Non-communicable diseases (NCDs) —primarily heart and lung diseases, cancers, and diabetes—are now the leading cause of death globally, with 41 million deaths attributed to NCDs annually, according to the World Health Organisation (WHO). This is equivalent to 71% of all deaths globally and 82% of these deaths occur in developing countries, including Africa, with about half occurring prematurely (under 70 years of age).
In the past, NCDs were regarded as diseases of the West and associated with an affluent lifestyle. However, today this is largely no longer the case. While the government and international community focused on dealing with communicable diseases like malaria, HIV/AIDS, polio, and tuberculosis, NCDs have permeated many corners in Africa.
On the verge of a non-communicable disease epidemic
The WHO has predicted that over the next 10 years, Africa will experience a 27% increase in deaths from NCDs. This means that by 2030, NCDs are expected to become the leading cause of death in Africa, exceeding deaths caused by communicable, maternal, perinatal, and nutritional diseases combined.
Some African countries like Mauritius, Namibia, and Seychelles, already report that NCDs are linked to over 50% of all adult deaths. For countries in North Africa like Algeria, Morocco, and Egypt, the situation is dire, as NCDs already account for over 75% of all deaths.
Africa, therefore, seems to be on the verge of an NCD epidemic. Of particular importance to the public health sector is that 30% of the African populace already have high blood pressure (140/90 mm/Hg) and are likely to develop other complications like stroke, coronary heart diseases, kidney diseases, visual impairments, etc.
Consequences for Africa’s health system
These statistics show NCDs will soon become the leading cause of diseases, disability, and premature death in Africa. The consequences of this are not only devastating for the individuals affected, but also for Africa’s health system and socioeconomic development.
In a continent where availability of advanced diagnostics and drugs, intensive disability management, and prolonged care facilities are grossly inadequate, Africa’s healthcare system lacks the capacity to cope with a full-blown NCD epidemic, as it is already overstretched by efforts to combat communicable diseases like malaria, TB, and HIV/AIDS and poor maternal and child health.
Addressing the root causes of the surge of NCDs in Africa
NCDs are also referred to as ‘lifestyle diseases’ because they are largely linked to the day-to-day habits of people. The four major risk factors associated with NCDs are tobacco use, physical inactivity, harmful use of alcohol, and an unhealthy diet. Unfortunately, these risk factors remain a major problem among the African populace.
A quarter of secondary school students (ages 13-15) in Zambia smoke or use tobacco products, while 24% of boys and 19% of girls in secondary schools in South Africa use tobacco products. In Namibia, about 26% of boys and 21% of girls (ages 13-15) are alcohol users. With figures like these, there is little wonder why cases of NCDs are expected to surge over the next decade in Africa as adolescence is typically when risky behaviours which set the stage for later development of lifestyle diseases are established.
Strategies to combat NCDs burden in Africa
Combating NCDs in Africa will require a collaborative approach through continental, national, and individual commitment. Globally, the WHO supports the Member States, including African countries, to develop and implement comprehensive strategies for the management of NCDs. These strategies include:
1. Development of national policies with the goals of reducing exposure to risk factors of the diseases and strengthening health systems to cope with NCDs. The partnership between government authorities, non-governmental organisations, and the private sector is crucial to improving the availability of care for NCDs at the primary, secondary, and tertiary healthcare levels. For example, in some African countries, Bloom Public Health partners with the government, working with policymakers and government officials to support the development of contextual public health interventions that include promotion of healthy lifestyles, and disease detection and prevention.
2. Increasing taxes and prices on tobacco products and alcoholic beverages these taxes can increase financing for public health. The WHO also encourages African governments to create and enforce laws that mandate plain packaging for tobacco products and place bans on tobacco and alcohol advertising.
3. Exploring diet-related approaches by compelling companies to formulate food products with reduced salt content to reduce risk of cardiovascular diseases and enforcing a tax on sugary drinks to reduce diabetic risk.
4. Increasing access to essential drug therapies and counselling for individuals with a higher risk of cardiovascular diseases or stroke patients and increasing awareness and availability of human papillomavirus (HPV) vaccination, which is a proven measure to prevent cervical cancer in women.
5. Advocating for individuals, particularly adolescents, to adopt healthy lifestyle choices such as healthy diets with more vegetables and fruits, avoiding tobacco and alcohol, and exercising, as the simplest and cheapest way to prevent NCDs.
Ultimately, there is a crucial need for urgent actions to limit the rapidly growing cases of NCDs in Africa, as the healthcare systems across the continent are in no position to cope with the burden of a full-blown NCD pandemic.
Professor Anyakora is the CEO of Bloom Public Health and a public health expert.
Odibeli is a pharmacist and the Research and Communications Coordinator at Bloom Public Health.