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.