Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2013 Jan 14;103(3):147-9. doi: 10.7196/samj.6281.
South Africa has a 'quadruple burden of disease'. One way to reduce this burden, and address the social determinants of health and social inequity, could be through health promotion interventions driven by an independent Health Promotion and Development Foundation (HPDF). This could provide a framework to integrate health promotion and social development into all government and civil society programmes. On priority issues, the HPDF would mobilise resources, allocate funding, develop capacity, and monitor and evaluate health promotion and development work. Emphasis would be on reducing the effects of poverty, inequity and unequal development on disease rates and wellbeing. The HPDF could also decrease the burden on the proposed National Health Insurance (NHI) system. We reflect on such foundations in other countries, and propose a structure for South Africa's HPDF and a dedicated funding stream to support its activities. In particular, an additional 2% levy on alcohol and tobacco products is proposed to be utilised to fund the HPDF.
南非存在“四重疾病负担”。减轻这一负担并解决健康和社会不平等的社会决定因素的一种方法，可能是通过由独立的健康促进和发展基金会（HPDF）推动的健康促进干预措施。这可以为将健康促进和社会发展纳入所有政府和民间社会方案提供一个框架。在优先事项方面，HPDF 将调动资源、分配资金、发展能力，并监测和评估健康促进和发展工作。重点将是减少贫困、不平等和发展不平衡对疾病发生率和福祉的影响。HPDF 还可以减轻拟议的国家健康保险（NHI）系统的负担。我们反思了其他国家的此类基金会，并为南非的 HPDF 提出了一个结构和一个专门的供资渠道来支持其活动。特别是，提议利用对酒精和烟草产品征收的 2%附加税来为 HPDF 提供资金。
