Cardiovascular Disease in Sub-Saharan Africa

Abstract

“I speak of Africa and golden joys.” — —Shakespeare, Henry IV part 2 “The wind of change is blowing through this continent.” — —Harold McMillan, former Prime Minister of the United Kingdom Open your eyes to Africa. It is big, complex and confounding,” says the British Medical Journal of October 1, 2005.1 It has some of world’s richest natural resources in minerals and oil. Yet 34 of the world’s 41 indebted poor countries are in Africa, and only 37% of Africa’s children attend secondary school. Africa, with one sixth of the world’s population, accounts for one fiftieth of the global trade. We also read of wars, civil disturbances, and devastating chronic diseases such as malnutrition, HIV/AIDS, tuberculosis, and malaria. The problems seem insuperable. “Who takes responsibility for Zimbabwe?” asked The Lancet in despair in a recent editorial.2 Why is the focus of the present series of articles on Africa in this issue of Circulation on sub-Saharan Africa? Linguistic maps of Africa show that the Sahara divides northern peri-Mediterranean Africa and some adjoining areas from sub-Saharan Africa. The language of the north is Hamito-Semitic and Arab, whereas the sub-Saharan is covered almost entirely by the Niger-Congo Bantu languages, with 2 exceptions: the Khoisan language in the Kalahari desert, lying in what is now Namibia and Botswana, and parts of South Africa in which the Indo-European languages are prominent. Thus, Sub-Saharan Africa differs linguistically and culturally from Northern Africa. Sub-Saharan Africa is also the putative cradle of humankind (Figure). Linguistic map of Africa, showing the marked division between the northern and sub-Saharan areas. Upward arrows indicate possible evolution of humankind, from the sites in South Africa and elsewhere as hominids about 3 million years ago, then from the East African site as Homo sapiens about 160 000 years ago. The …