Curbing the growing burden of NCDs

Just 30 minutes of walking every day can increase cardiovascular fitness and boost muscle power and endurance.

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  • Furthermore, the government should increase budget allocation for NCDs to facilitate recruitment of the required workforce, acquisition of the necessary equipment and setting up the necessary infrastructure.

Worldwide, about 41 million people die from non-communicable diseases (NCDs) annually according to the World Health Organisation (WHO). Cardiovascular diseases (heart diseases), cancer, respiratory diseases and diabetes are the leading NCDs for the deaths.

The 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge for sustainable development since poverty is closely linked with NCDs—they impede poverty reduction initiatives. Specifically, Sustainable Development Goal (SDG) target 3.4 aims to reduce premature mortality due to NCDs by one-third by 2030 through prevention and treatment.

In Uganda, World Bank estimates show that 4 in 10 people died from NCDs alone in 2019. This shows an upward trajectory as NCDs-deaths have risen from three in 10 noted in 2015. While data on prevalence of NCDs in the Ugandan population is still scanty, the burden of NCDs is expected to be on the rise.

At Uganda Cancer Institute, for instance, the number of cancer patients seeking care and treatment every day is reportedly over 1,000, far beyond the facility’s daily capacity of about 200 patients. As a result, the cancer care health workforce is scanty on the ground compared to the number of patients who need the services.

Previously perceived to be “diseases of the rich”, evidence has proven over time that everyone, whether rich or poor, child, adult or elderly are vulnerable to NCDs. For example, it is not uncommon to find children and youth at Uganda Cancer Institute battling different cancers.

Unhealthy diet, physical inactivity, excess alcohol consumption, and tobacco use are the key behavioral risk factors for NCDs. These together contribute to about 67 percent of all NCDs-deaths worldwide. Other risk factors include raised blood pressure, obesity, high blood glucose levels, and high levels of fat in the blood.

Consumption of sugar-sweetened beverages in particular has been identified as a major contributor to the rise of NCDs worldwide. As a result, the WHO recommends a tax rate of 20 percent on sugary drinks as an effective intervention to reduce sugar consumption and the associated growing burden of NCDs.

In 2018, South Africa became the first sub-Saharan African country to implement a sugary beverage tax of approximately 10 percent. Under this tax, sugar manufacturers are charged a fee of 2.1 cents per gram of sugar per 100 ml. This has pushed producers to cut sugar in their soft drinks, eventually reducing sugar intake in the country by nearly a third.

While Uganda levies a 12 percent excise tax on soft drinks, the tax does not target sugar content. The government should therefore introduce a sugar-sweetened beverages tax, based on grams of sugar to reduce sugar intake.

Most notably, Uganda has demonstrated commitment to fight NCDs, but the efforts are outpaced by the rapid rise of these diseases. For instance, the National Day of Physical Activity launched by the Ministry of Health (MOH) in 2018 as an annual event has not gained national-wide popularity. More so, the event seems not sufficient to galvanize Ugandans to adopt a healthy lifestyle as envisaged.

In China, physical exercises twice a day at state-owned companies are mandatory whereas in Japan, exercise breaks are a feature of a number of large companies. The Tech giant Google has also led the way in office gyms and encourages staff to do exercises.

Besides the National Day of Physical Activity, MOH should intensify health education and awareness about NCDs, with focus on prevention. This should entail regular and nationwide sensitization of Ugandans to adopt a healthy lifestyle, including physical exercises and eating healthy diets.

Relatedly, employers should embrace and facilitate health talks about NCDs and their prevention at work places, in addition to adopting exercise breaks. Evidence from a study at Bristol University shows that employees who exercise at work become re-energized, improve their concentration and problem solving, thus becoming more productive.

Furthermore, the government should increase budget allocation for NCDs to facilitate recruitment of the required workforce, acquisition of the necessary equipment and setting up the necessary infrastructure.

Smartson Ainomugisha 

Research Associate at EPRC

[email protected]