The East Africa NCDs Charter

The East Africa NCDs Charter

In light of the increasing burden of Non-Communicable Diseases (NCDs) in the East African Sub-Region, the East African NCD Alliance (EANCDA) convened and adopted the Charter, based on the results of a regional benchmark survey, conversations with people living with NCDs (PLWNCDs) and NCD health care providers, and outcomes from the stakeholders’ workshop held in Kigali on January 25-27, 2018.

The consideration of the East Africa NCDs Charter Commitments;

Incorporation of NCD prevention, management and control in all national development plans, ensure policy coherence and coordinated action to efficiently mainstream NCDs and health in all national development plans

Full implementation of tobacco and alcohol control legislation and policies, especially with regard to banning of advertising, and warning messages on products

Involvement of PLWNCDs and their caregivers in the formulation, implementation and review of all NCD policies, legislation, strategies, guidelines and activities

Increased national budgetary allocations for health (aimed at achieving the Abuja Declaration of 15% of the national budget) to support Universal Health Care through strengthened Primary Health Care (PHC) system with specific activities for NCD prevention and care. For countries with devolved governments, sub-national government budget allocation to the health sector should mirror the Abuja Declaration as well.

Full implementation of taxation for alcohol, tobacco and unhealthy foods and drinks, and the allocation of these taxes to the prevention, management and control of NCDs

Development and implementation of effective integrated nutrition policies for control of both under-nutrition, overweight and obesity

Regulations on production, sale and marketing of foods and drinks containing high sugar, salt and trans-fats, especially those targeting children

Ensuring that the environment is conducive for healthy living and the promotion of healthy recreational habits targeting the youth to counter the rising prevalence of tobacco use, substance abuse, unhealthy diets and low levels of physical activity amongst this age group

Comprehensive road safety interventions to mitigate the economic impacts from injuries and deaths due to road traffic accidents

Effective Inter-Sectoral Coordinating Committees at the sub-national and national levels that include NCD prevention, management and control in their remit

Proscovia Nabatte as Project Assistant

Project Assistant PROSCOVIA Nabatte

Public Relations and Communications Specialist; with notable experience in writing, developing communications strategies and policies, online media content development and management. She attained her Bachelor’s degree of Journalism and Communication at Makerere University Kampala, Uganda. At EANCDA, she is managing projects; Media Engagement for NCD awareness and advocacy; strengthening communication and media strategies/frameworks as well as building advocacy blocks on NCDs. The projects are geared towards developing comprehensive and cohesive NCD advocacy and communication strategies, enhancing media reporting and coverage skills on the intersection of NCDs and COVID 19 and, amplifying the voices of People Living with NCDs as a way of building broader health systems reform and UHC advocacy coalitions within the East Africa Member countries of Burundi, Kenya, Rwanda, Tanzania, Uganda and Zanzibar. She is the former Assistant Communication Officer at Makerere University (Public Relations Office). A Fellow of the Young Africa Leaders Initiative (YALI) and Africa Women’s Leadership Initiative (AWLI). Proscovia is also a trainer on Peace and Conflict Management at Women Situation Room. She is also the Communications Associate at Africa NCDs Network.

EANCDA mobilises global coalition to call for action on NCDs at WHO Meeting

The East Africa Non-Communicable Diseases Alliance (EANCDA) has decried the low level of priority given to non-communicable disease in Africa and called on the World Health Organization to do more in its power to increase the response of governments and other stakeholder to the scourge in the Region.

This call was made by Dr Mucumbitsi Joseph, the Vice-Chair of EANCDA, in a Joint Statement presented at the annual AFRO Regional Committee Meeting (RCM) of the World Health Organization which took place in Addis Ababa on August 19-23, 2016. The Joint Statement, which was supported by the Global NCD Alliance, was co-signed by a coalition of over twenty partners from all over African and overseas; these included civil society organisations and research institutions working on NCDs.

In the Statement Dr Mucumbitsi noted that that ‘2011 Political Declaration on NCDs marked a watershed moment and an awakening to the need to address NCDs’ and was followed by global momentum and action to address the problem. He, however, lamented that there has been slow progress in Africa yet the continent is the most vulnerable to NCDs, which now pose  a threat not only to health but to wider development.

The Statement expressed disappointment that despite the urgency of the NCD problem and the RCM having a lot of influence on health in the continent, NCDs were not high on the agenda at the RCM. It then called for urgent action on four key areas: development of policies and strategic plans, adequate financing, health systems strengthening, and health information systems.

The delicious, healthy and affordable alternative

A traditional lunch in Uganda consists of 5-6 components of starch, accompanied with small bits of meat and a bean stew. The lunch is unhealthy and leads to obesity. We have made an alternative.

At the photo are the regular lunch of our volunteer coordinator Molly, and our alternative.

Local ingredients

The focus of the alternative lunch was to use indigenous nutritious food and prepare them in a simple and culturally acceptable manner with each recipe component consisting of about 2-3 ingredients. Still, the alternative lunch included the beef stew and kidney bean stew served at the office regularly. It was then supplemented by a mixed mash of pumpkin, potato and carrot, a watermelon and avocado salad topped with roasted pumpkin seeds and lastly a tomato salsa with red onions.

The health gains

A change in nutrient contents when comparing the two meals was obvious. By reducing the amount of starchy foods on the plate, the carbohydrate content was reduced by approximately 50%. Serving of the alternative lunch resulted in an increased amount of several vitamins and minerals including an estimated increase of vitamin A, vitamin C, and vitamin K by 90%, 32% and 663%, respectively. In addition, the amount of saturated fat was reduced by approximately 30%.

The economic gains

To ensure the usefulness, it is essential, that the dishes are created of commodities that are easily accessible pricewise to the local population in spite of economic status. By comparing the costs of the alternative and the regular lunch, a reduction in the price of 2.097 UGX per person was found (table 1). Therefore, the changes will not pose a financial burden. Moreover, it will practically save time since the alternative contains more uncooked, fresh components.

Table 1 Estimated prices for the regular and alternative lunch

This is a good example of how little it takes to change the nutritional composition of a meal when rethinking the use of indigenous foods, and that it is actually manageable with local available foods at an equal or lower price level.

Recipes for the alternative lunch (excluding meat and bean stew) (pdf)

Alternative Lunch 2

Local ingredients

The second alternative lunch served for our colleagues consisted of rice with chopped vegetables, a red cabbage salad with diced vegetables and an oil-, honey- and lemon juice dressing topped with sesame seeds served with the beef stew from the regular lunch.

The health gains

By focusing on using rice as the only starchy component from the regular lunch, the content of carbohydrate was reduced by approximately 55%. Furthermore, the saturated fat was reduced by 30% and vitamin C and K increased by 251% and 187%.

The economic gains

The alternative lunch resulted in a saving of 23,200 UGX in total and 3,314 UGX per person (table 2).

Table 1 Estimated prices for the regular and alternative lunch

Edward Ligondo, Stroke Survivor; A Case of Near Fatal Negligence

Edward Ligondo Konzolo is a stroke survivor from Ikobero Village, Vihiga Sub Country, Kenya. The former high school teacher first learnt about his condition when he suffered stroke on Sunday June 10, 2012, by then just 46 years old. And the subsequent ordeal he went through within the health system and community stigma, drove him to mobilize others to do something.

Edward was living happily and without any serious health problem. Even on this life-changing June weekend, he had been to church and had his usual nice Sunday service with his family. But on his was back he collapsed. Although he regained consciousness and went home normally after, him and his family and friends kept wondering what the problem was. Again, later at home, he suffered more worrying and inexplicable incidences of paralysis: he was unable to unzip his trouser while in the bathroom where he also dropped his phone in the toilet. Moments later he spilled tea over himself as his hand could not support the cup.

After recovering from this bout of paralysis, Edward was rushed to Nairobi Women’s Hospital at 11am. He recalls that the hospital the doctor and nurses didn’t know what to do. Even after explaining what had happened and that he felt paralyzed on one side, the doctor insisted that he was okay and admitted him for monitoring overnight. At 8pm he suffered the second stroke and was found lying helpless by a night duty nurse doing ward round.

This is when he was given the shattering news that he could have suffered stroke, and sent for confirmatory tests after which he was admitted for treatment for the next thirty days. At this point Edward counted himself a very lucky man – not only because he survived two stroke attacks in less than 24 hours but – because he was insured from his teaching job. He notes that access to treatment and care is the biggest challenging to people like him. He says he has no idea how other people, especially the unemployed, manage to cover the staggering cost of treatment.

Yet, Edward’s ordeal was not over when he was discharged to go and recover from his village. Here the medicines were a $10 round trip away in the regional town of Kisumu. Moreover, availability of medicines was not guaranteed even when he had money to buy. At the same time, he lost his job and within the community, he was stigmatized and deserted by people who thought his condition was a result of being bewitched.

But with the help of family, Edward pulled through this. He later traveled to Nairobi where he met other stoke survivors with whom he decided to form the Stroke Association of Kenya to give voice and advocate for the people who are suffering with the condition.