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Non-communicable diseases (NCDs) have become a major cause of mortality globally, but especially in low and middle-income countries, where nearly 80% of all NCD related deaths occur. There has been a growing interest in tackling the burden of NCDs in South Africa. In September 2011, the South African government convened a summit on the 'Prevention and Control of Non-Communicable Diseases' which produced a declaration that endorsed action aimed at various levels of risk factors, i.e. behavioural, environmental and structural, and further acknowledged the need for intersectoral collaboration. In this short interview, Professor Thandi Puoane from the University of the Western Cape discusses some of the challenges associated with addressing NCDs in South Africa, particularly in low-income urban areas.