- United States
African Health Care needs “Paradigm Shift”
A “paradigm shift” is needed in health care in Africa to include greater focus on the prevention and treatment of noncommunicable diseases like diabetes and hypertension and not just infectious diseases like HIV/AIDS, health experts told the 2010 U.S.-Africa Private Sector Health Conference October 6.
“Health is as critical as institutions, infrastructure and education for Africa’s economic competitiveness and growth. It is a prerequisite for human energy, entrepreneurship, dynamic markets and a productive society,” said Haskell Ward, vice-president of Seacom Corporation and chairman of the Global Health Strategic and Advisory Committee of the American Cancer Society, who spoke at the conference.
Ward said noncommunicable diseases (NCDs) — cardiovascular diseases, cancers, respiratory diseases and diabetes — make up the largest contribution to mortality both globally and in the majority of low-income countries worldwide. “NCDs account for 60 percent or 35 million of global deaths … making NCDs a major cause of poverty and an urgent development issue.”
Silver Bahendeka, chair of the International Diabetes Association’s Africa region, predicted that “Africa will have the highest percentage of increase in the number of people with diabetes over the next 20 years.” Eighty percent of the people now living in Africa have not yet been screened for diabetes, he told the audience. “To date, no country in Africa has the money to turn around these figures, yet the resources remain skewed in favor of infectious diseases.”
“We need to look at diets … alcohol … physical activity and smoking without reducing the investments in infectious diseases,” he said. “We need to look forward to the U.N. summit” in September 2011 on noncommunicable diseases to get these issues on the table. “If the summit is successful, then governments and health workers will be asked to come out with measurable outcomes rather than solutions and declarations.”
Bahendeka stressed that “measurable outcomes” could translate into innovative, high-efficiency models of care that could include both noncommunicable and infectious diseases.
The costs of noncommunicable diseases on health care systems and business threaten to undermine Africa’s fragile economies and choke the progress that has been made so far in sub-Saharan Africa, he warned the audience of business executives and health care professionals.
But, Bahendeka said, there is progress. “Sub-Saharan Africa has made great strides” in achieving the first Millennium Development Goal: to eradicate extreme poverty and hunger. Ghana has outperformed other countries by reducing hunger from 34 percent to 8 percent of its population between 1991 and 2005, he said. In Ethiopia, he added, hunger numbers are also down, from 71 percent to 44 percent of the population. Even the millennium goal to reduce infant mortality has seen dramatic improvement in many sub-Saharan African countries including Niger, he said, but warned: “These impressive gains are set to be lost if NCDs are not addressed.”
Times have changed, he said. “We need to make a U-turn and put investment in sub-Saharan Africa into noncommunicable diseases.”
Health care across the continent, Bahendeka said, should be viewed “through the lens of noncommunicable diseases and no longer through the narrow kaleidoscope of infectious diseases.”
To illustrate his point, Bahendeka said it takes 25 years to train a doctor, teacher or engineer to be fully proficient, but only five years to lose that person to cardiovascular disease as a complication of diabetes. “This is a loss of investment” that must be addressed, he said.
Ward predicted that noncommunicable diseases would increase by 17 percent over the next 10 years worldwide and in Africa by 27 percent. “Africa’s disease burden is changing,” he said. “The region still suffers from high rates of certain infectious diseases … including HIV, malaria and TB, but is also now experiencing rising rates of NCDs.”
World Health Organization data reveal that “the impact of cancer, cardiovascular diseases, diabetes and other chronic noncommunicable conditions will be wide-ranging, detrimental and only continue to increase,” Ward said.
At the 2010 World Health Assembly, which convened in Geneva May 17–21, the United States delegation, led by Secretary of Health and Human Services Kathleen Sebelius, reaffirmed the United States’ commitment to working with the World Health Organization and its member countries to improve health in all nations.
In a statement to the assembly, Nils Daulaire, Sebelius’s director of global health affairs, said, “Over the past few days, we laid the foundation for continuing global progress in areas from expanding access to health care to reducing health disparities to responding to pandemics such as H1N1 to preventing and treating noncommunicable diseases.”
“These global issues can only be achieved if we work together, and it will take leadership, vision and commitment from all sectors of society.”
Under President Obama’s leadership, the United States has made improving health around the world a top priority, Daulaire said. “The president’s historic six-year, $63 billion Global Health Initiative expands and builds upon existing programs and incorporates what we’ve learned in the last decade to generate measurable, sustainable outcomes.”
The Global Health Initiative makes a global commitment to improve maternal and child health by expanding efforts to make pregnancy and childbirth safer, offers family planning and reproductive health, and strengthens health systems to better respond to the needs of women and girls. Also included in the initiative is treatment for tuberculosis, malaria and the goal to reduce the prevalence of neglected tropical diseases.