Diabetes now South Africa’s leading cause of death, killing about 79 people a day

Non-communicable diseases now dominate the death profile

Stats SA’s report shows the three top causes of death in 2024 were all non-communicable diseases illnesses that cannot be passed between people. Hypertensive diseases ranked second at 5.5% of deaths and cerebrovascular diseases, which include strokes, third at 5.4%. Together, these three conditions accounted for more deaths than any infectious disease, the report said.

Who is most affected

The report found that diabetes hit women hardest, accounting for 7.9% of all female deaths. Among men, tuberculosis remained the leading cause of death at 4.8%. HIV accounted for 3.8% of all deaths in 2024, down from 4.3% in 2022 and 4.0% in 2023. Covid-19 was responsible for 450 deaths in 2024, representing less than 0.1% of the total.

Geography and non-natural deaths

By province, Gauteng recorded the highest share of deaths at 21.2%, followed by KwaZulu-Natal at 18.8%. The Northern Cape recorded the lowest share at 3.1%. The report also recorded 62,871 deaths from non-natural causes, with three-quarters recorded as accidental injuries and 12% as assault.

Voices responding to the findings

Professor Tim Noakes, founder of the Noakes Foundation, described the three leading causes as linked rather than separate. He told IOL:

“[All those diseases] are caused by insulin resistance and high-carbohydrate diets.”

Noakes warned of a worsening trend and said:

“We are in the middle of the tsunami I have talked about years ago, and the problem is it’s only going to get worse.”

Diabetes SA branch manager Reverend Sean Cameron Gunn urged clarity about causes and treatment, saying:

“There are many contributing factors, but one of them is that misconception that sugar causes diabetes – and that’s not true.”

Gunn added:

“Type 1 diabetes almost starts off like an autoimmune disease, where your body begins to fail to produce any form of insulin.”

Armand de Wet, a return-to-play specialist in Stellenbosch, described seeing insulin problems in younger people and said:

“As soon as we start removing it by eating less carbs, the body becomes more insulin sensitive again.”

Advocacy and data gaps

Civil society groups and health advocates have pressed government for action. The Diabetes Alliance wrote to President Cyril Ramaphosa, finance minister Enoch Godongwana and health minister Dr Aaron Motsoaledi urging steps in response to the death toll. In April, 24 civil society organisations called for a national diabetes registry and for health funding to be redirected towards managing the disease.

Stats SA also warned that 18.2% of natural deaths in 2024 were recorded under ill-defined causes, a gap that the agency said makes it impossible to track disease trends properly and can create a distorted view of population health.

What the report makes clear

The Mortality Report positions diabetes and other non-communicable diseases at the centre of South Africa’s current public-health burden. The figures in the report document a shift in the country’s leading causes of death and have prompted calls from experts and civil society for changes in policy, data collection and health funding.