Abstract
The demographic and nutritional transitions taking place in Uganda, just as in other low- and middle-income countries (LMIC), are leading to accelerating growth of chronic, non-communicable diseases (NCDs). Though still sparse, locally derived data on NCDs in Uganda has increased greatly over the past five years and will soon be bolstered by the first nationally representative data set on NCDs. Using these available local data, we describe the landscape of the globally recognized major NCDs- cardiovascular disease, diabetes, cancer, and chronic respiratory disease- and closely examine what is known about other locally important chronic conditions. For example, mental health disorders, spawned by an extended civil war, and highly prevalent NCD risk factors such as excessive alcohol intake and road traffic accidents, warrant special attention in Uganda. Additionally, we explore public sector capacity to tackle NCDs, including Ministry of Health NCD financing and health facility and healthcare worker preparedness. Finally, we describe a number of promising initiatives that are addressing the Ugandan NCD epidemic. These include multi-sector partnerships focused on capacity building and health systems strengthening; a model civil society collaboration leading a regional coalition; and a novel alliance of parliamentarians lobbying for NCD policy. Lessons learned from the ongoing Ugandan experience will inform other LMIC, especially in sub-Saharan Africa, as they restructure their health systems to address the growing NCD epidemic.
Highlights
The demographic and nutritional transitions taking place in Uganda, just as in other low- and middle-income countries (LMIC), are leading to accelerating growth of chronic, non-communicable diseases (NCDs)
As would be suggested by the local data, Global Burden of Disease (GBD) 2010 estimates that a number of the NCDs and risk factors described are among the leading causes of disability-adjusted life years (DALYs) in Uganda
Today in Uganda, several challenges must be addressed to ensure that the relatively new surge in local NCD-related research and a rich environment of cross-sector collaborations translate into effective policy and implementation
Summary
The demographic and nutritional transitions taking place in Uganda, just as in other low- and middle-income countries (LMIC), are leading to accelerating growth of chronic, non-communicable diseases (NCDs). We describe a number of promising initiatives that are addressing the Ugandan NCD epidemic These include multi-sector partnerships focused on capacity building and health systems strengthening; a model civil society collaboration leading a regional coalition; and a novel alliance of parliamentarians lobbying for NCD policy. Opened Shaper and Jones’ seminal 1959 article in which they compared cholesterol levels in Asian and African communities of Kampala, Uganda’s capital city [1] The former was experiencing high mortality rates from myocardial infarction while the latter was largely unaffected. The above example from Shaper and Jones illustrates the importance of locally generated data regarding risk factors, incident and prevalent disease, and morbidity and mortality. Such data are lacking in most LMIC, including Uganda. We focus on features unique to Uganda, discuss intervention costs, describe various strategies addressing NCDs, and offer recommendations for the future
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