Diseases in Africa
Communicable diseases such as malaria, tuberculosis and HIV/AIDS are still the biggest health concerns in Africa. However, the World Health Organization (WHO) projects that by 2030, non-communicable diseases (NCDs) will become the leading cause of death in Africa. Currently, only two percent of all donor funding goes to chronic diseases. NCDs in Africa is an issue that deserves more attention.

Non-communicable diseases in Africa include diabetes, cardiovascular and chronic respiratory diseases, as well as cancer. These diseases often stem from unhealthy lifestyles, like diet, smoking, drinking and physical inactivity. These behaviors can cause high blood pressure, weight gain, respiratory ailments, high blood sugar and cholesterol levels.

NCDs are already the leading cause of death in most regions of the world. These diseases cause the deaths of 38 million people each year and almost three-quarters of these deaths occur in low and middle-income countries. Projections show that NCDs in Africa will see the biggest growth globally in the next few decades.

Widespread chronic illness is detrimental to the economy and poverty reduction initiatives in developing countries because they result in decreased labor outputs, lower returns on human capital investments and increased healthcare costs. Non-communicable diseases should thus be afforded more attention in discussions about alleviating global poverty.

There are several initiatives working to address the issue of NCDs and the impact they will have on developing countries. The WHO created a Global Action Plan for the Prevention and Control of NCDs, which focuses on national actions to address harmful lifestyle choices that cause NCDs. This includes the taxation of tobacco and alcohol products and targets education programs on healthy living.

However, the increase in cases of non-communicable diseases in Africa will also require more resources to strengthen and adapt healthcare systems to deal with the growing disease burden. In 2014, only 49% of African countries reported that they have the necessary funds for the early detection, screening and treatment of NCDs.

One program working to solve this issue is Access Accelerated, a partnership between the World Bank, the Union of International Cancer Control and more than 20 pharmaceutical companies. The Access Accelerated initiative aims to address the access barriers to NCD medicines in low-income countries. Novartis Access, for example, is providing 15 NCD treatments in Kenya at $1.00 per treatment per month. This program will roll out in 30 other developing countries over the next few years.

Providing affordable medicines is just one of the aspects of creating sustainable solutions to the growing burden of non-communicable diseases in Africa. Other priorities include training healthcare workers to deal with NCDs, educating local communities about these diseases and improving healthcare infrastructure and distribution networks in rural areas.

Helena Kamper

Photo: Flickr

Lifestyle Diseases in India
India, a third world country by economic profile, has morphed its morbidity profile to that of a first world nation. Lifestyle diseases in India are cropping up increasingly under the scanner making it a ticking time bomb with an alarming rise in cardiovascular disease, diabetes, hypertension, asthma and respiratory diseases as well as cancers.

Termed non-communicable diseases (NDC), many of these are found to be equally prevalent among the poor. In fact, ongoing studies prove they are increasing among the poorest. Sixty-six percent of the disease burden is borne by lifestyle diseases consequently cutting into the most productive asset of contemporary India- its people.

India has the highest number of diabetics at 50.8 million per the WHO, though only 11 percent of the population has health insurance. This figure, set to increase to 73.5 million by 2025, will include many of the poorest since India has one of the largest populations of the poor. Twenty-five million suffer from cardiovascular disease, 60 percent of the global total.

According to national diabetes expert Dr. Anoop Misra, diabetes is on the rise because the poor make bad and cheaper nutritional choices based on high fat and carbohydrates intake in their diet leading to malnutrition. They forego vitamins, proteins, and micronutrients as carbohydrates push up their insulin resistance and increase sugars. Diabetes is the forerunner to many opportunistic infections- fatty livers, high cholesterol leading to coronary heart disease and organ failures. Overcrowding and bad living conditions also increase stress leading to coronary heart diseases, asthma and cancers. Urbanization makes for a sedentary life leading to greater obesity. Mass migration from rural to urban areas has made it likely that nearly 60 percent of India will be urban by 2030.

One of the biggest problems with lifestyle diseases in India is that a large part of treatment is through self-monitoring and self-reporting. The high level of ignorance and lack of education about the ramifications of food and lifestyle choices amongst the urban poor leads to these diseases having the worst impact on them. Data collection in India is negligible and there is a large quantum of underreporting and underestimation among poorer patients.

India spends 4.2 percent of its GDP on health for its population of over a billion people. In comparison, Germany spends 11.3 percent for its relatively small population. Per capita spending on health amounts to 34 euros per person whereas in Germany it is over 4000 euros. Eighty percent of health care in India is dominated by the private sector. As a result, the poor become almost invisible for health care providers, leading to undetected and untreated morbidity.

Lifestyle diseases in India require prolonged treatment for a lifetime, including lasting changes in lifestyle. Without better and more consistent healthcare services being provided for the poor, NCDs could be the next big epidemic wiping out large parts of the Indian population.

Mallika Khanna

Photo: Flickr