The burden of non-communicable diseases

Non-communicable diseases are a diverse group of chronic diseases that are not communicable or transmitted from one person to another. They are defined as diseases of long duration, generally slow progression and they are the major cause of adult mortality and morbidity worldwide.

These include mental health, sickle cell, cancers, diabetes mellitus, chronic obstructive respiratory diseases, cardiovascular diseases such as hypertension, and stroke.

Non-communicable diseases (NCDs) are currently responsible for 35 per cent of all deaths in low- and middle-income countries and this alarming figure is predicted to rise in the near future. The World Health Organisation projects that the burden of disease due to NCDs will increase rapidly in the years ahead. From a projected total of 58 million deaths from all causes in 2005.

This epidemiological transition in global health from infectious diseases to NCDs is posing not only a threat to the health of those affected but also places an enormous burden on the health systems of nations, particularly those of the least-developed countries, as they must now address a double burden of acute and chronic diseases amidst scarcity.

Previous studies estimated that NCDs would account for 35 million deaths, which was double the number of deaths from all communicable diseases (including HIV/Aids, tuberculosis and malaria), maternal and perinatal conditions and nutritional deficiencies combined.

In addition, this epidemiological transition is adversely impacting on socio-economic development of Countries, as NCDs tend to be more prevalent in young working class people. As a more sophisticated workforce becomes a highly valued and harder-to-replace economic investment, the increasing prevalence of NCD risk factors in developing countries, particularly Sub-Saharan Africa (SSA), becomes a real threat to economic progress, adversely impacting on all the previous gains made in combating HIV, malaria, tuberculosis and other infectious diseases and the previous gains of Millennium Development Goals.  

In Uganda, while acute infectious communicable diseases still contribute the major (75 percent) disease burden, with malaria, acute respiratory infections and HIV/Aids among the top 10 causes of illness and death, the burden of NCDs is increasingly posing a threat of dual epidemics of communicable and non-communicable diseases.

The International Diabetes Federation put estimates of incidence of diabetes mellitus in Uganda at 50 000 affected individuals in the previous years and projected a 10-fold increase in the cases of diabetes by 2025 if no interventions are initiated. Estimates suggest that as many as 8 percent of people living in Kampala may have type 2 diabetes (T2D). 

Estimates of age-standardised mortality from NCDs suggest that countries in SSA, including Uganda, might have a more than three-fold higher mortality rate than several European countries if no measures to control. The United Nations (UN) and the World Health Organization (WHO) have called for a 25 percent reduction by 2025 in mortality from NCDs, adopting the slogan “25 by 25.”  There is a need to obtain local high-quality epidemiological data on the burden of NCDs and their risk factors, particularly in Sub Saharan Africa and Uganda in order to achieve Sustainable health.

This article was co-authored by  Dr Harriet Nakigozi Yiga,  a Public Health and Laboratory Specialist- Uganda(Health Policy and Global Health) and Mr Dickson Turamye who works with School of Research &     Postgraduate Studies, UCU.