Southern Africa’s new health care battle

Lazarus Sauti

Sub-Saharan Africa (SSA) has the most serious HIV/Aids epidemic in the world. HIV prevalence for the region is 4.7 percent, but varies greatly between regions within SSA as well as individual countries.

Southern Africa, for instance, is the worst affected region and is widely regarded as the ‘epicentre’ of the global HIV epidemic.

Swaziland has the highest HIV prevalence of any country worldwide (27.4 percent) while South Africa has the largest epidemic of any country – 5.9 million people are living with HIV.

As countries in southern Africa seek to eliminate Aids by 2030, a new plague is on the rise in the region, a pandemic of non communicable diseases (NCDs).

The World Health Organisation (WHO) defines NCDs as cardiovascular diseases that can lead to heart attacks and stroke; ‘cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes’.

Chief reasons for the rise of these chronic diseases in southern Africa are poor lifestyle choices such as too much fast food, not enough exercise, excessive alcohol as well as tobacco use.

Zimbabweans, for instance, are adopting more sedentary lifestyles such as braaing, and eating excessive meat and this can expose them to problems such as obesity as well as diseases such as cancer, osteoporosis and diabetes, says dietician Frank Makombe.

An estimated 31 percent of deaths in Zimbabwe in 2014 were a result of non-communicable diseases, adds WHO statistics.

Figures in the country also show that cardiovascular disease like heart attack and stokes account for 9 percent of deaths from NCDs, while 10 percent of deaths were result of cancer illnesses.

WHO says annually, 28 million people die from non communicable diseases in low- and middle-income countries like Zimbabwe, representing nearly 75 percent of deaths from non communicable diseases globally.

The UN health agency adds, “In African nations, non-communicable diseases are rising rapidly and are projected to exceed communicable, maternal, perinatal, and nutritional diseases as the most common causes of death by 2030.”

Sadly, adds WHO, large population suffering from non-communicable diseases and other ailments in southern Africa and other developing nations are struggling to access quality health care due to poor infrastructure, cost of healthcare services, drug shortages, corruption as well as lack of access to trained health practitioners.

The significant urban/rural divide in access to highly qualified health practitioners, with many graduates choosing to stay in towns and cities due to lack of clinical support, poor pay and working conditions in some secondary rural hospitals heightens the problem.

Further, the lack of access to trained physicians in East, Central and southern Africa is stark and well documented.

The latest WHO health workforce figures show that the physician-to-population ratio does not exceed 20 per 100 000 anywhere in the region.

Now, WHO says without losing focus on the ongoing battle against Aids, southern Africa as well as other developing nations must turn attention to chronic diseases.

“It is not enough to just talk about chronic diseases,” says WHO. “Ministries and departments responsible for health services in the region should be proactive in dealing with this class of inflictions.”

In line with Article 13 of the Southern Africa Development Community’s Protocol on Health, which encourages member states to “adopt appropriate strategies for the prevention and control of non-communicable diseases”, SADC member states must effectively endorse specific health promotion efforts such as tobacco control, good diet as well as physical activity.

Governments, development partners as well as other relevant stakeholders in health service provision in the region should also provide citizens with information and education programmes on mental health, substance abuse, life skills, integrated nutrition, health promotion, peer education, reproductive health and primary health care.

Makombe says although most countries in southern Africa are facing some challenges politically, economically, socially and technologically, policy makers should use knowledge to fight the scourge of non communicable diseases.

“Knowledge is power. To tap from this power, it is noble for governments in the SADC region to power communities with knowledge about healthy lifestyles and nutritious foods,” he says, adding that national plans, strategies, policies and programmes that promote healthy eating habits, physical health, and well-being should be propagated and implemented.

Collence Chisita, a researcher, says governments in the region need to invest in research and development in order to understand the levels, patterns and trends of non communicable diseases and their causes at national levels.

He adds that there is need by policy makers to develop cost-effective approaches for translation of evidence-based health promotion interventions to cater for all people in regional countries.

“Collaborations with reputable and credible partners are important and research findings should be repackaged so that they can be understood by ordinary folks,” he says, adding that more funding should be provided to encourage research in non communicable diseases.

Private practitioner and former chair of the Zimbabwe Association of Doctors for Human Rights, Douglas Gwatidzo, says offsetting diabetes, heart disease or even strokes, can be fun, involving a little music and dancing.

He advises people to become active, and for those who have access to join group activities like aerobics, dancing or even a walkathon.