“Road traffic injuries (RTIs) disproportionately affect the poor, whose limited access to emergency care may mean worse outcomes […] Action against noncommunicable diseases and RTIs in sub-Saharan Africa is needed now, and must take place alongside continued efforts to address communicable diseases and maternal and child health, and to reach the Millennium Development Goals. One set of actions cannot wait for the other.”
This report draws on a comprehensive review of the literature and on input from policy makers, researchers, and practitioners to address four questions:
- How is the growing burden of noncommunicable diseases (NCDs) and road traffic injuries (RTIs) changing the epidemiology of sub-Saharan Africa?
- What determines and drives this burden, and what are the commonalities with communicable diseases?
- What is the rationale for public intervention?
- How could resource-constrained governments approach NCD prevention and treatment and road safety in a comprehensive, effective, and efficient way?
The data show that action against NCDs and RTIs in sub-Saharan Africa is needed, together with continued efforts to address communicable diseases and maternal and child health as well as to reach the Millennium Development Goals (MDGs). The report suggests that NCDs/RTIs should not be tackled separately as a vertical program, nor should they displace communicable diseases as priorities. Instead, given resource constraints, and some shared determinants, characteristics, and interventions, there is a scope for an integrated approach focusing on functions (prevention, treatment, and care) rather than disease categories.
Examples are cited of potential opportunities to integrate and add NCD prevention and treatment into existing services and programs. Proven, cost-effective, prevention interventions are clearly needed, many of which (such as tobacco and alcohol taxes, road safety measures, and fuel-efficient ventilated cookstoves) require action beyond the health sector. These can deliver broader development benefits in addition to their benefits for health. Selective, evidence-based actions to reduce NCDs and RTIs would address the changing disease burden in Africa and achieve a more sustainable improvement in health outcomes, more efficient use of resources, and better equity across patients and populations.
Core messages include:
- Ensuring synergies between Millennium Development Goals and NCDs to maximize resource envelopes
- Putting primary focus on prevention and population-based actions
- Promoting “treatment as prevention” as effective care
- Adapting and strengthening health systems
- Revisiting governance for health