The Challenge of Non-Communicable Diseases and Road Traffic ...

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12 The Challenge of Non-communicable Diseases and Road Traffic Injuries in Sub-Saharan Africa some tropical diseases and infections of poverty cause heart disease [23]; TB worsens outcomes for diabetes [24]; stunting is associated with increased risk of obesity in later life [22, 25]; and many infectious agents such as hepatitis B (HBV), human papilloma virus (HPV), and HIV are associated with increased risk of cancer [26-27] – about one third of cancers in Africa are infection-related, double the world average [27]. By 2010, cerebrovascular disease, diabetes and COPD already ranked as the 7 th , 8 th and 9 th highest causes of DALYs in Southern SSA [16]. A further shift in relative disease burden is expected: by 2030, the disease burden (in DALYs) for HIV/AIDS, malaria, and other infectious and parasitic conditions is expected to be significantly lower, with the four main NCDs becoming pre-eminent (Figure 2) [28]. FIGURE 2: Projected Burden of Disease (percentage of Total DALYs) by Groups of Disorders and Conditions, SSA, 2008 and 2030 NCDs Injuries Communicable, maternal, perinatal, nutritional Intentional injuries Other unintentional injuries RTIs Other NCDs Neuropsychiatric disorders 4 NCDs (CVD, cancer, respiratory diseases, diabetes) Nutritional deficiencies Perinatal conditions Maternal conditions Respiratory infections Other infectious and parasitic diseases Malaria HIV/AIDS Tuberculosis 2030 2008 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% Source: Authors from [28] 4 Projected DALYs by cause for 2008, 2030 - standard DALYs (3 percent discounting, age weights) – Baseline scenario. 4 At the time of preparation of this report, projections of mortality and burden of disease were not available through the Global Burden of Disease study 2010 [17] so an earlier version [28] was used for Figures 2 and 9.
An Overview 13 A Rising Epidemic of NCDs and RTIs NCDs are becoming a significant burden in SSA, and RTIs are rapidly emerging as a major cause of death and disability. By 2010, cerebrovascular diseases (stroke) and road injuries were already within the top 15 causes of years of life lost (YLL) for all four SSA regions, joined by ischemic heart disease (IHD), diabetes mellitus (DM), and hypertensive heart disease in Southern SSA (Table 1) [29]. TABLE 1: Top 15 Leading Causes of YLL in Each Region of SSA, 2010 Global rank Southern SSA Eastern SSA Central SSA Western SSA 1 Ischemic heart disease 11 17 16 17 2 Lower respiratory infections 2 3 4 2 3 Cerebrovascular disease (stroke) 7 14 13 12 4 Diarrhoeal diseases 3 4 2 3 5 Malaria 14 2 1 1 6 HIV/AIDS 1 1 5 4 7 Pre-term birth complications 6 5 6 7 8 Road injury 12 11 11 9 10 Neonatal encephalopathy (incl. birth asphyxia/trauma) 9 9 10 10 11 Tuberculosis 5 8 8 11 12 Sepsis 18 7 12 5 14 Congenital anomalies 13 15 7 15 15 Protein-energy malnutrition 29 6 3 6 18 Meningitis 19 10 9 8 19 Diabetes mellitus 8 26 26 24 20 Interpersonal violence 4 18 17 23 23 Fire, heat, and hot substances 23 16 19 13 27 Hypertensive heart disease 15 38 39 46 28 Maternal disorders 20 13 15 14 34 Exposure to mechanical forces 10 28 22 40 40 Syphilis 31 12 14 18 Ranking legend 1-5 6-10 11-15 16-20 21-25 26-30 31-35 36 + Source: Authors from [17, 29]
Page 1 and 2: The Challenge of Non-Communicable D
Page 3: THE CHALLENGE OF NON-COMMUNICABLE D
Page 7 and 8: TABLE OF CONTENTS Abstract.........
Page 9: List of Tables Table 1: Top 15 Lead
Page 13: LIST OF ACRONYMS AIDS Acquired Immu
Page 16 and 17: 2 The Challenge of Non-communicable
Page 25: 2. BURDEN OF NCDs AND RTIs This sec
Page 29 and 30: An Overview 15 Types of Disease Ref
Page 31 and 32: An Overview 17 FIGURE 7: ASMR by NC
Page 33 and 34: An Overview 19 For young men, RTI a
Page 35 and 36: 3. THE DRIVERS AND DETERMINANTS OF
Page 37 and 38: An Overview 23 FIGURE 10: The Doubl
Page 39 and 40: An Overview 25 TABLE 5: Prevalence
Page 41 and 42: An Overview 27 Life expectancy has
Page 43 and 44: An Overview 29 employ business prac
Page 45 and 46: 4. THE RATIONALE FOR PUBLIC INTERVE
Page 47 and 48: An Overview 33 factors (given that
Page 49 and 50: 5. A COMPREHENSIVE, INTEGRATED APPR
Page 51 and 52: An Overview 37 clarity of vision an
Page 53 and 54: An Overview 39 Tobacco There is str
Page 55 and 56: An Overview 41 into account [255].
Page 57 and 58: An Overview 43 • Secure sustainab
Page 59 and 60: An Overview 45 financing and extern
Page 61 and 62: An Overview 47 percent) - or those
Page 63 and 64: An Overview 49 Several intervention
Page 65 and 66: An Overview 51 BOX 7: Country Respo
Page 67 and 68: An Overview 53 some NCD prevention
Page 69 and 70: An Overview 55 to fragmentation and
Page 71 and 72: An Overview 57 experienced shortfal
Page 73 and 74: An Overview 59 for managing chronic
Page 75 and 76: An Overview 61 In this example, a s
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An Overview 63 Guidelines and Quali
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An Overview 65 a balance needs to b
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An Overview 67 death statistics to
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An Overview 69 nations of intervent
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“As we start the journey of the n
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REFERENCES 1. The Economist, Africa
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An Overview 75 56. Bukhman, G. and
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An Overview 77 114. BeLue, R., et a
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An Overview 79 168. Stuckler, D., S
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An Overview 81 222. Narayan, K.M.V.
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An Overview 83 278. Catford, J., Im
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An Overview 85 336. O’Brien, M.,
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An Overview 87 390. Beran, D., A. M
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An Overview 89 444. The World Bank,
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MAP IBRD 39854: SUB-SAHARAN AFRICA
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