There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: 'Africa's chronic disease burden: Local and global perspectives'. The papers offer new empirical evidence and comprehensive reviews on, among others, diabetes in Tanzania, and HIV and AIDS care-giving among children in Kenya. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. The editorial discusses insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. It argues that there is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub-Saharan Africa. The editorial concludes that the economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them.
Equity in Health
Malnutrition can be dealt with, for less than $US 20 per child per year. This has always seemed like quite a lot of money, but the comparison with HIV/AIDS should inspire us to be more ambitious. Children have a right not to be brain damaged by malnutrition. But, in addition, not tackling malnutrition makes achieving the MDGs simply impossible: malnutrition is an indicator for the poverty MDG, but improving nutrition status is also an absolute requirement if the health and education MDGs are to be met.
With talks on a draft global plan of action to fight AIDS set to conclude on Friday, two of the chief negotiators said the text was near completion and should be ready for adoption by a General Assembly session next month. Ambassador Penny Wensley of Australia and Ambassador Ibra Deguène Ka of Senegal said agreement remained elusive on certain key issues, including financing the plan of action, but both expressed hope that progress would be achieved before the expected conclusion of the talks on Saturday.
With four years to go, Tanzania still lags behind other East African countries towards the realisation of the Millennium Development Goals (MDGs), according to this article, only surpassing war-torn Burundi. The minister for Health and Social Welfare, Dr Haji Mponda, admitted that he was aware of the problem and expressed the government’s willingness to ensure that some of the targets are fully realised by 2015. He highlighted the achievements made by the government, specifically in 2007, when the rate of HIV prevalence dropped from 7% to 5% and that of 2004 to 2005, when the number of maternal deaths went down from 98 to 51 out of every 1,000 deaths. The report comes exactly 10 years since the UN's adoption of the goals and twenty years since the recording of most baseline data surface. Despite an extraordinary public campaign to mobilize support for the MDGs, there has been surprisingly little effort to track, record, and disseminate information regarding progress toward the goals at the country level, the authors of the report argued. Reacting to Tanzania’s poor performance, the head of Twaweza, an information advocacy organization, expressed concern that Tanzania still lagged behind its peer East African neighbours. He challenged the government to review each of the eight MDGs by involving stakeholders in health, poverty reduction, environment and other sectors that are related to the MDGs. He also called for independent evaluation bodies of these strategies, with stakeholders involved and not just the government officials and added reports ought to be made available in the public domain, so that citizens know where the country is headed.
The East African community (EAC) partner states have been urged to re-focus monitoring and achieving of the Millennium Development Goals (MDGS) as the set deadline 2015 draws near. According to Tanzanian vice-president Dr. Mohammed Gharib Bilal, there is need for constant monitoring of MDGs by EAC partner states especially THE ‘shelter for all’ goal as an important agenda in social - economic development. Gharib addressed a two-day East African Legislative Assembly (EALA) conference on MDGs in Arusha Tanzania. He told the conference that Tanzania had taken measures aimed at addressing the challenges of unplanned settlement and slums in the urban population and was undertaking a study with the United Nations-Habitat. Legislators must re-focus their oversight activities in the development agenda, he argued: they should not only be critical of their governments but must stress what has been achieved, where the failures are and the reasons whether they resulted from inadequate resources or misplaced priorities.
Tanzania is on track to meet Millennium Development Goal (MDG) 4 for child survival, but is making insufficient progress for newborn survival and maternal health (MDG 5) and family planning. To understand this mixed progress and to identify priorities for the post-2015 era, Tanzania was selected as a Countdown to 2015 case study. The authors analysed progress made in Tanzania between 1990 and 2014 in maternal, newborn, and child mortality, and unmet need for family planning, in which they used a health systems evaluation framework to assess coverage and equity of interventions along the continuum of care, health systems, policies and investments, while also considering contextual change (eg, economic and educational). In the past two decades, Tanzania's population has doubled in size, necessitating a doubling of health and social services to maintain coverage. Trends along the continuum of care varied, with preventive child health services reaching high coverage (≥85%) and equity (socioeconomic status difference 13–14%), but lower coverage and wider inequities for child curative services (71% coverage, socioeconomic status difference 36%), facility delivery (52% coverage, socioeconomic status difference 56%), and family planning (46% coverage, socioeconomic status difference 22%). Mixed progress in reproductive, maternal, newborn, and child health in Tanzania were found to indicate a complex interplay of political prioritisation, health financing, and consistent implementation.
Following recent confusion over the potential side effects of a new malaria drug - Sulphadoxine-Pyrimethamine (SP)- the Tanzanian health ministry has reiterated its faith in the drug as the most effective method of treating the deadly disease.
United Nations HIV/AIDS experts believe HIV/AIDS prevalence in Zanzibar is on a steady increase, but are worried that currently available data could be underestimating the actual magnitude of the pandemic in the semi-autonomous islands.
More than 80 members of parliament have formed a movement, The Tanzania Parliamentarians Aids Coalition (TAPAC), intended to battle the HIV/AIDS scourge. The movement, formed in the last parliament session, will be launched by President Benjamin Mkapa in Dodoma in November.
President Benjamin Mkapa of Tanzania, where two million people are infected with the HIV virus, has said he is confident the country should be able to reverse the spread of the disease in the next five years, given the current level of nationwide mobilisation against the epidemic. "We are now at a stage of all-round mobilisation that will result in the total reversal of the trend in the next five years," the UNDP quoted Mkapa as saying at a press conference in New York to coincide with the UN General Assembly's special session on HIV/AIDS.