Global Health Governance and the Challenge of Chronic, Non-Communicable Disease

2010 ◽  
Vol 38 (3) ◽  
pp. 490-507 ◽  
Author(s):  
Roger S. Magnusson
Keyword(s):  
Cardiovascular Disease ◽  
Population Growth ◽  
Communicable Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Sub Saharan

Judging by their contribution to the global burden of death and disability, chronic, non-communicable diseases (NCDs) are the most serious health challenge facing the world today. The statistics tell a frightening story. Over 35 million people died from chronic diseases in 2005 — principally cardiovascular disease, cancer, and chronic respiratory disease. Driven by population growth and population ageing, deaths from non-communicable diseases are expected to increase by 17% over the period 2005-2015, accounting for 69% of global deaths by 2030.Cardiovascular disease (CVD), the leading cause of death in all regions except sub-Saharan Africa, is estimated to rise from 17.1 million deaths (2004) to 23.4 million deaths (2030). Cancer deaths will increase from 7.4 million to 11.8 million over the same period. Due to population growth, mergers and acquisitions, and the marketing of global cigarette brands in developing countries, deaths from tobacco will rise from 5.4 million per year (2005), through 6.4 million (2015), to 8.3 million by 2030. These figures include a doubling in tobacco deaths in low- and middle-income countries from 3.4 million to 6.8 million lives annually. By 2015, smoking will cause 50% more deaths than HIV/AIDS.

scholarly journals Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: A New Challenge for Public Health in Low and Middle-Income Countries

2021 ◽  
Vol 18 (23) ◽  
pp. 12449
Author(s):  
Ahmad Alkhatib ◽  
Lawrence Achilles Nnyanzi ◽  
Brian Mujuni ◽  
Geofrey Amanya ◽  
Charles Ibingira
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Sub Saharan Africa ◽  
Lifestyle Interventions ◽  
African Countries ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Economic Disparity ◽  
Middle Income Countries ◽  
Sub Saharan

Objectives: Low and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.

Making primary healthcare responsive to non-communicable diseases in sub-Saharan Africa

2020 ◽  
Vol 114 (4) ◽  
pp. 229-231 ◽  
Author(s):  
Frank Baiden
Keyword(s):  
Primary Healthcare ◽  
Communicable Disease ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Non Communicable Diseases ◽  
Formal Integration ◽  
Sub Saharan ◽  
Non Communicable Disease

Abstract Primary healthcare (PHC) meets the needs of people's health throughout their lives and empowers individuals and communities to oversee their own health. Most of the community-based activities currently undertaken in PHC in sub-Saharan Africa (SSA) address child and maternal health. Non-communicable diseases are now major causes of morbidity and premature mortality in SSA. In this paper, I propose the formal integration of community-based, non-communicable disease prevention and early detection into PHC activities. I offer practical suggestions on how this can be achieved to ensure a continuum of care.

scholarly journals Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

2021 ◽  
Vol 18 (20) ◽  
pp. 10751
Author(s):  
Marie Brault ◽  
Sten Vermund ◽  
Muktar Aliyu ◽  
Saad Omer ◽  
Dave Clark ◽  
...  
Keyword(s):  
South African ◽  
Communicable Disease ◽  
Low Cost ◽  
Healthcare Delivery ◽  
Strong Support ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Non Communicable Diseases ◽  
Sub Saharan

In Sub-Saharan Africa, communicable and other tropical infectious diseases remain major challenges apart from the continuing HIV/AIDS epidemic. Recognition and prevalence of non-communicable diseases have risen throughout Africa, and the reimagining of healthcare delivery is needed to support communities coping with not only with HIV, tuberculosis, and COVID-19, but also cancer, cardiovascular disease, diabetes, and depression. Many non-communicable diseases can be prevented or treated with low-cost interventions, yet implementation of such care has been limited in the region. In this Perspective piece, we argue that deployment of an integrated service delivery model is an urgent next step, propose a South African model for integration, and conclude with recommendations for next steps in research and implementation. An approach that is inspired by South African experience would build on existing HIV-focused infrastructure that has been developed by Ministries of Health with strong support from the U.S. President’s Emergency Response for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. An integrated chronic healthcare model holds promise to sustainably deliver infectious disease and non-communicable disease care. Integrated care will be especially critical as health systems seek to cope with the unprecedented challenges associated with COVID-19 and future pandemic threats.

scholarly journals Preventing Multimorbidity with Lifestyle Interventions in Sub-saharan Africa: A New Challenge for Public Health in Low and Middle Income Countries.

2021 ◽  
Author(s):  
Ahmad Alkhatib ◽  
Lawrence Achilles Nyanzi ◽  
Brian Mujuni ◽  
Geofrey Amanya ◽  
Charles Ibingira
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Communicable Diseases ◽  
Lifestyle Interventions ◽  
African Countries ◽  
Middle Income ◽  
Economic Disparity ◽  
Middle Income Countries ◽  
Sub Saharan ◽  
Low And Middle Income

Objectives: Low and Middle Income Countries (LMICs) are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity (MMD). However, preventing MMD has received little attention in LMICs, especially in Sub-Saharan African Countries. Design: Narrative review which scoped the most recent evidence in LMICs about MMD determinants and appropriated them for potential MMD prevention strategies. Methods: MMD in LMICs is affected by several determinants including increased age, female gender, environment, lower socio-economic status, obesity, and lifestyle behavious, especially poor nutrition and physical inactivity. Results: MMD public health interventions in LMICs, especially Sub-Saharan are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent MMD clusters, especially hypertension, diabetes and cardiovascular disease, can provide an early prevention of MMD, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing MMD in LMICs.

Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries

2021 ◽  
pp. bjsports-2020-103640
Author(s):  
Peter T Katzmarzyk ◽  
Christine Friedenreich ◽  
Eric J Shiroma ◽  
I-Min Lee
Keyword(s):  
Cardiovascular Disease ◽  
Low Income ◽  
Physical Inactivity ◽  
Communicable Diseases ◽  
High Income ◽  
Asia Pacific ◽  
Global Burden ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries

ObjectivesPhysical inactivity is a risk factor for premature mortality and several non-communicable diseases. The purpose of this study was to estimate the global burden associated with physical inactivity, and to examine differences by country income and region.MethodsPopulation-level, prevalence-based population attributable risks (PAR) were calculated for 168 countries to estimate how much disease could be averted if physical inactivity were eliminated. We calculated PARs (percentage of cases attributable to inactivity) for all-cause mortality, cardiovascular disease mortality and non-communicable diseases including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers of the bladder, breast, colon, endometrium, oesophagus, stomach and kidney.ResultsGlobally, 7.2% and 7.6% of all-cause and cardiovascular disease deaths, respectively, are attributable to physical inactivity. The proportions of non-communicable diseases attributable to physical inactivity range from 1.6% for hypertension to 8.1% for dementia. There was an increasing gradient across income groups; PARs were more than double in high-income compared with low-income countries. However, 69% of total deaths and 74% of cardiovascular disease deaths associated with physical inactivity are occurring in middle-income countries, given their population size. Regional differences were also observed, with the PARs occurring in Latin America/Caribbean and high-income Western and Asia-Pacific countries, and the lowest burden occurring in Oceania and East/Southeast Asia.ConclusionThe global burden associated with physical inactivity is substantial. The relative burden is greatest in high-income countries; however, the greatest number of people (absolute burden) affected by physical inactivity are living in middle-income countries given the size of their populations.

scholarly journals Identifying and Describing Impact of Disasters on Non-Communicable Diseases: A Systematic Review

2021 ◽  
Author(s):  
Elham Ghazanchaei ◽  
Davoud Khorasani-Zavareh ◽  
Javad Aghazadeh-Attari ◽  
Iraj Mohebbi
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Natural Disasters ◽  
Respiratory Disease ◽  
Communicable Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
The Impact

Background: Patients with non-communicable diseases are vulnerable to disasters. This is a systematic review describing the impact of disasters on non-communicable diseases. Methods: A systematic review was conducted using PRISMA standards. Relevant articles published from 1997 to 2019 collected by searching the Scopus, PubMed, Science Direct, databases. We specifically examined reports describing NCDs and including the key words “non-communicable disease and Disasters”. NCDs included cardiovascular, respiratory, diabetes, cancer and mental health diseases. Results: Of the 663 studies identified, only 48 articles met all the eligibility criteria. Most studies have shown the impact of all natural disasters on non-communicable diseases (39.8% n=19). The largest study was the effect of earthquakes on non-communicable diseases (29.2% n=14). For the NCDs targeted by this research, most of the included studies were a combination of four diseases: cardiovascular disease, respiratory disease, diabetes and cancer (44% n=21). Followed by cardiovascular disease (14.6% n=7), chronic respiratory disease (12.5% n=6), diabetes and cancer (6.2% n=3) and mental health (12.5% n=6). Conclusion: The incidence of disasters affects the management of treatment and care for patients with NCDs. Specific measures include a multi-part approach to ensuring that patients with non-communicable diseases have access to life-saving services during and after disasters. The approach of the health system should be expanded from traditional approaches to disasters and requires comprehensive planning of health care by policy makers and health professionals to develop effective strategies to enable patients to access medical, therapeutic and diagnostic services in natural disasters.

scholarly journals Smoking and Non-Communicable Diseases in Sub-Saharan Africa: The Nigeria Scenario

2021 ◽  
Author(s):  
Abayomi Ayodapo ◽  
Babalola Ibisola
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Diseases ◽  
Strong Evidence ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Non Communicable Diseases ◽  
Adverse Health Effects ◽  
Premature Deaths ◽  
Sub Saharan

Smoking remains a strong factor in the emergence of Non-Communicable Diseases (NCDs) and it contributes to the development of cardiovascular diseases, cancers, diabetes mellitus and chronic respiratory disease which are the four leading NCDs worldwide. Non-Communicable Diseases has been implicated in about two thirds of the global premature deaths. However despite the strong evidence of link of smoking to NCDs, the prevalence of smoking is still high among the youths and adults, with an attendant adverse health effects. Nigeria, though a signatory to WHO Framework Convention on Tobacco Control (WHO FCTC) of 2005, and its recent domestication in National Tobacco Act of 2015, effective operationalization and implementation is still a mirage.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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