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

An Overview 19
For young men, RTI are the second leading cause
of premature death after HIV/AIDS. Economically
active young people are most at risk of road injury –
in South Africa over half of pedestrian deaths were
people aged 20-44 years. Road crashes are estimated
to cost African countries between 1 and 3 percent of
their Gross National Product each year [63].
FIGURE 8: Distribution of Road Traffic Deaths by
Type of Road User in SSA Countries
2 and 3 Wheelers – 7%
Source: [59, 61]
Cyclists – 7%
Other – 5%
Occupants – 43%
Pedestrians – 38%
Note that the small difference in the percentage of pedestrians between this source
and [17], cited in the text above, results from differences in the countries included.
FIGURE 9: Projected Disease Burden (DALYs) in SSA
for Children Aged 5-15 Years, 2008-2030
6000000
5000000
4000000
3000000
2000000
1000000
0
2008 2015 2030
Tuberculosis HIV/AIDS Malaria Road traffic injuries
Source: Authors from [28]
Projected DALYs by age, sex, and cause for 2008, 2015, 2030 – standard DALYS
(3 percent discounting, age weights) – Baseline scenario.
2.2. Economic and Social
Development Consequences
As the leading cause of death in low- and middle-income
countries (LMIC), NCDs have costs for individuals
and families, health systems and economies,
and also for sustainable development. The two main
factors accounting for the macroeconomic impacts
are productivity loss—nearly 30 percent of NCD-related
deaths in low-income countries occur in people
under 60 years of age [64]—and costs of treatment,
which pose particular challenges in LMIC
where resources and health systems are already
overstretched.
Although the biggest economic burden is currently
in high-income countries, the burden will rise in the
developing world as economies enlarge and populations
grow and age [65]. Rising NCD mortality rates
are expected to reduce economic growth in developing
countries [66]. A review of LMIC in 2007 estimated
total losses in economic output during the
period 2006–15 from coronary heart disease, stroke,
and diabetes alone; namely, US$1.88 billion in South
Africa, US$1.17 billion in Nigeria, US16 million in
Ethiopia, and US15 million in Democratic Republic
of Congo [67]. The estimated economic cost (direct
and indirect) of diabetes alone in the African region
in 2000 was I$25.51 billion 5 (at purchasing power
parity) [68]. Total costs attributed to CVD in the African
region were US$11.6 billion, of which 41 percent
represented loss of productivity costs [65]. A review
of over 7,000 employees in Namibia found that high
blood glucose and diabetes had the largest effect on
absenteeism, greater than being HIV positive [69].
NCDs and the risk factors that fuel them can inflict
substantial financial and psychosocial burdens
on individuals and their families, particularly where
treatment costs are paid mostly out-of-pocket. In
the poorest households of some countries, 15 percent
of disposable income is spent on tobacco [31].
One study in Sudan showed that for a family with
a diabetic child, 65 percent of their family’s annual
health expenditure was spent on their child’s diabetic
care [70]. A study of how households in Afri-
5 I$ refers to International dollar which is a hypothetical unit of currency
that has the same purchasing power parity that the U.S. dollar
had in the United States at a given point in time.