Section 27 and the overlooked crisis — why healthcare access starts with diabetes action

Detailed summary

Political acknowledgement must be backed by actionable public health measures, including early diagnosis, accessible primary healthcare screening, and uninterrupted medication…

Political acknowledgement must be backed by actionable public health measures, including early diagnosis, accessible primary healthcare screening, and uninterrupted medication supplies, if South Africa is to beat the country’s leading cause of natural death.

Dr Patrick Ngassa Piotie is chairperson of the Diabetes Alliance South Africa and co-founder of the University of Pretoria Diabetes Research Centre.

This year marks three decades since South Africa adopted a Constitution rooted in human dignity, equality, and social justice. Enshrined within Section 27 is a promise: that every person in our country has the right to have access to healthcare services.

Yet, as we mark Diabetes Awareness Month this November, we are confronted by a sobering disconnect between constitutional ideals and lived reality.

The latest mortality figures from Statistics South Africa tell an unambiguous story. For three consecutive years, diabetes has stood as the leading recorded underlying natural cause of death in South Africa. In 2024, it accounted for more than 6% of all recorded deaths in the country. Every day, nearly 80 South Africans lose their lives to diabetes.

Behind these numbers are parents, breadwinners, community leaders, and children. What makes this loss particularly tragic is that many diabetes-related deaths, along with devastating complications such as amputations, blindness, stroke and kidney failure, can be prevented or delayed through timely diagnosis and effective care.

When Health Minister Dr Aaron Motsoaledi publicly acknowledged in August that diabetes was already a crisis, it marked an essential shift in political visibility. But an acknowledgement is only a starting point. It does not put insulin on clinic shelves, shorten long diagnostic queues, or equip primary healthcare facilities with the tools required for early detection.

For a person living with diabetes, the constitutional right to healthcare is not an abstract concept.

When health systems fail to detect…

Opening of the article, excerpted from Daily Maverick. To read the rest, open the article on the publisher's site.