Non-communicable diseases in the WHO African region: analysis of risk factors, mortality, and responses based on WHO...

Historically overshadowed by communicable diseases, the burden of non-communicable diseases (NCDs) has surged over the past two decades, posing a significant threat to public health, and necessitating urgent attention. This study examines the mortality burden from four major groups/categories of NCDs including cancers, cardiovascular diseases (CVD), chronic respiratory diseases (CRD) and diabetes, prevalence of four NCD associated risk factors including tobacco use, alcohol consumption, physical inactivity and overweight, availability of NCD essential medicines and progress indicators of the NCD response in the WHO African region. The data used in this study were obtained from the WHO NCD data portal, Global Health Observatory, and Global Health Estimates, covering the most recent available data for each indicator, ranging from 2000 to 2019 to assess how trends in NCD mortality burden have evolved, as well as the current status of the four main risk factors, availability of essential medicines, and key NCD response indicators. The analysis focused on descriptive statistics for globally used, disease-specific key indicators to examine trends and variations across countries: (i) age-standardized mortality rates (ASMR) for major NCDs (cancers, CRD, CVD and diabetes), (ii) prevalence of NCD risk factors (tobacco use, alcohol consumption, physical inactivity, and overweight), (iii) availability of essential medicines for NCDs in public health facilities, and (iv) national NCD response indicators, such as the presence of NCD targets, mortality data, risk factor reduction measures, and surveillance. Mortality was reported as ASMR or percentages; risk factors as prevalence, except alcohol (litres per capita). Changes in mortality were calculated as absolute and relative differences, with tables and figures generated in Microsoft Excel. Between 2000-2019, NCD-related deaths and the percentage of deaths due to NCDs increased from 24.2 to 37.1% resulting in 12.9 and 53.3% absolute and relative increases. The ASMR decreased by 130.6 per 100,000 population resulting in an 18.2% relative decrease, during the same period; however, it remains consistently higher than the global average. In 2019, 64% of NCD deaths were among people 70 years or younger and the percentage of premature deaths from NCDs ranged from 36.5 to 72.1%. Despite the burden of NCDs, the availability of essential medicines and health services was sub-optimal in public health facilities. The prevalence of key risk factors such as tobacco use, physical inactivity, overweight, and alcohol consumption per capita varied by sex and across the region, with the prevalence of tobacco use and consumption of alcohol higher among men, while the prevalence of insufficient physical activity and overweight higher among women. Public health responses to NCDs remained sub-optimal due to limited national NCD targets, inadequate surveillance, risk factor reduction measures, and access to essential medicines. Though the NCD ASMR has decreased, there has been an increase in NCD-related deaths and the percentage of deaths due to NCDs over the last two decades in the WHO African Region. The mortality burden of NCDs and the prevalence of risk factors remains relatively high, while mounting a public health response for preventing and controlling these NCDs remains challenging. Accelerated action is essential to meet global and regional NCD reduction targets. Strengthening national NCD targets, improving surveillance, ensuring access to essential medicines, and scaling up risk factor reduction strategies are critical to reversing current trends and achieving the 2030 SDG NCD targets.