EDITORIAL
SA JOURNAL OF DIABETES & VASCULAR DISEASE
138
VOLUME 7 NUMBER 4 • NOVEMBER 2010
An historic event: non-communicable diseases in
sub-Saharan Africa acknowledged at last?
WF MOLLENTZE
I
t was an historic event when the first Diabetes Leadership
Forum for Africa was held on 30 September and 1 October
in Johannesburg (see report in this edition). The meeting was
co-hosted by the International Diabetes Federation, the World
Diabetes Federation and the Non-Communicable Disease Global
Alliance. The forum was attended by healthcare workers, NGOs,
officials from the World Health Organisation, several ministers
of health or their representatives from sub-Saharan African
(SSA) countries, including the Caribbean islands. The event was
sponsored by Novo Nordisk and organised from their offices in
Greece. The aim of the forum was to discuss the way forward on
how best to deal with the epidemic of non-communicable diseases
(NCDs) in SSA.
NCDs were responsible for 60% of all deaths globally in 2004,
while in Africa during the same period, 25% of all deaths were
attributed to NCDs.
1
In spite of the growing contribution of
NCDs to the total burden of disease, NCDs until recently did not
receive adequate recognition from the World Health Organisation
or its member states. A turning point in the fight against NCDs
was reached when the United Nations General Assembly passed
Resolution 61/225 on 20 December 2006, recognising diabetes as
a chronic, debilitating and costly disease.
2
The second landmark event took place during the 62nd World
Health assembly meeting in Geneva in May 2009 when the
NCD Alliance was formed between the International Diabetes
Federation, the World Heart Federation and the International
Union Against Cancer.
3
The NCD Alliance was joined by a fourth
member in April 2010, the International Union Against Tuberculosis
and Lung Disease. The NCD alliance now represents nearly 900
national member associations, bringing a united voice to the global
campaign for non-communicable diseases.
Due to the efforts of the NCD Alliance, a UN resolution calling
for a summit on NCDs was unanimously passed by member states
on 13 May 2010. The NCD summit will raise the profile of NCDs
on the global stage, mobilise the international community to take
action, secure the commitment of heads of state to lead the cross-
government effort necessary to reverse the epidemic, and send
a clear message to donors and funders.
3
The four NCDs that will
be the focus of discussion at the UN summit include diabetes,
cardiovascular disease, respiratory disease and cancer.
At the recent Diabetes Leadership Forum held in Johannesburg,
delegates were informed that NCDs are playing havoc in SSA
countries with their double or triple burden of disease. NCDs
are already collectively responsible for the highest (premature)
mortality rate in the region. The bad news is that this is going to get
worse over the next century. NCDs hit the poorest people hardest.
Poverty is not only a cause of type 2 diabetes (T2DM), it is also
a result of T2DM. Young and working people are affected most.
The young and strong die prematurely and thus hamper economic
development in the region. This is happening at a time when SSA is
starting to deliver on at least some of the millennium development
goals (MDG), for example, the eradication of extreme poverty
(MDG no 1) and childhood mortality (MDG no 4). ‘It is cruel and
unfair that children in SSA should still die due to a lack of insulin.’
4
Dawn has broken and Africa isn’t dark any longer: the widespread
use of cell phones and the general availability of broadband internet
access are examples of technological advances that have already
penetrated vast areas of the region. Innovative ways have already
been found to harness these technological advances to improve
health outcomes. Much more is possible and can still be done.
Major companies and governments from other continents are
investing heavily in SSA. Access to healthcare is not only a human
right but also forms an integral part of economic development and
therefore healthcare indicators must be improved, starting with
NCDs.
A common theme emerged during the two days of deliberation:
the need to form alliances and partnerships to effectively control
and prevent NCDs and thus achieve the MDGs for the region.
Examples were cited (see forum report) where the formation of
national and international alliances between NGOs resulted in
moving NCDs higher up on the political and health agendas of
various countries. Likewise, partnerships between communities
and industry resulted in strengthening of the healthcare system and
improved patient care in some regions. A holistic approach is called
for to address the growing burden of NCDs.
In the words of Lise Kingo, executive vice president and chief of
staff of Novo Nordisk, Denmark when she addressed the Forum, ‘if
you want to walk fast, walk alone; if you want to walk far, walk
together’.
Ke nako! It is time now.
References
1.
. Accessed 12 October 2010.
2.
-
resolution-on-diabetes. Accessed 12 October 2010.
3.
. Accessed 12 October 2010.
4.
J-C Mbanya, President of the IDF.
Correspondence to: Prof WF Mollentze
Department of Internal Medicine, University of the Free State, Bloemfontein,
South Africa
Tel: +27 (0)51 405-3154
e-mail:
S Afr J Diabetes Vasc Dis
2010;
7
: 138.
