Rise In Non-Communicable Diseases In Africa Needs To Be Addressed, Speakers Say

The International Organisation of la Francophonie in collaboration with French pharmaceutical umbrella organisation “les Entreprises du médicaments,” organised a roundtable on non-communicable diseases on the eve of the annual World Health Assembly.

Several health ministers as well as various stakeholders were invited to discuss “the fight against non-communicable diseases: a shared responsibility” on 18 May.

Non-communicable diseases (NCDs) are expected to show a sharp rise in the coming decade in Africa, already hit by a high prevalence of NCDs, said several speakers, with obvious serious consequences on public health and development.

Louis Loutan, president of the Geneva Health Forum, said an ageing population worldwide by 2050 will cause an increase in NCDs, such as diabetes, hypertension and cancer. Out of the predicted nine billion humans in 2050, two will be over 60, he said. Most of the global population will live in cities with no time to exercise or cook, and will rely on high-calorie, spicy food, he predicted, paving the way for NCDs.

In developed countries, NCDs are the main cause of death, he said, while developing countries are now bearing the double burden of NCDs and communicable diseases. A series of actions need to be taken, he said, among which are better access to medicines, community involvement, training of health professionals, engaged health policy, prevention measures, diagnostic tools, and better infrastructures.

Pharmaceutical Companies: Count Us In

According to Robert Sebbag, vice president for access to medicines at sanofi-aventis, there is no such thing as an NCD or a communicable disease, there are just diseases. “I feel uneasy when public health is cut into slices,” he said. Communicable diseases are still an issue in developing countries, he said, and some patients can combine both, like diabetes and tuberculosis.

Partnerships between governments, civil society, and the private sector are extremely important, he said. The pharmaceutical industry, sometimes seen as a “black sheep,” is a mandatory partner, he said, adding that medicines are needed, although there is an accessibility problem. If the gap is to be closed between the North and the South, all partners are needed, including the pharmaceutical industry, he said.

Sebbag mentioned tiered pricing as a possible solution being explored in several pilot projects. Tiered pricing would provide different prices to different countries. He also advised to take into account mental health and epilepsy, which he said were seldom mentioned. He said similarities could be drawn with HIV/AIDS because both led to social exclusion.

Pharmaceutical industries stand besides all other partners to tackle those challenges, he said. “Let’s try to go from a marriage of convenience to a love match,” he said.

National Experiences

Several health ministers presented their national experience. Roger Kolo, prime minister and minister of health of Madagascar, called for international cooperation, and said three major risk factors are an unhealthy diet, smoking and alcoholism.

Morocco Health Minister El Houssaine Louardi said a large number of premature deaths in Morocco were attributable to NCDs, including hypertension, cardiovascular diseases, and diabetes. He described Morocco’s national cancer prevention plan, and the national pharmaceutical policy, with a recent increase of the budget for medicines in public hospitals.

Raymonde Goudou Coffié, Côte d’Ivoire minister of health who is part of the Fight Against HIV, also underlined the high prevalence of NCDs in her country, and the worry about a potential sharp rise in cases in coming years. She noted that the rate of adolescents smoking cigarettes was increasing.

For Cécile Macé, technical advisor, WHO Essential Medicines and Health Products, an increased access to medicines is essential for NCDs.

The WHO global action plan for the prevention and control of NCDs 2013-2020, she said, includes nine voluntary global targets to be reached before 2025. One of them is an “80 percent availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities.”

The treatment costs often constitute a substantial financial burden that can push families under the poverty threshold, she said. However, most of those medicines are available at affordable costs on the global market, she said.

For medicines still under patents, she advised that countries make use of the World Trade Organization Agreement on Trade-Related Intellectual Property Rights (TRIPS) flexibilities and encouraged countries to use existing tiered pricing schemes.

She also said supply systems should be rigorous, and regulatory authorities strengthen to that only quality products reach the market, and substandard and counterfeit medicines are circumscribed.

Hamadoun Touré, secretary general of the International Telecommunication Union, presented “Health at your Fingertips,” a joint initiative between ITU and the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), and “Be He@lthy, Be Mobile,” a partnership with WHO.

The Health at your Fingertips initiative is meant to help users stop smoking for example, and people with diabetes to be diagnosed. In Zambia, the programme encourages women to be screened for cervical cancer.