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Analytical summary - Risk factors for health

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Recent decades have seen significant increases in noncommunicable diseases in the WHO African Region, in addition to the long-standing burden of infectious disease. This can be attributed to three main factors, namely population ageing, rapid urbanization and globalization.

Alcohol abuse, drug abuse and tobacco use are high on the list of critical health risk factors in the Region. Only a small number of countries have alcohol control policies or advertising regulation in place and very few have any in-depth understanding of the nature and extent of drug use. Health services and interventions for those affected are few.

Percentage of current tobacco use in persons 15 years of age or older in the WHO African Region, 2006

Chronic noncommunicable diseases are increasingly seen. Factors underlying this pattern are a nutritionally inadequate diet coupled with increasingly low levels of physical activity, and overweight or obesity. The latter has reached epidemic proportions in a number of African countries. For a variety of reasons, fruit and vegetables are no longer eaten in sufficient quantities.

These risks contribute to problems such as hypertension, or high blood pressure, and raised blood sugar and cholesterol measurements, leading to cardiovascular diseases and diabetes. The presence of multiple risk factors in the same individual is not uncommon; surveys have found three or more chronic noncommunicable disease risk factors in up to 35% of individuals.

HIV/AIDS continues to be a strong risk factor in the Region, particularly among women, and has reduced life expectancy at birth across the Region by several years. Almost three quarters of the global burden of unsafe sex occurs in sub-Saharan Africa.

The burden of both communicable and noncommunicable disease is exacerbated by lack of water and sanitation in African communities, coupled with poor hygiene practices. This constellation of risks is responsible for a high proportion of chronic and infectious disease.

Surveillance has greatly improved in recent years and more data are now becoming available to serve as the basis for planning and implementation activities. Examples are the WHO STEPS surveys, which have served as entry points for noncommunicable disease activities. Surveys on tobacco use among young people have been carried out in 43 countries of the Region, and a global school-based student health survey has been completed in 15 countries.