Priority should be given to developing and implementing preventive interventions based on an action plan for the NCD strategy, bearing in mind interventions that have been shown to be effective
Despite a wide range of policies and strategies, non-communicable diseases (NCDs) remain the leading causes of death in Tanzania.
Also known as chronic diseases, NCDs are medical conditions that are not infectious and cannot be transmitted among people. They generally progress slowly and most patients suffering from them can expect to be on drugs for a long time. They include heart attacks and stroke, cancer, chronic respiratory diseases such as obstructed pulmonary disease and asthma, and diabetes.
NCDs are driven by forces that include ageing, rapid unplanned urbanisation and the globalisation of unhealthy lifestyles.
According to the World Health Organisation, the major underlying risk factors for these diseases are tobacco use, unhealthy diets (high consumption of sugar, salt, saturate fats and trans fatty acids), physical inactivity and harmful use of alcohol,hence the reference to them as lifestyle diseases.
NCDs account for 124,930 (31 per cent) of the 403,000 deaths that occur in the country annually. According to the latest WHO non-communicable disease country profiles, global mortality due to NCDs continues to rise. The report says 38 million people die each year of NCDs. People aged between 30 and 70 comprise nearly half of those who die of these diseases in developing countries. But deaths caused by NCDs can be prevented if governments implement simple measures that reduce risk factors and enable their health systems to respond appropriately and on time. In 2009, the ministry of Health and Social Welfare launched the National Strategy for Non-Communicable Diseases, which was based on the WHO strategy framework and Global Strategy on Diet and Physical Activities. It is now drafting an implementation plan. Still, it appears that little is being done to curb the disease burden.
When survey questions were sent to health authorities in Tanzania and the other East African countries, they could not provide the necessary information on their commitment to curb the diseases. This means that no country in the bloc has an operational NCD department in the ministry of health or its equivalent.
Tanzania also did not respond to questions as to whether there is a multi-sectorial national policy, strategy or action plan that integrates NCDs and shared risk factors. It also did not respond to queries on whether there is strategy/plan to reduce harmful use of alcohol.
The Citizen on Sunday spoke with the programme co-ordinator of NCDs in the ministry of Health and Social Welfare, Dr William Kafura, who said a number of initiatives are already in place. “Have those questions been sent to the ministry?” he asked.
Dr Kafura added, though, that some measures have been taken to reduce the disease burden and that the ministry of Health and Social Welfare has a special unit for non-communicable diseases. “We have several interventions,” he went on. “Maybe there was miscommunication.” Tanzania relies on the World Health Organisation for its data and does not have a population-based cancer registry. The country is in the process of developing “evidence-based national guidelines for the management of the major NCDs through the primary health care approach”.
Tanzania has the highest number of NCD deaths in East Africa. A total of 124,930 people die of NCDs here compared to 99,310 in Kenya, 95,310 in Uganda, 31,640 in Burundi and 28,080 in Rwanda. In the study “Non Communicable Diseases: A Call for Urgent Action”, Mary Mayige and others say that although Tanzania has made efforts to respond to the growing burden of NCDs, more must be done at country level to boost the capacity for prevention and control of such diseases.
Sound and explicit directions are essential in the move to streamline policies on tobacco and alcohol, nutrition and diet, food labelling and marketing and school health--all of which are either inadequate or completely lacking. “Priority should be given to developing and implementing preventive interventions based on an action plan for the NCD strategy, bearing in mind interventions that have been shown to be effective,” says the study.
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