as my family and I have done.
The inaction that prevents millions of people from suffering and dying from preventable NCDs and road traffic injury is the unfortunate result of neglect across the globe. There has been a failure not only from our leaders and governments of the international community but as well as in global commitment and funding.
My hope is the U.N. High-level Meeting on NCDs would result in something more substantial than lip service paid to those living and affected by NCDs.
People living with NCDs, civil society organizations, communities that are overwhelmed by chronic diseases they have never seen before must stand together today. With one voice, we say: Enough.
We have heard from just a small proportion of the champion governments that are thankfully taking that first progressive course of action. I was delighted that we had an unprecedented number of heads of government and state coming together last week and hopefully we can be cautiously optimistic that the number of trailblazer governments who make commitments to NCDs will continue to grow.
We have heard from advocates and people living with NCDs who have committed their lives to tackling the injustices of NCDs, the inaction, the apathy, and the acceptance that NCDs are now the norm, rather than the exception. These are our rays of hope and the change agents who are making a difference on the ground.
And their energy and tenacity have yielded very real and important strides in the NCD response since the last two high-level meetings. While we still no doubt have our work cut out, to put it lightly, the NCD community has a lot to celebrate. The tide is turning. And the silence must end now.
Our leaders must respond to this global health crisis with serious action. They can, and they must strive to be better — they must strive to do everything possible to deliver health to all people, no matter their race, location, or status.
The silence must end now.
NCDs. Climate change. Financing. Read more of Devex's coverage from the 73rd U.N. General Assembly here.