SA has one of the world’s greatest misalignments between development and health progress, according to The Lancet’s latest Global Burden of Disease study, published on Friday.

The country is one of only a handful in which the number of years a person can expect to live in good health has declined since 1990, as disease and injury take their toll. The top five causes of premature death in SA are HIV, lower respiratory tract infections, road injuries, inter-personal violence and tuberculosis.

"The problem with South Africa is that it was overwhelmed by HIV," said one of the study’s collaborators Charles Wisonge, director of the Cochrane Centre at the Medical Research Council.

"There has been tremendous progress, but is still lagging," he said in a telephone interview.

Life expectancy for men rose 9.5 years over the past decade, to reach 59.2 years in 2016, while for women it improved by 13.6 years to reach 65.5 years over the same period.

But a South African man born in 2016 would enjoy only about 51.5 years of good health, down from 52 in 1990, while a woman born in 2016 could expect to have 56.1 healthy years, down from 58.6 in 1990, found the study.

Wisonge warned that SA faced a growing burden of non-communicable diseases, which it needed to tackle urgently.

"If we don’t do something now we will be caught off guard as we were with HIV," he said.

The study highlighted that worldwide, the rate of illness related to being overweight is soaring across all socio-economic groups. High body mass index is the fourth-largest contributor to the loss of healthy life, after high blood pressure, smoking and high blood sugar.

"Death is a powerful motivator, both for individuals and for countries, to address diseases that have been killing us at high rates," said Dr Christopher Murray, director of the Institute for Health Metrics and Evaluation, which co-ordinated the study.

"But we’re much less motivated to address issues leading to illness," he said in a statement.

"A triad of troubles — obesity, conflict and mental illness — poses a stubborn and persistent barrier to active and vigorous lifestyles," he said.

The global study found that one in five deaths is associated with poor diet, and that non-communicable diseases were responsible for 72% of deaths in 2016, up from 58% in 1990.

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