Brazzaville, 17 May 2011-- As Ministers of Health of  the WHO African Region gathered in Brazzaville on 6 April 2011 for their first ever session devoted to discussing how to address the high and growing incidence of noncommunicable diseases (NCDs), the WHO Regional Director for Africa, Dr Luis Sambo,   asked a thought-provoking question.

“How”,  he asked,  “did NCDs come to pose such a public health threat to the world” ?

“There are several possible explanations, “ he said, “but one reality observed worldwide is life-style changes brought about by advances in science and technology. While the progress and development made over the years has led to improvement in the quality of life, it has also induced lifestyle changes that are not always favourable to health.”

“There are several possible explanations, “ he stated, “but one reality observed worldwide is life-style changes brought about by advances in science and technology. While the progress and development made over the years has led to improvement in the quality of life, it has also induced lifestyle changes that are not always favourable to health.”

The Regional Director was very clearly referring to some off-shoots of modernization and development that have resulted in physical inactivity; harmful use of alcohol – which fuels violence and other risky behaviours; consumption of unhealthy diets, tobacco use and exposure to tobacco smoke, as well as increased availability of modes of mass transit which is blamed for the increasing number of injuries and deaths on our roads.

All these risk factors are very closely inter-related, and it is, indeed, ironic that many of the hallmarks of development are intrinsically linked to a growing number of Africa’s health problems.

Physical inactivity and increased motorization

More development typically means more cars, more motorcycles and tricycles, and more elevators resulting in more people driving or riding more; walking and exercising less, and generally being less physically active.

This, notes Dr Boureima Hama Sambo, an NCDs expert at the WHO Regional Office for Africa (WHO/AFRO), are coupled with progressively more sedentary work environments due to improved technology.

Lack of physical activity and an increase in both occupational and leisure time activities involving computers and television constitute considerable risk factors, contributing to a variety of health problems including weight gain and cardio-respiratory complications.

During the Brazzaville meeting, Dr Luis Sambo launched a book entitled “Status report on Road Safety in countries in the WHO African Region”. The book highlights grim and sobering statistics: in 2007 alone, an estimated 234,000 people aged between 15 and 44 died in Africa as a result of road traffic crashes, representing 20% of all road deaths worldwide that year, in a region which has only 2% of the world’s registered vehicles.

Unhealthy diet

In the same address to the experts and ministers at the first WHO African Ministerial Consultation on NCDs, Dr Luis Sambo also stated that technological advancement had now made possible the mass production and wide distribution of food rich in sugar , salt and fat.

Modern advertising techniques, he said, are being used to target particularly children and the youth whose generous consumption of these unhealthy foods may lead obesity-which is precursor to NCDs such as diabetes, cancers and cardiovascular diseases. These complications negatively affects vital organs such as the heart, the brain, the kidneys, the liver and the pancreas, among others.

Indeed, the growing world-wide cases of obesity have reached such an epidemic status that the new term “globesity” is beginning to gain popularity, commented one NCD expert from WHO Headquarters whose main area of interest is obesity.

Tobacco use and harmful use of alcohol

The Regional Director recalled that tobacco , once almost exclusively used by the elderly in Africa, is now widely used by people of all ages, especially the youth. It is estimated that between 6% and 36% of adults in Africa are smokers.

Similarly, said the Regional Director , alcohol, hitherto served on special occasions in traditional African societies, is now produced in large quantities, and is easily accessible to all including vulnerable groups such as the youth.

It is well documented in NCD literature that in the African Region, many suicides, acts of violence and road traffic accidents are attributable to harmful use of alcohol.

The risk factors described above, alone, or in combination, are responsible for most of the major NCDs and priority conditions which represent a significant challenge to people in the region.

These NCDs and priority conditions were clearly spelt out in the Brazzaville Declaration adopted by the Health Ministers at the end of their meeting: cardiovascular diseases, diabetes, cancers, chronic respiratory diseases, diseases of blood disorder (in particular sickle cell disease), mental health, violence and injuries.

Sickle cell disease got emphatic mention both in the Declaration and by the Regional Director who told the Ministers that, “each year, more than 500,000 babies are born with sickle cell disease and between 60% and 80% of these children die before their fifth birthday.”

Conclusion

Globalization, modernization and advances in science and technology are unstoppable forces with significant impact on health status of populations particularly in the African Region..

NCDs are no longer diseases of the rich. A report prepared by WHO/AFRO for the Brazzaville Ministerial Consultation on NCDs indicated that in 2004, NCDs were responsible for 28% (3.6 million) of the deaths in Africa; and this is projected to rise by 27% over the next 10 years.

The Brazzaville Declaration – which will feed into the September 2011 UN General Assembly High-Level Summit on NCDs – clearly states what actions must be taken particularly in the African Region in order to stem the tide of NCDs and other priority conditions. The other five WHO Regions have held similar consultations on NCDs and the outcomes of these consultations will also feed into the upcoming UN High Level Summit.

One inescapable conclusion is that with the holding of Ministerial consultations in all the six WHO Regions and the hosting of the first ever global Heads of State and Government Summit on NCDs by the United Nations later this year, a global consensus and mandate would seem to be emerging to save 36 million lives a year worldwide from NCDs.

For more information, please contact:

Samuel T. Ajibola, WHO/AFRO, Brazzaville; Tel: + 47 241 39378 ;

E-mail: ajibolas [at] afro.who.int (ajibolas[at]afro[dot]who[dot]int)