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Analytical summary - Non-communicable diseases and conditions

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Noncommunicable diseases are now responsible for an increasing share of Africa’s disease burden, with about 62% of older Africans dying from this cause. This double burden with communicable diseases (infectious diseases) requires coordinated approaches.

Noncommunicable diseases principally affecting the WHO African Region are cancers, diabetes mellitus, cardiovascular disease, and chronic lung and respiratory diseases. Violence, injury and disabilities also contribute a high proportion of morbidity and mortality.

Distribution of causes of noncommunicable burden of diseases (percentage of total disability-adjusted life years) in the WHO African Region, 2004

Lifestyle changes and urbanization are driving a latent cancer epidemic, much of which is infection related. Survival rates for cancer in the Region are low, due to problems with diagnosis, late presentation and appropriate treatment.

The cardiovascular disease burden is also a public health challenge in the Region, estimated at approximately 8 million. The higher profile now emerging is causing some countries to start taking action in respect of cardiovascular diseases. Many chronic respiratory diseases are leading killers and multisectoral action is needed to address the environmental and social determinants largely responsible.

The projected growth rate to 2030 for diabetes mellitus is almost 100%, showing that an epidemic is in the making. Oral health problems are still of concern, but data and services are in short supply. Screening and treatment for sickle-cell disease are rare and most patients die before the age of 5 years.

Epilepsy occurs more than twice as frequently as in industrialized countries and alcohol abuse accounts for 12% of young male mortality. Violence produces 35% of all injury deaths, while the Region has the highest fatality rate for road traffic accidents. Ten per cent of the Region’s population has some degree of disability, and eye and ear health is of particular concern. Half of all blindness is due to cataracts that can, in principle, be easily and cheaply rectified.

The majority of these noncommunicable diseases remain inadequately addressed for reasons of weak health systems, staff inadequately trained to respond to noncommunicable diseases, financial shortfalls and a lingering perception that the Region’s principal health focus should remain on infectious disease.