11 February 2018

East Africa: What's Likely to Kill You? Respiratory, Heart Diseases

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(file photo).

Health experts are sounding the alarm over non-communicable diseases, which now top the list of the region's killers.

In Uganda, heart disease takes up the lion's share of the health budget and claims the highest number of lives. In his 2018 New Year's address, President Yoweri Museveni noted that non-communicable diseases, which he called "diseases of prosperity," were killing more Ugandans than "the diseases of backwardness like malaria and cholera.

"We are now seeing heart diseases, some types of respiratory ailments and hyper-tension accounting for close to 43 per cent of the deaths," President Museveni said.

Malaria, HIV/Aids and lower respiratory tract diseases are the leading causes of death in the region, data from the Institute for Health Metrics and Evaluation shows.

The executive director of the World Health Organisation's health emergencies programme, Dr Peter Salama, said that new figures show the substantial social and economic cost influenza is having on the world.

"The numbers indicate how important influenza prevention should be for seasonal epidemics, as well as preparedness for pandemics," said Dr Salama.

Data from Jubilee Insurance, a regional medical insurer, shows that antibiotics such as Augmentin, Zinnat, Zithromax and Zyrtec topped the dispensed drugs from pharmacies. These drugs address most of the respiratory disease in the region including influenza and coughs, something doctors say could be avoidable.

The WHO says that more than 600,000 people die annually of respiratory problems, and is urging governments to focus more on these ailments.

In its situation report released last December, the organisation said that East Africa was among regions where these diseases have become a major burden.

The report shows that in Tanzania, HIV, respiratory infections, diarrhoeal diseases and tuberculosis were the leading cause of death in the country. HIV accounted for 17 per cent of the infections, followed by respiratory infections at 11 per cent, malaria at 7 per cent, diarrhoeal diseases at 6 per cent and tuberculosis at 5 per cent.

In Uganda, diarrhoeal diseases presented the highest burden on the health care budget -- costing millions of dollars in prevention measures and treatment -- followed by HIV and respiratory diseases.

Chronic lower respiratory infections are the leading cause of deaths in Rwanda, followed by tuberculosis, diarrhoeal diseases, HIV and ischemic heart disease.

Challenges

According to the non-communicable diseases (NCD) division at the Rwanda Biomedical Centre, challenges to prevention include by inadequate specialists and poor accessibility to health services. Another challenge is the lack of basic equipment, drugs and specialised infrastructure to treat NCDs.

According to WHO, nearly three-quarters of all deaths in 2016 were caused by non-communicable diseases, with heart disease being the single biggest killer.

The region has also seen a spike in influenza, which is taking up a huge chunk of health care funds, with high volumes of expensive anti-biotics being dispensed.

"Countries must work together to control influenza outbreaks before the arrival of the next pandemic. This includes building capacity to detect and respond to outbreaks, and strengthening systems to improve the health of the most vulnerable and those most at risk," WHO said in a statement.

The Rwandan government passed the NCD Policy in 2015 aimed at strengthening prevention, diagnosis and treatment, and is in the process of integrating NCD control in its health system.

Speaking on World Cancer Day on February 4, Minister for Health Diane Gashumba said that Rwandan women from the age of 40 and men from age of 45 can get access to affordable NCD screening at least once a year using their Mituelle de Sante Insurance scheme.

"The Ministry of Health also provides free cervical cancer vaccination for all girls from 12 years and above," she said.

Ms Gashumba added that Rwanda will soon offer free Hepatitis C screening and treatment to Rwandans, starting from Gisagara District in Southern Province.

Rwanda allocated Rwf193 billion ($230 million) in its 2017/18 financial year for health, 17 per cent of its total budget, up from 15 per cent in 2016/17.

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