Abstract
Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub Saharan Africa. The economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them.
Highlights
Africa bears a significant proportion of the global burden of chronic diseases, along with poor countries of Asia and Latin America
The World Health Organisation (WHO) projects that over the ten years the continent will experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes [1]
The evidence presented in this special issue on the medical, psychological, community and policy dimensions of the chronic disease burden in sub-Saharan Africa emphasises the urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies
Summary
Africa bears a significant proportion of the global burden of chronic diseases, along with poor countries of Asia and Latin America (see appendix 1). De-Graft Aikins, Boynton and Atanga provide a comprehensive overview of the structural, community and individual dimensions of tackling chronic disease in Ghana and Cameroon [36] They discuss the role of community interventions in bridging the gap between 'social logic' and 'medical logic' regarding health and illness, and in contributing to the vexing challenge of translating abstract health expertise and policy into effective practice in real social settings. The challenge is in undertaking the sorts of analyses that enable appropriate knowledge transfer and knowledge exchange based on extant research Reviews such as the special issue papers by Agyeman et al [16] on the risk factors for chronic diseases among the African diaspora in Europe, by Belue et al [17] on the cultural dimensions of the CVD burden, and by Young et al [2] on the co-morbidity between infectious and chronic diseases are a critical contribution towards an analysis of knowledge transfer. The literature from the social sciences was not included in the review, the authors touch on the potential effects of factors such as gender and poverty which would add significant socio-cultural challenges to interventions in this area
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