Department of Social and Developmental Psychology, Faculty of Politics, Psychology, Sociology and International Studies, University of Cambridge, Cambridge, UK.
Global Health. 2010 Apr 19;6:5. doi: 10.1186/1744-8603-6-5.
Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. 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 diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. 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. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. 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 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.
非洲面临着传染病和慢性病的双重负担。虽然传染病仍然占该大陆至少 69%的死亡人数，但整个撒哈拉以南非洲地区的慢性疾病特定年龄死亡率实际上高于世界上几乎所有其他地区，无论是男性还是女性。在未来十年，该大陆预计将经历心血管疾病、癌症、呼吸道疾病和糖尿病死亡率的最大增长。非洲卫生系统薄弱，国家对医疗保健培训和服务提供的投资继续优先考虑传染病和寄生虫病。人们强烈认为，非洲在慢性病研究、实践和政策方面面临重大挑战。本社论审查了提交给全球化与健康特刊的八篇原始论文，主题为“非洲慢性病负担：本地和全球视角”。这些论文提供了关于坦桑尼亚糖尿病、尼日利亚镰状细胞病、加纳农村地区慢性精神疾病、肯尼亚儿童艾滋病护理以及加纳和喀麦隆慢性病干预的新的实证证据和综合评论。提供了关于非洲心血管风险、传染病和慢性病之间的共病以及欧洲撒哈拉以南非洲裔人群的心血管疾病、糖尿病和既定风险因素的区域和国际评论。我们在慢性病的医学、心理、社区和政策维度内讨论了这些论文的见解。迫切需要初级和二级干预措施，需要非洲卫生政策制定者和政府优先制定和实施慢性病政策。有两个差距需要引起关注。第一个差距涉及需要多学科研究模型来为干预措施的设计提供正确的信息。第二个差距涉及了解撒哈拉以南非洲政策制定的过程和政治经济学。慢性病对家庭、卫生系统和政府的经济影响以及国家政策制定与国际经济和政治压力之间的关系对慢性病的风险和国家应对这些疾病的能力有巨大影响。
