By Syriacus Buguzi
Insight Correspondent
Dar es Salaam. Just as it was hard for Tanzania to escape from the sharp pangs of the last global recession, the wellbeing and prosperity of the country are currently being threatened by the growing global problem of the non-communicable diseases (NCDs) burden.
According to a new World Health Organisation (WHO) report, which has heightened international concern about the dangers of lifestyle diseases, the likes of diabetes, cardiovascular diseases, cancer, chronic respiratory diseases and mental disorders as well as obesity are now causing almost two-thirds of deaths worldwide.
The UN agency says in the World Health Statistics 2012 report that of the estimated 57 million global deaths in 2008, 36 million (63 per cent) were due to NCDs. The report has it that around 80 per cent of all NCD deaths (29 million) occurred in low- and middle-income countries, including Tanzania.
“The probability of dying from an NCD between the ages of 30 and 70 is highest in sub-Saharan Africa, Eastern Europe and parts of Asia,” WHO notes in the document, which was released last week.
In Tanzania, that probability is between 30-40 per cent. The WHO figures show that out of 100,000 people, 745 are dying from NCDs in the country compared to 782 deaths caused by communicable diseases and 120 from injuries.
In Africa, more than 40 per cent (and up to 50 per cent) of adults in many countries are estimated to have high blood pressure. Most of these people remain undiagnosed, although many of these cases could be treated with low-cost medications, which would significantly reduce the risk of death and disability from heart disease and stroke. Globally, high blood pressure afflicts one in three adults, putting them at greater risk of heart disease and stroke, the report finds. It also has it that one in 10 adults has diabetes, which can lead to cardiovascular disease, blindness and kidney failure if left untreated.
The World Health Statistics 2012 also mentions obesity as another major issue.
“In every region of the world, obesity doubled between 1980 and 2008,” says Dr Ties Boerma, director of the Department of Health Statistics and Information Systems at WHO. “Today, half a billion people (12 per cent of the world’s population) are considered obese.”
It is projected that the annual number of deaths due to cardiovascular disease will increase from 17 million in 2008 to 25 million in 2030, with annual cancer deaths increasing from 7.6 million to 13 million. As a result of such trends, the total number of annual NCD deaths is projected to reach 55 million by 2030 – whereas annual infectious disease deaths are projected to decline over the next 20 years.
On the positive side, the WHO assessment also finds notable improvements in some areas. The report celebrates a number of impressive achievements the global community reached in improving access to health services, reducing the burden of disease and mortality.
Prevalence of malnutrition in young children have reduced from 29 per cent to 18 per cent and under five mortality dropped by 35 per cent from 1990 to 2010. Measles deaths reduced by 74 per cent from 2000 to 2010, maternal mortality reduced from 543 000 in 1990 to 287 000 in 2010. The world achieved the target relating the access to drinking water and is on track to achieve MDG target regarding TB control.
Despite the above progress, the world will likely fail to achieve the millennium development goals relating to maternal and child mortality and access to basic sanitation. The progress in improving health and access to health care has been uneven with sub Saharan Africa lagging behind other regions.
The WHO concern and alarm comes as studies done over a period of six years in Tanzania have established spiralling rates of chronic diseases related to obesity such as hypertension, stroke, type-2 diabetes mellitus and certain cancers, mainly affecting the urban areas.
Early this year, President Jakaya Kikwete warned that the number of deaths caused by cardiovascular complications in the country was alarming and the government capacity to control this situation is very low.
The president’s remark at the official opening of the first international conference on heart diseases held in Dar es Salaam affirmed fears of the growing plague of non-communicable diseases in the country. Apart from being a public health challenge in the country, regionally and across the world, WHO lists the NDCs menace of cardiovascular diseases, diabetes, cancers and chronic respiratory illnesses as the biggest killers in the world.
Evidence of NDCs becoming chronic in Tanzania and the size of the challenges they are posing to the national health system include last year’s Kikombe cha Babu mania. The Loliondo phenomenon followed news of the existence of an alternative cure for chronic illnesses and triggered massive migration to the remote Samunge village.
The kikombe enthusiasts included desperate admitted patients, who sneaked from hospital wards to go and scramble for the infamous cup of an herbal concoction. They all expected a miraculous cure for diabetes, heart diseases, cancers and even HIV/Aids a mere cost of Sh500 a dose.
Ironically, the Loliondo craze was on one part, a sign of desperation and a last resort, owing to the high treatment cost that patients have to incur at health local facilities when they succumb to NCDs, especially heart diseases.
Medical experts have it that most of the NDCs are caused by what we eat especially junk food, the drinking styles and failure to regularly exercise. The matter is worsened by the escalation of prices of tradition diets while exotic meals like fattening foods are increasingly becoming cheaper and the outlets selling them mushrooming in all corners of major town.
The degree of the NDC epidemic is also evidenced by the increasing number of diabetic patients in tertiary hospitals who end up having their legs chopped off as a desperate measure to rescue them from the complications of chronic diabetes.
It is being estimated that 70 per cent of leg amputations at hospitals in Tanzania, occur among diabetic patients with foot complications. A study done over a period of two years at Bugando Medical Centre in Mwanza and published in The International Wound Journal last year, revealed that out of 4238 diabetic patients that reported at the medical centre, 136 had developed diabetic foot ulcers-majority of whom had to be amputated.
The study titled, “Surgical management of Diabetic foot ulcers: A Tanzanian university teaching hospital experience’’ and authored by a team of surgeons and physicians from the Muhimbili University of Health and Allied Sciences (Muhas) and Bugando Medical Centre established that diabetic foot infections are among the major causes of disease and deaths.
“This health challenge is threatening more of the developing countries like Tanzania due to illiteracy; poor socioeconomic status, bare-foot walking and inadequate facilities for diabetes care,” the study reads in part.
Global concern about the rise in numbers of deaths from heart and lung disease, diabetes and cancer prompted the UN to hold a high-level meeting on non-communicable diseases in New York in September 2011.
The NDCs problem is so alarming that the World Health Assembly, which took off in Geneva, Switzerland, on Monday and ends today, has been reviewing progress made since the US meeting and is to outline on next steps to deal with the menace. Work is currently under way to develop a global monitoring framework and a set of voluntary targets for prevention and control of these diseases.
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