Non-communicable diseases (NCDs) have become a global public health problem, threatening Ethiopia and the entire Sub-Saharan Africa. Studies show that non-communicable diseases cause 42% of deaths in Ethiopia and 27% of those are premature deaths. If NCSDs continue like this, Ethiopia will be the first among the most populous nations in Africa to experience the dramatic burden of premature deaths and disability from NCDs by 2040.
About 38 million people die every year due to non-communicable disease in the world. Out of this 70-80% deaths occur in low and middle-income countries. Over the last decade the NCDs burden has increased resulting in a barrier to development goals including poverty reduction, human security, economic stability and health equity. The increase in NCDs can be linked to increasing longevity and societal & cultural changes such as increasing tobacco and illicit drug use. Ethiopia is currently facing a rising burden from non-communicable diseases.
Dr. Mesafint Abebe is a General Medical practitioner. He argues that early screening and early diagnosis of these NCDs is very important when it comes to stopping disease or limiting their progress. Other steps include exercise and changes in lifestyle. Capital’s reporter’s Tesfaye Getnet talked with Dr. Mesafint Abebe to learn more about the status of NCDs in Ethiopia and how to make an impact in the fight against them. Excerpts;
Capital: Tell us about your work with NCDs.
Dr. Mesafint Abebe: I have been working in clinical medicine both abroad and in the country for over twenty years. During this long time, by working together with well experienced physicians and as a result of my close connections and close attachments with highly qualified medical professionals from standardized international hospitals, I have gained and learned a lot in the field. The unusual increasing number of patients with different types of non-communicable diseases in our day to day practice was an unanswered and unexplained disease shift. As a result, I studied Public Health and joined the Roehampton University of London and did my Masters Degree online. Now I’m contributing to reducing the growing burden of the major global non-communicable diseases (NCDs) in Ethiopia
Capital: What are the biggest factors of NCD?
Dr. Mesafint Abebe: Non-communicable diseases (NCDs), mainly diseases like cancer, cardiovascular diseases, diabetes mellitus and chronic obstructive pulmonary disease (COPD), are becoming emerging public health issues of Ethiopia. The nation, currently is facing and suffering the double burden of both non-communicable diseases on the top of the already existing higher burden from communicable diseases. Considering the nature of the NCDs and the people’s medical visit seeking behavior (The fact that people in Ethiopia tend to not go to the doctor unless they are quite ill and don’t go in for checkups), the burden of these diseases is expected to be very huge. Most of these NCDs don’t show any symptom or keep to be silent until it is too late. The majority of our people will visit health facilities mainly when they feel sick and become symptomatic, and the trend of doing routine general annual check-ups are considered a luxury. As a result of poor public awareness about the seriousness of these diseases and poor early screening and early diagnosis of these diseases and other factors, the death rate from these NCDs in Ethiopia is increasing and it is expected to increase further at an alarming rate. These are the factors that we Ethiopians should focus and work on.
Capital: Health experts say the biggest challenge for Ethiopia will be the imminent explosion of non-communicable diseases (NCDs), what are your thoughts?
Dr. Mesafint Abebe: According to the World Health Organization’s (WHO) report in 2011, the estimated deaths from these diseases in Ethiopia were about (34%). NCDs were considered the major problems of the developed countries and the developing countries like ours didn’t give this the attention it deserves, until very recently. It is well known that NCD’s are the leading causes of death globally.
From other report, in 2012 from a total of 56 million deaths worldwide, NCDs were responsible for the majority which is 38 million or (68%). What is so interesting here is that the majority of NCDs caused deaths (three quarters of all, which is equivalent to 28 million) were from low and middle income countries. This is showing us that how much the burden of these diseases is in countries like Ethiopia is. The developed countries have worked hard to limit the impact and progress of these NCDs whereas developing countries like Ethiopia are still in the early phase of intervention activities. Different factors are believed to contribute to the emergence of these NCDs in Ethiopia. During the last decade, there is well proven socio-economic development in Ethiopia. Urbanization and globalization are behind this socio-economic development and as a result of these changes epidemiological transition is expected and that is already happening. The people’s life style and dietary changes and preference augmented by lack of physical activity and these and related lifestyle changes are believed to facilitate the progress and emergence of the NCDs.
Hypertension, tobacco-use, excessive alcohol consumption, higher consumption of processed food and sweets, being obese/overweight, khat-chewing and lack of physical activity are some of the associated factors for the development and fast progress
Capital: Is the Ethiopian healthcare system well prepared to address NCDs?
Dr. Mesafint Abebe: Recently the health system in Ethiopia has started to implement different activities targeting non-communicable disease. But still it is at its very infancy level and lots of hard work is expected at the national level. The information on this is so inadequate, but the results from the few research studies done related to the NCDs in relation to the readiness of the health facilities towards addressing these diseases are showing us that the availability of inadequate medical diagnosis and/or management services diseases like diabetes, cardiovascular diseases, COPD and cancers. There is a lot of work for us to do.
Capital: The WHO says that by investing just USD 1-3 per person per year, countries can dramatically reduce illness and death from NCDs. However, some doctors in Ethiopia say that, the investment for Ethiopia should be much higher. What is your comment regarding this?
Dr. Mesafint Abebe: WHO has given high attention for these NCDs and has identified a package of 16 “best buy” interventions, which is believed to be cost effective and affordable by all countries. But governments should be committed to implementing these WHO “best buys”. The government of Ethiopia is expected to implement it. The WHO focuses on proven interventions for NCDs and they say that for every USD invested; there would be a return of 7 USD by 2030. The situation in Ethiopia is a little bit complicated, and the available health facilities and the trained health professionals don’t meet the demand, and most of the available health facilities need upgrading. Despite all these factors, I am optimistic and I agree with the WHO’s saying that 1-3USD per person per year can definitely bring dramatic changes in our country by reducing illnesses and premature deaths from the NCDs. The bigger emphasis should be given to different efforts towards prevention. By targeting and modifying the major risk factors of NCDs, different interventions can be designed and be implemented.
Capital: A recent study done by the Ministry of Health says 27 percent of youth and the adults suffer from mental health problems. What are the factors and what is the solution?
Dr. Mesafint Abebe: Mental Health is another emerging public health issue in Ethiopia. There is no adequate research about the risk factors of such a high prevalence rate of mental health problems in Ethiopia. Low educational status, smaller family size, family history of mental health illnesses, smoking, co-morbidities, history of stressful life events, khat chewing and drug abuses are some of the risk factors behind mental health illnesses and associated with the high prevalence.
Capital: Weeks ago you and your friend opened a clinical laboratory in Addis, what motivated you?
Dr. Mesafint Abebe: Yes, me and my best friend since our child hood, Tesfaye Duki has opened one clinical laboratory. It is called “Life Addis Clinical Laboratory”. Our people need more of such type of clinical laboratories and we believe that people need facilities they can access easily. In Ethiopia, it is known that people would go to clinics or hospitals when they feel sick and become symptomatic. The people don’t give any attention for general checkups. Because of this behavior, patients tend to get to a serious stage when they first get diagnosed. But the current situation in Ethiopia compels for routine medical checkups either self-initiated by the patient or by doctor’s recommendation. Such type of clinical laboratories would be easily accessible for all peoples in need of having routine checkups. Besides doing the laboratory tests our laboratory would give them results based medical advice and give them complementary wellness test results which help them understand their risk factors. They would also get health tips accordingly. We believe that such things should be encouraged in health facilities.
Capital: The status of health check-up is very poor in Ethiopia. Often people go to hospitals when they feel pain. What is the overall consequence of neglecting check -ups?
Dr. Mesafint Abebe: Early screening and early diagnosis of these NCDs is so important for prevention of the diseases and limiting the progress of these diseases. This can be done mainly by creating awareness of the public and increasing their knowledge about these diseases. Media can play bigger role on this. High schools and universities can do the same. To work together towards the control and prevention of these NCDs. Health problem is one of the other emerging public health issues in Ethiopia. There is no adequate research result about the risk factors of such high prevalence rate of mental health problems in Ethiopia. Low educational status, smaller family size, family history of mental health illnesses, smoking, co-morbidities, history of stressful life events, khat chewing and drug abuse are some of the risk factors behind mental health illnesses and associated with the high prevalence rate.
Capital: What are the biggest challenges in NCD intervention?
Dr. Mesafint Abebe: The challenges are multi-faceted, and it requires the involvement and co-operation of different sectors like finance, trade, agriculture and education and environment sectors with in our country and it also requires the involvement of international NGOs like WHO to co-operate and work together for better effective intervention. People are expected to develop their general knowledge about the NCDs and should be well aware about the impact of these diseases both at personal and country level.
Early screening and early diagnosis of these NCDs is so important for prevention of the diseases and limiting the progress of these diseases. This can be done mainly by creating awareness of the public and increasing their knowledge about these diseases. Media can play bigger role in this. High schools and universities can do the same. To work together towards the control and prevention of these NCDs.