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

An Overview 69
nations of interventions and costs of new types of
community based services.
Without research in clinical- and cost-effectiveness
of NCD prevention interventions in SSA to
guide and evaluate improvements, treatment and
prevention may be overly subject to the influence of
local and global commercial interests [482]. It can
also be very useful to monitor and make public the
activities in Africa of these global commercial interests,
notably of the transnational manufacturers of
unhealthy commodities [483].
For road safety, indispensable research would include
assessment of knowledge, attitudes, and behaviors,
and an evaluation of the effectiveness of
interventions [484]. Much knowledge and information
is potentially transferable from existing studies
elsewhere, given the similarity in contributory factors
and that many motorized countries have undergone
a similar developmental stage, taking into
account cultural, economic, and social conditions in
adapting successful experiences [63].
Research in Africa needs to address broader social
and cultural factors, as well as interventions.
This means that research policy leaders must engage
national governments and international agencies,
service providers, and research communities [485].
Multi-disciplinary, multi-institutional, and multi-country
collaborations could conduct research
and properly inform the design of interventions,
working with health care providers, policymakers,
NGOs, and communities to bridge the gap between
research, practice, and policy [129, 179]. Investment
in postgraduate training in chronic disease research
is also needed to produce the next generation of
multidisciplinary researchers. Under country ownership,
public-private research and training partnerships
can result in country-wide workforce development
[486]. There is a growing recognition that
current incentive systems fail to generate enough
research and development to address the health care
needs of developing countries and that global financing
and coordination needs to be strengthened
[487]. A promising model for ‘growing research’
in developing countries is to use funding to link a
developed country supervisor with a developing
country supervisor for PhD students working in the
developing country on local projects; this model is
further strengthened if students from both settings
work together in the developing country [488]. The
impact of all these efforts, however, would need to
be rigorously measured.
5.7 Role of Public and Private
Employers and Businesses
Public and private employers and businesses have an
important role to play in addressing the socio-economic
determinants of health. Indeed, their involvement
could be particularly important in addressing
the complex burden of disease in Africa. The poor
health of employees quickly affects a company’s bottom
line and has a longer-term impact on earnings
and profits. Firms have a vested interest in supporting
activities to improve employee health, and can
have a strong influence on their employees’ behavior
and make them aware of health risks in ways unavailable
to the government.
The involvement of major African companies,
multinational corporations, and other stakeholders
with experience in employee- and community-directed
health programs will be critical in reducing
NCDs and injuries. As discussed in Box 14, the concept
of employers playing a larger role in improving
employee fitness and health is not new, and there is
robust international evidence on its positive impact.