2 January 2018

Uganda: Top Causes of Death (Museveni Is Wrong)

Photo: Health Access Connect
A health clinic on the shores of Lake Victoria.

In his New Year's address for 2018 on Sunday, President Museveni claimed, while extolling the health achievements of his government, that non-communicable diseases are now the top killers in Uganda.

"Even on the side of Health, there have been dramatic changes so much that, apparently, it is now the non-communicable diseases that are killing more Ugandans than the communicable ones," he declared.

"Ugandans are now suffering more and more from the diseases of prosperity - heart diseases, diabetes, hyper-tension, cancers, obesity - than from the diseases of backwardness - malaria, diarrhea, worms, TB, eye diseases, malnutrition, jiggers, plague caused by [fleas], cholera... "

While it is true that the number of Ugandans killed by non-communicable diseases has been rising, while that of non-communicable diseases has been declining, non-communicable diseases remain, by far, the top killers.

According to the latest data from various international agencies (which is based on data reported by national authorities), communicable diseases account for 63 percent of all deaths, while non-communicable diseases account for 29 percent. Injuries, including road accidents which were also mentioned by the President in his speech, account for 8 percent.

Neonatal (relating to infants), maternal (relating to new mothers) and nutritional disorders are grouped with communicable diseases by health experts. However, even when neonatal, maternal and nutritional disorders are excluded from the category, communicable diseases remain the top killer, accounting for 48 percent of all deaths, compared to the 29 percent caused by "diseases of prosperity".

In 2016, nearly 300,000 deaths were recorded. Almost 190,000 died of communicable diseases, non-communicable diseases claimed nearly 90,000 while injuries killed just over 20,000. The top killers were HIV/AIDS, neonatal disorders (communicable) and heart diseases (non-communicable). Of the top 10 killer diseases, only four are categorised as non-communicable diseases: cardiovascular (heart) diseases, neoplasms (abnormal tissue growth including various cancers), cerebrovascular (brain-related) diseases and injuries.

Cause Number Percent Type

HIV/AIDS 33207 11 Communicable

Neonatal disorders 32764 11 Communicable

Cardiovascular diseases 30706 10 Non-communicable

Tuberculosis 24023 8 Communicable

Malaria 23461 8 Communicable

Lower respiratory infections 23050 8 Communicable

Neoplasms 23021 8 Non-communicable

Injuries 23019 8 Injuries

Diarrheal diseases 16406 5 Communicable

Cerebrovascular disease 10409 3 Non-communicable

Others 59600 20 Unclassified

All causes 299666 100 All

Between 1990 and 2016, the number of people killed by non-communicable diseases increased by 64 percent. Those dying of injuries also increased by 64 percent. The number killed by non-communicable diseases declined by 13 percent.The President is correct, however, when he notes that more and more Ugandans are dying from non-communicable diseases while fewer are dying from communicable diseases.

It is not clear where President Museveni got his figures from. Publicly available data, including that from the World Health Organisation, contradicts the President's assertions.

The President further claimed "The non-communicable ones are the ones where you cannot infect the other person. These are the cancers, hyper-tension, accidents, heart diseases etc. The 43% of the deaths are now from non-infectious diseases. From 1986 to 2000 these only accounted for about 8%."

This claim does not seem to be supported by publicly available data. Data from international health agencies indicates that only about 30% die from non-communicable diseases, up from 20 percent in 1990.

Technically, communicable and infectious diseases are not exactly the same thing. However, the President used the two terms interchangeably and the data cited here does not make a distinction between the two. Strictly speaking, infectious diseases (which may or may not be communicable) accounted for 30 percent of all deaths in Uganda in 2015, according to the World Health Organisation.

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