Preventing non-communicable diseases in sub-Saharan Africa:

Non-communicable diseases (NCDs) are the leading causes of death worldwide, accounting for almost 60% of all deaths and 43% of the global burden of disease (1). Moreover 80% of the NCD deaths occur in low and middle income countries (1). As African countries make the transition from a sole focus on infectious diseases to a dual focus on both infectious and NCDs there are key lessons to be learned related to the prevention and control of NCDs. In this supplement issue of Global Health Promotion, the 12 papers that follow provide concrete examples of how public health practitioners are effectively implementing strategies to prevent and control NCDs. There are a number of key themes that cut across these articles and commentaries: the important role of data and surveillance in describing the burden, creating the political will, and mobilizing leadership in the area of NCDs; the need to work across multiple governmental agencies including the Ministries of Health, Commerce, Education, Housing and Labor; the vitally important role that policies play, particularly in the areas of tobacco, nutrition and physical activity, in creating healthy environments; and finally the importance of engaging community members and non-governmental organizations in the planning, implementation and evaluation of NCD prevention and control efforts. Strengthening the capacity for health promotion in sub-Saharan Africa continues to be a challenge. Van den Broucke and colleagues (2) describe their work in two provincial areas of South Africa. They outline a process by which there was active participation of the community in the planning, implementation and evaluation of health promotion activities. By linking all relevant agencies including local authorities, community groups, non-governmental organizations, donor agencies and the private sector they were able to create a broad-based network for health promotion and NCD prevention. They note that creating these broad-based coalitions helps to increase community capacity and sustain health promotion efforts. The effective screening, treatment and control of hypertension and diabetes are extremely important components of NCD control efforts. Debussche et al. (3) describe their efforts in Burundi to mobilize a network of community health practitioners related to the screening and treatment of diabetes and cardiovascular disease. Likewise Mbeh and colleagues (4) in Cameroon depict the role that traditional healers can play in the screening and treatment of diabetes. The collaboration between traditional medicine and biomedicine is possible when it is understood that both traditional healers and biomedical personnel are on the same side of health issues, and are working against a common enemy – disease/illness – and for one goal – the health of the patient. They conclude that with careful selection and close educational supervision, traditional healers can do a good job at identifying potential diabetes patients, referring them to health facilities, and educating their peers, patients and the population about diabetes. Villalon and colleagues (5) conducted a nutrition education program among 47 pregnant women in Benin. Noting improvements in healthy weight gain and Apgar scores in the intervention group. Lins and colleagues (6) in their commentary describe the growing burden ofNCDs in sub-Saharan Africa. They discuss the links between heart disease, cancer, chronic obstructive pulmonary disease and type 2 diabetes with the risk factors: high blood pressure, high blood cholesterol, overweight/obesity,