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Publication date: 
January 31, 2014

Health challenges can seem insurmountable, unimaginably vast, and requiring unattainable financial investment.

"There is a perception that health is a bottomless pit into which you have to throw resources,” Professor Craig Househam, head of the health department for the Provincial Government of the Western Cape of South Africa, told the South African newspaper The Weekender.

But Househam planned to change that perception. In 2005, he commissioned a burden of disease study for the Western Cape that was rooted in a national burden of disease study conducted by the South African Medical Research Council in 2000, which emerged from the Global Burden of Disease findings from 1993. The Western Cape Health Department used the evidence published in a 2007 report to motivate local government officials to address a major cause of premature death and disability: alcohol.

The study found that alcohol was among the most prominent causes of disease burden in the province, primarily by contributing to injuries from road accidents and violence.

The disease burden study’s authors highlighted their findings about the negative health effects of alcohol in public hearings on liquor laws in the province. Instead of seeing the alcohol problem as a bottomless pit, Western Cape policymakers took specific steps to reduce alcohol use after learning about the harm it was causing in their communities. They tightened restrictions on alcohol, such as limiting the hours that liquor can be sold and requiring previously unregulated liquor vendors to obtain licenses.

“Understanding the burden of disease is fundamental to the planning and decision-making processes in health departments,” Househam wrote in 2007. “Rather than being reactive to the pressures placed upon the health system, information is actively sought that will enable Government to act in a manner that begins to address – and indeed reduce – the burden of disease.”