Apart from the struggle to eradicate poverty, Africa also faces an equally gruelling battle to survive the scourge of deadly diseases that are claiming lives in millions annually. As if dealing with such killer diseases as the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome, tuberculosis and Ebola has not been tough enough, Africa is now saddled with additional challenges of confronting non-communicable diseases, which are fast emerging as the leading causes of death on the continent.
NCDs are defined by the World Health Organisation as “chronic diseases (that) are not passed from person to person.” This means that, unlike infectious diseases, NCDs cannot be contracted through close personal contact. They include such deadly diseases as cancer, cardiovascular diseases (like heart attacks and stroke), chronic respiratory diseases (like chronic obstructive pulmonary disease and asthma) and diabetes that are gradually taking over as the leading killers in Africa. In fact, these four are responsible for up to 82 per cent of NCD deaths.
Globally, NCDs are said to be responsible for estimated 38 million deaths annually, out of which three quarters (or 28 million) occur in low- and middle-income countries. African countries mostly fall under the low-income category, meaning that they carry a disproportionately heavier burden of the diseases. According to a report on a study carried out in 32 countries on the continent, most adults have at least one risk factor that increases the chances of developing these diseases.
These factors include rapid urbanisation and globalisation of unhealthy lifestyle, leading to unhealthy diets, for instance. Unhealthy diets also nurture raised blood pressure, increased blood glucose, elevated blood lipids and obesity. These are termed intermediate risk factors capable of causing cardiovascular diseases. Other factors are physical inactivity, harmful use of alcohol (or alcohol abuse), exposure to tobacco smoke, either through direct smoking or passive smoking. Also important is the ageing factor; experts believe that the longer a person lives, the more likely the person will become ill with any of the NCDs.
Part of the study showed that the prevalence of hypertension in Africa was the highest in the world. “In half of the countries in the Africa region, at least one in three adults was found to be hypertensive,” the report noted. Given the role of hypertension in triggering other health challenges, such as kidney failure, heart failure or heart attack, vision loss, sexual dysfunction and stroke, the prevalence should give health authorities a cause for concern.
While every country is at risk of NCDs, the poorest countries carry the greater burden because they lack the resources to manage such diseases, which are usually very exorbitant. NCDs have even been identified as a factor in many countries not being able to meet the 2015 Millennium Development Goal target for poverty eradication.
Of the 16 million premature deaths (before the age of 70) attributable to NCDs, for instance, 82 per cent occur in low- and middle-income countries, according to the WHO. This thus gives the lie to earlier belief that they were diseases of the affluent. The impact on Africa forced WHO’s Director for the continent, Matshidiso Moeti, to lament, “These life-threatening diseases are robbing people and families of those who otherwise should be enjoying their most productive years and place a significant hardship on the region.”
Africa’s problems have, no doubt, been compounded by the challenge posed by infectious diseases such as HIV/AIDS, Ebola and tuberculosis, which have wreaked havoc on the continent over the years. South Africa, for instance, with over five million people living with HIV/AIDS, has the largest concentration in a single country in the whole world, followed by Nigeria. This has resulted in millions of deaths annually. The same also goes for TB and Ebola, which claimed thousands of lives when it struck on an unprecedented scale in West Africa a few years ago. Yet, the argument for the commitment of more resources and attention to NCDs remains unassailable.
The best point to start from is the elimination of the risk factors. If tobacco smoking, for instance, is responsible for about 6 million deaths annually, then it is reasonable to advise people to shun smoking. The same piece of advice is relevant for those who abuse alcohol. People should be encouraged to jettison sedentary lifestyle and embrace a new lifestyle with increased physical activities.
Lack of sufficient exercises and consumption of unhealthy diets, even among children, predispose people to obesity and inability to produce sufficient insulin to regulate sugar in the blood. The presence of high level of sugar in the body causes diabetes just as taking too much salt predisposes one to hypertension, which could also result in cardiovascular diseases and deaths.
This is where the role of the government becomes very important, especially in implementing the action plan of the WHO, which has set a target of 25 per cent “…reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2025.” The government has to lead the campaign to enlighten the citizenry about the need to review their lifestyle and habits so as to put the diseases in check.
Here in Nigeria, the National Agency for Food and Drug Administration and Control has to be up and doing, to be able to enforce quality in both locally manufactured and imported food items available in the market. Foods that do not comply strictly with required health standards should be banned. These are mainly in the area of prevention.
But beyond prevention, the government also has a big role to play to ensure that health care gets to the poor and most vulnerable, since it is not everybody that can afford the cost of travelling abroad for treatment. For diseases like cancer, where early detection can play a major role in obtaining cure, the government should equip the hospitals well to be able to perform their functions efficiently and continue to ensure healthy citizens to keep the country running.
