*Africa's illness trends will strain health systems/ Oxford Analytica 31.08.16*
Non-communicable disease is increasingly a socio-economic threat to the continent South Africa's health minister yesterday urged the country to reduce intakes of sugary drinks as the country works to combat an increase in non-communicable diseases (NCDs), including by a proposed tax on sugary beverages. South Africa is not alone: NCDs are rising across sub-Saharan Africa (SSA), creating new health care needs, as well as social and economic challenges. What next The incidence of NCDs among SSA populations will rise, especially among younger populations. This could further stretch already over-burdened health systems in many SSA countries as more patients develop life-long illnesses while potentially reversing gains in life expectancy and reducing productivity. Subsidiary Impacts · International health organisations will increase advocacy for addressing these health issues. · Foreign aid and budget allocations for NCDs are unlikely to improve without an increase in political will or global attention. · If health systems lack capacity, the burden of care will shift to households with economic consequences. · Governments pursuing preventative strategies targeting consumption patterns risk public standoffs with trade groups and industries. Analysis Health concerns in SSA focus on communicative disease: Ebola, HIV/AIDS and malaria, among others. However, the burden of NCDs is rising. Looming illness By 2030, the NCDs may comprise 75% of the continent's death toll, surpassing communicable diseases and maternal/neo-natal conditions as the leading cause of death. Primary causes of death will shift to cardiovascular disease, cancer, chronic respiratory diseases and diabetes. Already around half the population suffers from hypertension, a dangerous precursor to cardiovascular conditions like heart attacks and strokes. Incidences of NCD are rising globally for multiple reasons, including: · diets comprising high-fat, high-sugar foods; · increased urbanisation and lower levels of physical activity; and · higher rates of tobacco and alcohol consumption. The combination of poor diet, low physical activity and risky consumption behaviours have led to a steep rise in rates of hypertension, diabetes and early-onset cardiovascular disease). Attention, please Despite the growing threat of NCDs in SSA, health care actors and donors have paid scant attention to preventing and treating these conditions . Funding remains earmarked for fighting known communicable diseases, such as HIV/AIDS. With NCDs comprising 34% of SSA's current disease burden, levels of health aid and spending on NCDs is disproportionate, standing at less than 5%. The landscape of NCDs in SSA is unique: while the population is urbanising, changing diets and consuming alcohol and tobacco as elsewhere in the world, NCDs strike the population at a much younger age. Populations in SSA contract NCDs at much younger ages In high-income countries, just 13% of the population aged under 60 suffers from these ailments. In low- and middle-income countries, this figure rises to 30%. People with cardiovascular disease in SSA, for example, die an average of ten years earlier than those in high-income countries. Early onset of these diseases is not solely a symptom of inadequate treatment but also the result of higher risk factors among African populations. Children with malnutrition and stunting have an elevated risk of developing NCDs in early adulthood. When these children grow to adulthood and experience a change in diet or physical activity, or when they are exposed to alcohol and tobacco, they are more likely to develop high blood pressure, diabetes and cardiovascular disease. In SSA, behaviours that begin in adolescence cause 70% of premature deaths from NCDs. Societal ills Globally, the projected economic burden of NCDs stands at a cumulative output loss of 60 trillion dollars between 2010-2030. In 2005, Nigeria lost an estimated 400 million dollars to premature deaths from heart diseases, stroke and diabetes; by 2015, this figure had climbed to 8 billion dollars. Populations with NCDs tend to have diminished economic productivity. Because these conditions occur in African populations at a young age, the lower levels of economic productivity present an additional burden to national development and growth. Further, poorer households treating family members may see a decline in productivity and income. Many NCDs require consistent treatment, creating life-long health costs Straining the system As this burden rises, expanding health treatments could strain public service systems and national economies. Without a substantial injection of both economic and human capital, fragile health systems will struggle to cope. Since 2000, life expectancy in African countries has expanded by a range of 20% to 40%. Improved care for HIV/AIDS patients and advances in anti-retroviral treatment has contributed to bolstering life expectancy. The looming threat of NCDs could reverse the progress made in improving population longevity. Unaddressed NCDs could reverse progress made in expanding life expectancy Because NCDs in SSA tend to strike the working-age population, there could be a dip in life expectancy and economic productivity in the coming decades as was experienced with the surge in HIV infections. Like HIV before, NCDs will require a unified, well-funded strategy of attack, both in prevention and treatment; however, these ailments lack the strong emotional appeal and urgency of communicable diseases. Significant funding may not arrive until conditions reach dire levels. Solutions? In tackling NCDs, focusing on prevention is both more cost-effective and efficient in safeguarding populations from experiencing an undue disease burden. Recognising the connection between child and adult health, the UN World Health Organisation (WHO) has advocated for an early-life course approach to prevent NCDs, addressing problems of nutrition from infancy to lower NCD risk in adult populations in low- and middle-income countries. In 2011, the UN held a summit on NCDs which further encouraged governments to step up prevention efforts, both in improving population health and curbing the proliferation of unhealthy lifestyles. Some African countries have already begun implementing policies which aim to prevent the spread of NCDs. South Africa has been at the forefront of enacting prevention policies, including increasing taxes on tobacco, which reduced the rate of smoking among adults by 25%. The country has also begun to introduce strict regulations on sodium content in processed foods. Several nations, including Kenya, Ghana and Tanzania, have implemented higher taxation and advertisement bans on alcohol. These measures have all been proven to curb levels of alcohol consumption, especially among young people -- an essential measure in averting the risk of NCDs among youth. Meanwhile, interventions to reduce levels of malnutrition, especially among infants and children, are ongoing across SSA. To be effective, these efforts require initiatives which tackle issues of poor nutrition and over-nutrition in adolescents and adult to prevent the rise in NCDs. With policy statements from the WHO and UN, and initial prevention programmes put in place across the continent, there are inklings of successful NCD prevention strategies. Such campaigns will require financing to ensure that they achieve their goal of reducing the health burden. The impetus cannot rest solely on the shoulders of donors and legions of aid workers; SSA governments will also need to demonstrate a more robust political will to address these issues. Outside of prevention, local success could ultimately depend in part on having the health care system in place to treat the rise in patients. -- To post to this group, send email to [email protected] To unsubscribe from this group, send email to [email protected] Visit this group at https://groups.google.com/d/forum/southsudankob View this message at https://groups.google.com/d/msg/southsudankob/topic-id/message-id For more options, visit https://groups.google.com/d/optout --- You received this message because you are subscribed to the Google Groups "South Sudan Info - The Kob" group. To unsubscribe from this group and stop receiving emails from it, send an email to [email protected]. To post to this group, send email to [email protected]. Visit this group at https://groups.google.com/group/SouthSudanKob. To view this discussion on the web visit https://groups.google.com/d/msgid/SouthSudanKob/CAJb14oq6sOJQQjiuWvxXkLUteZ2XfihPy3yWKr8J%3DbLvZ3X23Q%40mail.gmail.com. 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