The national essential medicines list committee has prioritised the review of glucagon-like peptide (GLP)-1 medicines, according to a senior health department official.
The review will determine whether the drugs — used to treat type 2 diabetes and obesity — will be added to SA’s essential medicines list and provided to state patients. The review will include an assessment of the affordability of GLP-1, said the health department’s deputy director-general for primary healthcare, Jeanette Hunter.
In September, the World Health Organisation (WHO) added GLP-1s to its essential drugs list for managing diabetes and on Monday released a new guideline for their use as a long-term obesity treatment.
Three GLP-1s are approved by the South African Health Products Regulatory Authority: Novo Nordisk’s liraglutide and semaglutide, sold as Ozempic and Wegovy, and Eli Lilly’s tirzepatide, branded Mounjaro and Zepbound, and marketed in South Africa by Aspen Pharmacare.
Medical schemes provide limited cover for their use as a diabetes treatment, but none cover their use for obesity, forcing most patients to pay out of pocket.
The WHO guideline on GLP-1s would make it possible, in time, to add another facet to SA’s multi-pronged strategy to combat obesity, said Hunter.
The prevalence of obesity in SA is one of the highest in Africa and is driving the country’s growing rates of non-communicable diseases, such as diabetes and cardiovascular disease, she said. An estimated 67% of women, 31% of men and 13% of children are overweight or obese, according to government figures.
“The economic toll is unsustainable and includes healthcare expenses, lost productivity, absenteeism, disability and premature mortality,” said Hunter.
The government recognised that obesity was not due to individual choices alone, but was driven by social, economic, environmental and commercial factors, including inequities in access to healthy food and safe spaces for physical activity, she said.
Obesity was associated with 3.7-million deaths worldwide in 2024, and if current trends continue, the number of obese people is projected to double by 2030, according to the WHO. It emphasised that GLP-1 treatment should be accompanied by improvements in diet and exercise
“While medication alone won’t solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms,” WHO director general Tedros Adhanom Ghebreyesus said in a statement.
The WHO added the three GLP-1 medicines that have been approved by stringent medicine regulators to its essential drug list — liraglutide, semaglutide and tirzepatide.
It said obesity was a complex, chronic disease that, in addition to driving non-communicable diseases, worsened the outcomes for patients with infectious diseases.
The costs associated with managing obesity and associated health complications are skyrocketing, said the WHO, with the global economic cost of obesity projected to reach $3-trillion a year by 2030.
