BACKGROUND
Non-communicable diseases (NCDs) have become a major public health concern worldwide. It prematurely takes 16 million lives annually. A Decrease in communicable diseases, which disproportionately affect children has led to greater survival into adulthood and a relative aging of the population. Currently, the population pyramid of most African countries is cone shaped, with a large base of young people and the median age less than 20 years, compared with high-income countries where it is usually closer to a cylinder and the median age is greater than 40 years. Additional drivers of these epidemics are urbanization and changes in lifestyle associated with economic development. These include changes in diet, physical activity, smoking, adiposity and alcohol use. In high-income countries, 90% of all new diabetes mellitus cases are attributable to relatively modest differences in these lifestyle factors. Similarly, the interheart study that included nine African nations and 43 other countries found that five risk factors (smoking, hypertension, and diabetes mellitus) accounted for 90% of the risk for a first myocardial infarction in the African sites. High rates of death and disease, particularly in low- and middle-income countries, are a reflection of inadequate investment in cost-effective NCD interventions. In fact, WHO report states that “From 2011-2025, cumulative economic losses due to NCDs under a “business as usual” scenario in low- and middle-income countries is estimated at US$ 7 trillion. WHO estimates the cost of reducing the global NCD burden is US$ 11.2 billion a year: an annual investment of US$ 1-3 per capita. Hence, WHO recommends all countries move from commitment to action, by setting national targets and implementing the “best buy” interventions starting in 2015. NCDs are already, and will continue to be, a significant burden on the world’s poor.
According to the World Health Report (2001), NCDs accounted for 22% of the total deaths in sub-Saharan Africa in the year 2000. The increasing epidemic of NCDs has several root causes, deaths due to NCDs are overtaking those from infectious diseases. Almost three quarters of all NCD deaths (28 million), and 82% of the 16 million premature deaths, occur in low- and middle-income countries. In 2008, an estimated 347 million people in the world had diabetes and the prevalence is growing, particularly in low- and middle-income countries. The first WHO Global report on diabetes demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. In 2012, the disease was the direct cause of some 1.5 million deaths, with more than 80% of those occurring in low- and middle-income countries. WHO projects that diabetes will be the 7th leading cause of death by 2030. Forty-three percent of these 3.7 million deaths occur before the age of 70 years. The percentage of deaths attributable to high blood glucose or diabetes that occurs prior to age 70 is higher in low- and middle-income countries than in high-income countries and the factors driving this dramatic rise include overweight and obesity. Similarly, World health report in 2014 reveals that more than 1.9 billion adults, 18 years and older, were overweight. Of these over 600 million were obese. Overall, about 13% of the world’s adult population (11% of men and 15% of women) were obese in 2014. In 2014, 39% of adults aged 18 years and over (38% of men and 40% of women) were overweight. The worldwide prevalence of obesity more than doubled between 1980 and 2014.
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