Reversal of the tide of NCDs requires a strategy shift

Roger Paul Kamugasha, CNS Correspondent
Of the 56.4 million global deaths in 2015, 39.5 million, or 70%, were due to non-communicable diseases (NCDs). The four main NCDs are cardiovascular diseases, cancers, diabetes and chronic lung diseases. The burden of these diseases is rising disproportionately among lower income countries and populations.

We are all aware of the anticipated donor transition where countries are encouraged to increase investments towards NCDs. This imminent priority shift is an innovation towards facing NCDs headlong in the face.

From the perspective of low and some middle income countries, this indeed is a paradigm shift. Take the example of diabetes. In these countries, there has been a looming and popular belief that diabetes was a disease of the rich. This myth traded ignorance that led to an escalated burden of diabetes, because people remained actually ignorant about the symptoms of diabetes.

An interesting wake-up call was the onset of discovering that TB and diabetes impact each other. This was indeed an interesting information, because all along TB- an airborne infectious disease- was always regarded as a disease of poverty. This misconception made the elite ignore TB until it knocked on their doors since, being airborne, it has no borders. The integration of TB, an infectious disease, and diabetes, a non communicable disease, repudiated the decades long fallacy and achieved a paradigm shift by bringing the poor and rich on the same side of the table.

Indeed the myth of TB being a disease of the poor stems from the social determinants of TB where most of the identified cases are in places like slums, prisons and places with poor ventilation. This is coupled with the fact that every other person might be having latent TB, that can flare up as an active case, depending upon the immune system and the living conditions of the person concerned. No wonder that the statistics of TB case findings or notifications always indicates its presence in poor congregated settings.

In conclusion, action against NCDs will require an innovative strategy shift. We will have to stop doing the same things, while expecting different results. This will require more investments in advocacy, communications and social mobilization for NCDs. People continue living with diabetes ignorantly and it is often diagnosed in its late stages. There is need for awareness. Similarly early cancer detection, to make it manageable, is likely only if people have some knowledge of its symptoms and are able to go for diagnosis early enough.

The integration of NCDs with infectious diseases, like TB, should be given the attention it deserves, and may generate more research priorities. Setting up a policy agenda for NCDs is pertinent and will go a long  way in increasing the focus on NCDs in national health programmes. Nutritional education in managing some NCDs is equally important in the awareness process.

Roger Paul Kamugasha, Citizen News Service - CNS
July 8, 2017

(The author of the story is also the Editor in Chief of The Health Times, Africa)  

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