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72 The Challenge of Non-communicable Diseases and Road Traffic Injuries in Sub-Saharan Africa conditions, and NCDs; for example, evidence for common causes; shared underlying social conditions; interacting co-morbidities; as well as common solutions such as vaccination, standardized syndromic protocols, and care models. Many of the measures needed for strengthening health systems cut across disease categories, and there are opportunities for NCDs and RTIs to benefit from the lessons and initiatives of interventions for HIV/ AIDS, TB, and maternal health, for example, and vice versa. Thus, the report concludes that there is likely to be added value in capitalizing on the shared challenges, drivers, and potential solutions across the different disease categories, with broader health-systems strengthening measures, and that there is already evidence of this taking place and being effective. Globalization, rapid urbanization, population growth, and ageing are contributing to the burden of disease in SSA, as NCDs and RTIs emerge from the shadows. The response to NCDs and RTIs in SSA needs to avoid establishing yet another set of vertical programs in competition for scarce resources. As the evidence shows, divisions between disease categories, or between so-called vertical and horizontal programs, are to some extent artificial, and may not be optimal for Africa at this stage of its health development. Opportunities for integration can arise out of synergies between targeted interventions, necessity, or desirability [493]. Consideration of NCDs and/or RTIs within broader development initiatives could, for example, mean mitigating the impact of road infrastructure, buildings, and urban design on safe and active travel, by building in from the start ways of keeping pedestrians and cyclists safe and for managing speed. Or it could mean designing programs to maximize benefit and minimize harm in terms of NCD and RTI outcomes, such as ensuring that infant feeding programs and conditional cash transfer programs are not designed in such a way that they worsen NCD outcomes. It should also be possible to continue ongoing efforts to strengthen health systems in ways that enable the benefits to be shared – this report has included examples of how improvements for NCD care can ‘piggy-back’ onto other existing efforts at little additional cost, such as extending chronic care delivery to span a spectrum of diseases with similar care needs, or for palliative care to reach beyond AIDS, or for demographic and other health surveys to be expanded to incorporate measurement of NCDs and their risk factors. Finally, there are a number of NCD interventions that are not only cost-effective but also potentially resource-generating and beneficial for dealing with other diseases, such as putting in place and enforcing a strong regulatory and fiscal framework for tobacco and alcohol including the raising of prices. In making this happen, and facilitating it, there are roles not just for politicians and policymakers within countries but also at the regional and international level. There is also work for researchers in furthering the evidence base on the integration of health programs, the integration of health concerns into other development interventions, and in different country contexts. In conclusion, it should be clear that controlling NCDs and RTIs are key public health issues in Africa. Ensuring an effective response, however, is a particularly difficult challenge in countries facing a double or triple burden of disease with a low national income level and weak health care systems. As argued here, and fully consistent with the health improvement and poverty alleviation objectives of World Bank work in the health sector [494-495], efforts to address this challenge effectively in Africa should be part of broader multisectoral effort, including health system strengthening programs and activities, that need to be supported by national governments, public and private employers and businesses, civil society, and the international community over the short and medium terms. It is expected therefore that this report will contribute to advance the discussion on this topic in Africa and beyond in the years to come.
REFERENCES 1. The Economist, Africa rising., in The Economist. 2011. 2. UNECA, Economic Report on Africa 2012: Unleashing Africa’s Potential as a Pole of Global Growth. 2012: Addis Ababa. 3. UNECA, Assessing Progress in Africa toward the Millennium Development Goals, 2011, in MDG Report. 2011: Addis Ababa. 4. UN, Improving global road safety. 2010, United Nations: New York. 5. Levitt, N.S., et al., Chronic noncommunicable diseases and HIV-AIDS on a collision course: relevance for health care delivery, particularly in low-resource settings - insights from South Africa. American Journal of Clinical Nutrition, 2011. 94(6): p. 1690S-6S. 6. WHO, WHO African Region Ministerial Consultation on Noncommunicable Diseases: Background document. 2011, WHO Regional Office for Africa: Brazzaville. 7. Hyder, A.A., S.S.F. Muzaffar, and A.M. Bachani, Road traffic injuries in urban Africa and Asia: A policy gap in child and adolescent health. Public Health, 2008. 122(10): p. 1104-1110. 8. UN, Political declaration of the high-level meeting of the general assembly on the prevention and control of noncommunicable diseases. 2011, United Nations: New York. 9. WHO. 65th World Health Assembly closes with new global health measures. 2012 27 May 2012]; Available from: http://www.who.int/mediacentre/news/ releases/2012/wha65_closes_20120526/en/index. html. 10. WHO. Fourth round of informal consultations on the development of a WHO global action plan for the prevention and control of NCDs 2013-2020. 2013 1 April 2013]; Available from: http://www.who.int/ nmh/events/2013/consultation_201303015/en/. 11. WHO. NCD global monitoring framework. 2013 1 April 2013]; Available from: http://www.who.int/ nmh/global_monitoring_framework/en/. 12. Chisholm, D., et al., What are the priorities for prevention and control of non-communicable diseases and injuries in sub-Saharan Africa and South East Asia? British Medical Journal, 2012. 344(e586). 13. Chisholm, D., et al., Cost effectiveness of strategies to combat road traffic injuries in sub-Saharan Africa and South East Asia: mathematical modelling study. British Medical Journal, 2012. 344. 14. Beaglehole, R., et al., UN High-Level Meeting on Non-Communicable Diseases: addressing four questions. Lancet, 2011. 378(9789): p. 449-455. 15. UNECA. Report of the Second African Road Safety Conference. in Second African Road Safety Conference. 2011. Addis Ababa, Ethiopia: UNECA. 16. Murray, C.J.L., et al., Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 2012. 380(9859): p. 2197-2223. 17. IHME, Global Burden of Disease. 2013, Institute for Health Metrics and Evaluation. 18. UNAIDS, World AIDS Day Report 2011. How to Get to Zero: Faster, Smarter, Better. 2011. 19. Stop TB Partnership, The Global Plan to Stop TB 2011-15: Transforming the Fight. Towards the Elimination of Tuberculosis. 2011: Geneva. 20. WHO, World malaria report 2011. 2011: Geneva. 21. WHO, Trends in Maternal Mortality: 1990 to 2010. WHO, UNICEF, UNFPA and The World Bank estimates. 2012, World Health Organization: Geneva. 22. Onis, M.d., M. Blossner, and E. Borghi, Prevalence and trends of stunting among pre-school children, 1990-2020. Public Health Nutrition, 2011: p. 7. 23. Moolani, Y., G. Bukhman, and P.J. Hotez, Neglected Tropical Diseases as Hidden Causes of Cardiovascular Disease. Plos Neglected Tropical Diseases, 2012. 6(6). 24. Young, F., et al., A review of co-morbidity between infectious and chronic disease in sub-Saharan Africa: TB amd Diabetes Mellitus, HIV and Metabolic Syndrome, and the impact of globalization. Globalization and Health, 2009. 5(9). 25. Bove, I., et al., Stunting, overweight and child development impairment go hand in hand as key problems of early infancy: Uruguayan case. Early Human Development, 2012. 88(9): p. 747-751. 73
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The Challenge of Non-Communicable D
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THE CHALLENGE OF NON-COMMUNICABLE D
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TABLE OF CONTENTS Abstract.........
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List of Tables Table 1: Top 15 Lead
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LIST OF ACRONYMS AIDS Acquired Immu
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2 The Challenge of Non-communicable
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Page 22 and 23:
Page 25 and 26:
2. BURDEN OF NCDs AND RTIs This sec
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An Overview 13 A Rising Epidemic of
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
Page 77 and 78: An Overview 63 Guidelines and Quali
Page 79 and 80: An Overview 65 a balance needs to b
Page 81 and 82: An Overview 67 death statistics to
Page 83 and 84: An Overview 69 nations of intervent
Page 85: “As we start the journey of the n
Page 89 and 90: An Overview 75 56. Bukhman, G. and
Page 91 and 92: An Overview 77 114. BeLue, R., et a
Page 93 and 94: An Overview 79 168. Stuckler, D., S
Page 95 and 96: An Overview 81 222. Narayan, K.M.V.
Page 97 and 98: An Overview 83 278. Catford, J., Im
Page 99 and 100: An Overview 85 336. O’Brien, M.,
Page 101 and 102: An Overview 87 390. Beran, D., A. M
Page 103 and 104: An Overview 89 444. The World Bank,
Page 105: MAP IBRD 39854: SUB-SAHARAN AFRICA
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