Thesis (MPhil)--Stellenbosch University, 2010. / Chronic diseases have been described as “the biggest public health threat society has ever faced” (World Economic Forum, 2010). The forecast from both the World Health Organization and the World Bank is that the morbidity and mortality rate of these diseases will impact severely on low and middle-income countries (WHO, 2005). The burden of disease in South Africa comprises both communicable and non-communicable burden maladies, including high rates of HIV/AIDS and tuberculosis (TB). A high incidence of injury, peri-natal and maternal disorders also contributes to the health burden (Mayosi, Flisher, Lalloo, Sitas, Tollman & Bradshaw, 2009). The country is approaching a demographic transition with an accelerating ageing population. The factors contributing to the ageing of the population differ from those of the rest of the world (Haldenwang, 2009). The Western Cape Province is unique in its position as the province in South Africa with the highest life expectancy, a population change rate that is double the national average, and a higher than average older population (Provincial Government of the Western Cape, Department of Health. 2010. Strategic Plan 2010-2014). An extensive literature survey employing an integral environmental scanning approach was used to determine the impact of ageing on the burden of disease in the Western Cape. The connection between ageing, chronic disease and physical functionality was explored in a non-standardised questionnaire and in the literature survey. An evaluation of the Western Cape Department of Health Strategic Plan 2010-2014 found that non-communicable diseases and mental health issues that constitute about 28 per cent of the burden of disease (WHO, 2008) are not considered in future planning. This study shows that the Western Cape Province has limited time to prepare for the expanding and accelerating ageing population. The analysis of the questionnaire and the literature survey forms the foundation for the building of scenarios to visualise possible health futures in 2030 in the Western Cape. The desirable scenario is a balance between life expectancy and health expectancy.