Civil society groups and health experts are calling on government to urgently declare diabetes a National Public Health Priority Crisis, warning that the disease has become the leading cause of natural death in South Africa.
The appeal is contained in the Johannesburg Declaration for Accelerated Action on Diabetes in South Africa, adopted following the 2025 Diabetes Summit held in Johannesburg from 11 to 13 November. The gathering brought together more than 400 delegates and culminated in what advocates describe as one of the most unified national calls yet for urgent intervention.
The coalition includes 24 civil society organisations, including the Diabetes Alliance, Healthy Living Alliance and Diabetes South Africa, among many others, alongside clinicians, researchers, advocates and people living with diabetes.
Convened by the Diabetes Alliance, with support from the National Department of Health, the Department of Science, Technology and Innovation, the Gauteng Department of Health, the South African Medical Research Council, the World Health Organization Country Office for South Africa and the World Diabetes Foundation, the summit brought together a broad coalition committed to accelerating action.
Signatories warn that diabetes is driving rising disability, premature deaths and mounting economic pressure. They reveal that the cost of diabetes is projected to reach at least R35 billion by 2030, a figure advocates say threatens the sustainability of the proposed National Health Insurance and the broader public health system.
“Diabetes is no longer a silent epidemic. It is a full-scale national crisis undermining families, communities, and the health system. The current fragmented response is failing South Africans,” said Diabetes Alliance chairperson Dr Patrick Ngassa Piotie.
Ngassa Piotie says the declaration notes that the burden of diabetes falls disproportionately on low-income households, women, rural communities and people facing intersecting vulnerabilities, including HIV, disability, food insecurity and mental health challenges.
Among the key demands, signatories are urging the President to formally declare diabetes a National Public Health Priority Crisis and establish a high-level multisectoral mechanism within the Presidency. National Treasury is also being called on to ring-fence Health Promotion Levy revenue for non-communicable diseases and allocate at least five percent of national health expenditure to diabetes by 2030.
The declaration further calls for the integration of comprehensive diabetes services into primary healthcare, the establishment of a National Diabetes Registry by 2027, and the appointment of national and provincial diabetes programme managers. Parliament is also being urged to conduct an inquiry into the diabetes crisis.
The private sector is meanwhile encouraged to reformulate high-sugar and ultra-processed foods, introduce front-of-pack labelling, end the marketing of unhealthy foods to children and expand medical scheme coverage for essential diabetes diagnostics and technologies.
Signatories emphasise that access to diabetes prevention and care is a constitutional right, warning that failure to act will deepen inequality, strain the health system and undermine national development goals.
“The time for half measures has passed. The time for a decisive national response is now,” the declaration states.