THE BIG ISSUE – Non-communicable diseases in East Africa: A region at risk

Non-communicable diseases (NCDs) represent the fastest growing disease burden in the Africa Region, and are set to become a major healthcare and development challenge in Africa in coming decades. In what has been called an epidemiological transition in Sub Saharan Africa (SSA), the disease burden is moving away from infectious to non-communicable diseases. Already, in North African countries like Egypt, NCDs are responsible for 85% of all deaths. Some of the worrying facts include:

  1. On average, NCDs are responsible for 30% of all deaths in the five East African countries.
  2. While mortality due to infectious diseases decreased by 10% from 2000 to 2012, the mortality due to NCDs rose from 21% in 2000 to 30% in 2012.
  3. By 2030 NCDs will be the leading cause of death in Sub Saharan Africa from current 28% to 46%

Yet, more than any other region, Africa is particularly unprepared and under-resourced to address NCDs. As the WHO 2015 NCD Progress Monitor reveals, in East Africa only Kenya and Rwanda have national integrated NCD policy and strategy plan. But across the region, our benchmark report (2014) shows that despite high level declarations of intention, there is very limited prioritization of NCDs in programming and budgeting. In Uganda for example available information shows that only 0.011% of the health budget was allocated to NCDs in 2014, mainly on salaries and administrative costs yet the diseases cause 27% of death in the country.

Obvious challenges exist, mainly limited resources. But other institutional challenges exist for example the health care systems were built to handle infectious, one-off diseases but they are yet to be restructured to respond adequately to NCDs; there is shortage of NCD-trained health workers and technologies such as those for screening.

NCDs constitute a public healthcare and development challenge in East Africa. They are threatening to wipe out the progress made in areas like reproductive health and economic growth. Research shows that NCDs are also creating social inequality as the risk factors and cost burden are shifting towards the poor yet NCDs are chronic and very costly to treat. For such low-income countries of East Africa, this is hitting poor people hardest because governments cannot provide full health coverage. Citizens face heavy out-of-pocket costs for medical care. In Uganda, for example, up to 75 percent of health care is paid for through private spending.

In view of this, the East Africa NCD Alliance, in a Statement issued in Nairobi on April 9, 2016, equated the situation to a ‘malignant tumor which has been developing unattended and virtually ignored over the years’ and warned that ‘we are sleep-walking into a healthcare disaster’. The EANCDA is working with various partners to find affordable and relevant solutions to these multifarious problems and to advocate for more action on NCDs at national and global levels.