Diabetes in sub-Saharan Africa: from clinical care to health policy

Rapid demographic, sociocultural, and economic transitions are driving increases in the risk and prevalence of diabetes and other non-communicable diseases (NCDs) in sub-Saharan Africa. The impacts of these transitions and their health and economic consequences are evident. Whereas, in 1990, the leading causes of death in sub-Saharan Africa were HIV/AIDS, lower respiratory infections, diarrhoeal diseases, malaria, and vaccine-preventable diseases in children, in more recent years, cardiovascular diseases and their risk factors are replacing infectious diseases as the leading causes of death in this region, and rates of increase of cardiovascular risk factors are predicted to be greater in sub-Saharan Africa than in other parts of the world. Thus, sub-Saharan Africa—which contains a high proportion of the world's least developed countries—will face the multifaceted challenge of dealing with a high burden of infectious diseases and diseases of poverty, while also addressing the increasing burden of cardiovascular disease and its risk factors. At present, many of the health systems in sub-Saharan Africa struggle to cope with infectious diseases. Meeting the goals of the UN high-level meeting on NCDs (to reduce premature mortality from NCDs by 25% by 2025) and Sustainable Development Goals (SDGs; to reduce premature mortality from NCDs by a third by 2030) requires a coordinated approach within countries, which starts with a firm consideration of disease burden, needs, and priorities. The crisis of diabetes in sub-Saharan AfricaIn The Lancet Diabetes & Endocrinology, Rifat Atun and colleagues1 report findings of a Commission on diabetes in sub-Saharan Africa, bringing together and critically analysing evidence to paint a sobering picture of the disease in the region. The prevalence of diabetes in sub-Saharan Africa has increased rapidly in the past 10 years or so,2 affecting people in all sectors of society but, in particular, and disproportionally compared with high-income settings, affecting younger people, with substantial economic effects. Full-Text PDF Diabetes in sub-Saharan Africa: let us not forget type 1In the past two decades, the global health landscape has undergone rapid transformation, from communicable diseases being the leading causes of disability and death to non-communicable diseases taking the lead. People around the world are living longer than ever before, and the population is getting older. However, the observed trends in the global health landscape have varied substantially across regions and countries, with sub-Saharan Africa being a striking example. Communicable, maternal, nutritional, and newborn diseases have continued to dominate in sub-Saharan Africa alongside the increasing prevalence of type 2 diabetes, hypertension, cardiovascular and respiratory diseases, and cancer. Full-Text PDF