Curbing Africa’s chronic disease crisis
In an effort to curb Africa’s chronic disease crisis, African health ministers approved a new regional strategy to improve the diagnosis and treatment of severe forms of non-communicable diseases (NCDs) in district hospitals and referral facilities. level one where care is often not available today.
Ministers and government officials also launched a campaign to tackle sickle cell disease, agreed on health system reforms in response to the COVID-19 pandemic and decided on new measures needed to fight tuberculosis in children in Africa during the meeting of their 72nd WHO Regional. Committee on Africa this week.
The new regional strategy for NCDs is known as PEN-PLUS. It addresses the cardiovascular diseases, diabetes, cancer and chronic lung diseases that are responsible for almost 70% of all premature deaths worldwide – and a rapidly increasing proportion of premature deaths in Africa.
In addition, African nations face a particular burden from sickle cell disease, which can cause severe anemia and premature death if left untreated.
In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnose and treat NCDs in the level of primary health care, and most are equipped only to treat severe diseases of severe infectious diseases in tertiary health institutions, which means large hospitals, located in large cities.
This, WHO says, puts care beyond the reach of rural and poorer patients, who typically rely on district hospitals and local health centers that lack the capacity and resources to effectively manage serious non-chronic diseases.
Only 36% of countries have public hospitals equipped with basic NCD medications
PEN-PLUS, developed by WHO in collaboration with African Ministers of Health over the past two years, provides a roadmap for countries to establish standardized programs to treat chronic and severe non-chronic diseases, ensuring that essential medicines, technologies and diagnostics are available and accessible in district hospitals.
It also encourages African governments to improve training and treatment protocols for chronic NCDs and ensure that people in private hospitals can access services for severe NCDs.
Currently, only 36% of countries in the African region have public hospitals equipped with the necessary drugs to treat infectious diseases, and private hospitals must also provide such services, according to the WHO.
In Liberia, Malawi and Rwanda, where the strategy is already in place, WHO says there has been a significant increase in health and the number of patients treated for severe infectious disease.
In Africa, the most prevalent NCDs include type 1 and 2 diabetes, hypertension, heart disease and asthma, as well as sickle cell disease, a genetic disorder, according to WHO data.
New campaign for sickle cell disease
Regarding the promotion against non-chronic diseases, the ministers of health also started a campaign for it treat sickle cell disease, an inherited blood disorder that causes anemia and can shorten life if left untreated.
More than 66% of 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day.
In 2019, the number of deaths from sickle cell disease in the African region rose to 38,403 – an increase of 26% since 2000.
This increase in disease burden is attributed to a lack of investment in disease-fighting tools, including prevention, early detection and appropriate care, according to the WHO. The level of care is also hampered by inadequate staffing and services, particularly in lower level facilities.
The campaign aims to strengthen political will, commitment and financial resources for the prevention and control of sickle cell disease throughout the region.
It relies on financial support and resources from the World Bank, the US Department of Health and Human Services, the Novartis Foundation, Global Blood Therapeutics and the Sickle in Africa consortium.
Primary targets are schools, communities, health facilities and news media.
WHO notes that progress in disease control in Africa is hampered by a lack of newborn screening and surveillance programs, a lack of accurate and reliable data on sickle cell disease, and a lack of collection of sickle cell disease data in most national surveys .
“We need to put the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.
Renewing Africa’s health systems in the wake of the pandemic
At the meeting, the countries also agreed to initiate other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination.
“Domestic investment in health, including health research, has significant economic returns while promoting resilience and sustainability; A healthy population translates into a healthy economy,” said Moeti.
Senegal’s Minister of Health, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her country’s health system placed more emphasis on sustainability and investment.
This “significantly strengthened disease prevention and management capacities,” she said.
The fight against tuberculosis in children
In terms of infectious diseases, long the main focus of African health programs, more comprehensive and immediate measures are needed to combat tuberculosis among children in Africa, WHO and African Union representatives said at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).
Currently, two thirds of the children with TB in the WHO African Region go undiagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children.
Among children under the age of five who are believed to have TB, only 32% in the African Region are diagnosed and treated, the lowest percentage for that age group globally.
Seventeen of the world’s 30 countries with the highest global burden of tuberculosis are in Africa, where 322,000 children and young adolescents under the age of 15 are affected.
“There is an urgent need for innovative interventions to integrate tuberculosis diagnosis into nutrition programs to quickly identify the disease in children,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development.
“Children with TB are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, “so their suffering is an indication of our failures to diagnose and treat tuberculosis in children.”
A child dies from tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. .
Handling the cholera outbreak in Malawi
At the meeting, WHO and UNICEF also announced joint plans to step up efforts to contain a recently reported cholera outbreak in Malawi.
The spread has increased to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeside communities and crowded, urban areas with inadequate water and sanitation.
UN agencies say they will increase surveillance for early detection and management; improving the quality of case management in cholera treatment units; and provide critical supplies needed to manage cholera cases.
They also plan to help improve water treatment, personal hygiene and household water conservation.
The WHO representative in Malawi, Dr Neema Rusibamayila Kimambo, emphasized that every death from cholera is preventable.
The UN health agency will provide additional support to Malawi’s Ministry of Health to “help ensure that lives continue to be saved and a resilient health system maintained during and beyond the current outbreak,” Kimambo said.
UNICEF Malawi Representative Rudolf Schwenk said it is urgent to help Malawi’s already overburdened public health services and health care delivery systems.
“The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian aid in the affected districts, but we need more support to further scale up our response.”
Image credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO.
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