Simple solutions to non-communicable diseases

 

“Non-communicable diseases kill 38 million people each year, and almost three quarters of NCD deaths – 28 million occur in Africa and other low- and middle-income countries,” notes the World Health Organisation (WHO) 2015 Fact sheet.

The fact sheet goes on to say: “Sixteen million NCD deaths occur before the age of 70; 82 per cent of these ‘premature’ deaths occurred in low- and middle-income countries.

“Cardiovascular diseases account for most non-communicable disease deaths, or 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million).”

According to the fact sheet, these four groups of diseases account for 82 per cent of all NCD deaths, and tobacco use, physical inactivity, the harmful use of alcohol as well as unhealthy diets all increase the risk of dying from a non-communicable disease.

Without doubt, non-communicable diseases are halting socio-economic growth in Africa as they threaten progress towards the United Nations’ (UN) Millennium Development Goals and post-2015 development agenda.

“The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries, particularly by increasing household costs associated with health care,” notes WHO.

To lessen the impact of NCDs on individuals and society, adds WHO, a comprehensive approach that requires all stakeholders to work together to reduce the risks associated with NCDs, as well as promote the interventions to prevent and control them is needed. 

The World Health Organisation also says that low-cost solutions could effectively reduce the common modifiable risk factors and map the epidemic of NCDs and their risk factors.

A study published recently by think-tank, the Copenhagen Consensus Center, titled “Benefits and Costs of the Non-Communicable Disease Targets for the Post-2015 Development Agenda”, concurs.

“Simple policies such as taxing cigarettes could be a cost-effective way to largely meet the proposed global development target of slashing premature deaths from non-communicable diseases.”

The report, authored by Rachel Nugent, a global health researcher at the University of Washington, in the United States adds: “Five prevention and treatment interventions – increase of tobacco price by 125 per cent through taxation, aspirin therapy at the onset of acute myocardial infarction (AMI), salt reduction, chronic hypertension management for medium to high risk patients as well as secondary prevention of cardiovascular disease with polydrug – could avert 5 million premature deaths from NCDs in 2030, equivalent to a 28.5 per cent reduction in projected NCD mortality.”

The report also urges governments in developing countries to do more to address growing health threats such as obesity, heart disease and lung cancer. 

“Governments should encourage citizens to reduce the amount of salt they eat, introduce a tobacco tax and ensure access to multi-drug treatment for heart disease,” it says.

Other avenues to reduce non-communicable diseases, according to the report, are high impact essential NCD interventions that can be delivered through primary health-care approaches to strengthen early detection and timely treatment.

“The greatest impact can be achieved by creating healthy public policies that promote NCD prevention and control and re-orienting health systems to address the needs of people with such diseases,” consents WHO.

Public health education campaigns are, therefore, of paramount importance. 

Jared Odhiambo Owuor, a programme leader at the Nairobi-based African Institute for Health and Development’s Consortium for NCD Prevention and Control in Sub-Saharan Africa, advises that public health education programmes, to be effective, must be targeted and culturally sensitive.

“In some African countries, for example, there is the perception that a fat, married man is ‘well-fed’ and well taken care of. The wife is, thus, told she is doing a good job,” he says, adding that these perceptions are rooted in culture and can, thus, be tackled with targeted education programmes.

However, Owuor believes that the biggest obstacle to implement simple solutions and/or interventions is the weak health systems across Africa and other developing states.

“The heart of the issue is providing effective healthcare, and our health systems have always been underfunded,” he says, adding: “A broad set of changes will be needed for countries to meet the proposed NCD Target for Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages.

“These must include more and better trained health care providers, simplifying treatment guidelines, formulations, and delivery, improving affordability and more education and training for patients to take responsibility for their own disease management.”

African governments should simply increase their budget allocations to public health if the continent is to improve its public health systems. 

They should be committed to fulfil their pledges towards health funding, well documented in the Abuja Declaration.

In the 2001 Abuja Declaration, African Union member-states pledged to allocate at least 15 per cent of their national budgets to public health by 2015. 

Unfortunately, most African nations are yet to meet this commitment.

April 2015
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