Africa has a new strategy to combat chronic disease – here’s what you need to know

Chronic diseases like heart disease, cancer and diabetes kill more than 15 million people a year between the ages of 30 and 69, according to the World Health Organization (WHO).

In Africa, cases of chronic non-infectious diseases like these – known as noncommunicable diseases, or NCDs – are rising.

Between half and 88% of deaths across seven countries in Africa are caused by chronic diseases, the WHO says.

In another seven of Africa’s most populated countries, NCDs cause between 100,000 and 450,000 deaths annually.

Health ministers in Africa are responding by launching a new regional strategy to combat severe non-communicable diseases in district hospitals and other local health centres.

Severe non-communicable diseases are chronic conditions that lead to high levels of disability and death among children, adolescents and young adults, explains the United Nations. In the worst cases, patients will die within a year of their diagnosis

Africa’s most severe noncommunicable diseases include sickle cell disease. This is an inherited blood disorder that shortens the life of red blood cells. Of the 1,000 or so children born with sickle cell disease every day in Africa, about half will die before the age of five.

Diabetes, rheumatic heart disease, cardiomyopathy – a disease of the heart muscle – severe high blood pressure and asthma are other chronic diseases on the rise in Africa.

Noncommunicable diseases like these are treated at health facilities in big cities in most parts of Africa. This puts treatment for chronic disease out of reach for most rural, semi-rural and low-income patients.

Urban health facilities also often don’t have the “capacity and resources” to effectively manage severe non-communicable diseases, the UN explains.

The PEN-Plus strategy was signed on 23 August at the 72nd session of the WHO’s Regional Committee for Africa in Lomé, Togo.

It urges African countries to introduce standardized programmes to treat chronic and severe noncommunicable diseases. This involves making sure that medicines, technologies and diagnostics are available at district hospitals – and accessible.

Just 36% of African countries said they had essential medicines for noncommunicable diseases in public hospitals, according to a 2019 WHO survey.

While health workers in Africa need to undergo training and skills development, to bolster procedures for preventing, caring for and treating chronic noncommunicable diseases, the strategy suggests.

The aim is to reduce deaths from chronic disease by helping district hospitals and other local health centres diagnose and manage it early.

This would also cut out-of-pocket health spending for patients in Africa, which can get to “catastrophic” levels, the UN says. This is partly because the patient’s disease is chronic and partly because they have to spend money on travelling to and staying in cities away from home.

About 97 million Africans – more than 8% of the population – incur catastrophic healthcare costs every year, according to a 2021 report on healthcare in Africa from the Africa Health Agenda International Conference.

This pushes about 15 million people into poverty annually. Sierra Leone, Egypt and Morocco are among the worst affected countries.

The WHO says similar initiatives to treat chronic diseases locally have shown promising results in Liberia, Malawi, and Rwanda. The number of patients accessing treatment for severe noncommunicable diseases has “significantly increased”, the organization says, with more positive health outcomes as a result.

Less than half of Africa’s population - 615 million people - have access to healthcare they need, according to news site, Health Policy Watch.

WHO Director General, Dr Tedros Adhanom Ghebreyesus, believes initiatives like PEN-Plus will be crucial in the fight to achieve adequate healthcare for all in the country.

“We are calling on all Member States to make an urgent paradigm shift, towards promoting health and well-being and preventing disease by addressing its root causes, and creating the conditions for health to thrive,” he said in his opening remarks at WHO’s Regional Committee for Africa.

“The updated Regional strategy for the management of environmental determinants of health that you will consider this week is an important step in that direction. Likewise, the PEN-Plus regional strategy to address NCDs is centred on addressing the risk factors for non-communicable diseases and avoiding the suffering and costs they bring.”