Diseases of the Affluent Encroach Africa

Published on 24th July 2007

Western economies are home to thousands of African migrants who include intellectuals, professional and skilled workers. The reasons for the never-ending exodus are multifaceted, but they include political instability, warfare, and social and economic insults in their countries of origin.

 

While brain drain continues to receive political condemnation of foul play among the wounded African governments, the exodus of Africans to the cemetery as a result of increasing incidents of non-communicable (chronic) diseases such as cancer, diabetes, high blood pressure and stroke is a steadily growing reality. In 2005, the World Health Organisation (WHO) estimated that worldwide, 35 million people would die of chronic diseases such as diabetes, cancer and cardiovascular diseases, with 80% of the fatalities occurring in low- and medium-income countries (LMICs). Although age is a non-modifiable risk factor of such diseases, 43% of the deaths and 86% of years of healthy life lost were estimated to occur in people under the age of 70 years. Writing in the Lancet, Dr Kate Strong and colleagues projected that pursuing a goal to reduce chronic disease death rate by 2% every year between 2005 and 2015 would cumulatively avert 36 million deaths, globally.

 

Comparatively, chronic diseases are dwarfed by leading killers such as malnutrition, malaria, pneumonia, diarrhoea, AIDS as well as respiratory infections, which dominate the health agendas of LMICs. However, adoption of western lifestyles and dietary habits (leading in part to overweight and obesity), coupled with poor health care systems are fertile grounds for the escalation of chronic disease incidents, particularly among Africa’s affluent minority. Paradoxically, therefore, Africa is already battling a dual burden of under nutrition (hunger and micronutrient malnutrition) and over nutrition (overweight and obesity).

 

That our lifestyles and diets are changing, particularly in the urban affluent niche is a fact which consequently raises the risk of chronic diseases. Understandably, problems with meagre budgetary allocation to health services, overstretched and poorly-motivated healthcare professionals, poor health sector infrastructure and other factors synergistically translate into low availability and accessibility to, and poor delivery of health services. According to Adamson Muula of the Malawi College of Medicine, the patient/physician ratio in Mzimba district in the northern region of Malawi is estimated at 317,856:1, which renders enormous health delivery challenges. Between 2003 and 2005, Kamuzu Central Hospital, the second of four tertiary hospitals in Malawi experienced a turn-over of 288 (60.5%) of its nursing workforce. These human resource realities are similar across the continent, perhaps worse-off in other countries, yet much better in others.

 

Can Africa deflect chronic disease predicaments?

 

Over the last three decades, high-income countries have reduced heart disease death rate by 70%. In the midst of meagre public health resources, African health ministries can implement strategies to address the growing problem before it goes out of hand.

 

Drawing on lessons from high-income countries, Dr JoAnne Epping-Jordan of the WHO and her colleagues recommend a planning and implementation framework consisting of: 1) assessment of the situation; 2) formulation and adoption of a chronic disease policy; 3) identification of the most effective implementation steps; and 4) implementation. Does Africa possess professional and political will to address chronic diseases in a manner that would avert fire-fighting in future? Are our tertiary institutions preparing Africa’s human resource to recognise the enormity of the problem, and gather an array of preventive arsenals that can be taken to avoid a crisis? It is the responsibility of central governments to spearhead interventions that would minimise poor quality of life and premature demises of their much-needed citizens due to preventable chronic diseases.

 

While the above recommendations are obviously best handled by health ministries, as individuals, we can play critical roles to improve the quality of our personal lives, and those of our families. The leading risk factors of chronic diseases have been elucidated. They include smoking, being overweight/obese, leading sedentary lifestyles, elevated consumption of high-energy and fatty foods, low consumption of nutritious fruits and vegetables, and having a family history of diabetes, cancer, high blood pressure and stroke. Embracing the culture of “Big is Beautiful” whereby our women and children are allowed to gain unhealthy weights is a sure way of beckoning a troubled life with chronic diseases, soon or later.

 

Some of these risk factors are modifiable if early appropriate intervention is sought. For example, quitting smoking, exercising, consuming more fruits and vegetables, and reducing the intake of high-energy and fatty foods, are some of the ways that individuals can employ to improve the quality of their own lives. Individuals can also request for assessment of body weight relative to their height, blood pressure, and actively seek appropriate professional advice where possible. An easy-to-read resource is available from the WHO website for use even by lay people: http://www.who.int/cardiovascular_diseases/resources/cvd_report.pdf. Readers should seek professional advice on how to interpret and/or implement the strategies which the WHO has suggested.

 

The notion that chronic diseases are solely a problem of the West is fallacious. In fact, technological advancement, excellent health care infrastructure, retention of trained medical professional and relatively effective healthcare systems have enabled high-income countries to significantly tilt the chronic disease balance in their favour. Unless deliberate policy and programme responses are formulated and implemented with generous political commitments, Africa has the potential to become the epicentre of chronic diseases that are already ‘silently’ eroding the continent of its limited human resources.


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