The impact of lifestyle diseases on the health care system in Sub-Saharan Africa

Abstract

Introduction

Sub Saharan Africa(SSA) is facing a rapidly growing number of people with chronic non-communicable diseases while at the same time experiencing continual high death rates from infectious diseases e.g. HIV/AIDS, TB and malaria. Although this region comprises just over 10% of the world’s population, it carries the highest burden of disease in the world. It is well known that some infections increase the risk of certain chronic diseases and vice versa. With an increasing dual burden of disease in SSA, the associations between diseases and our understanding of them will become of increased public health importance. The aim was to explore the relationships reported between HIV, its treatment and metabolic risk.

Methodology This article is based on review of detailed literature published in MEDLINE and EMBASE since 1997, potentially relevant reports, bulletins and guidelines from the UN, WHO and International Diabetes Federation (IDF).

Findings

Introduction of AntiRetroviral Therapy(ART) in SSA having high prevalence of HIV has been recognized as a public health priority through reduction of its price, raised donor funding and enhanced political commitment e.g. WHO ‘3 by 5’ initiative. This has been associated with an increased risk of developing metabolic syndrome. HIV has been linked with an increased risk of developing both diabetes and cardiovascular disease. Diabetes prevalence and incidence is increasing in SSA compared to the industrialized world due to increased use of ART.

Conclusion

The impact of these co-morbidities in SSA is likely to be large. Roll out of ART coverage within the region is an essential response to the HIV epidemic. However, it is likely to lead to a growing number of individuals suffering from adverse metabolic consequences. HIV disease requires life-long treatment, meticulous adherence to ART and intensive clinical and laboratory monitoring. Therefore, robust and sustainable healthcare systems are needed to provide adequately trained staff, laboratory facilities and a reliable supply of effective drugs with fewer side effects. Research is also needed to develop effective approaches to reducing the frequency and health impact of the co-morbidities described here.

Correspondence: Anzibert A. Rugakingira, e-mail: ranzibert@yahoo.com