Take President Museveni seriously on NCDs

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40% of the Population, is in hospitals, dying of NCDs – Museveni

 

President Yoweri Museveni,75, is a man who harbors zero doubts as to his vitality and actually never garbles about it. Last Year, at the commemoration of the National Day of Physical Activity, he let on to his listeners that at 74 years of age, he was free of diabetes and high blood pressure, thanks to his fitness.

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” I have been able to knock off 20kgs from 100, because of my fitness” The President added, boastfully.

President Museveni( with stick) leads thousands of “ Trekkers” on a 195 Kilometer Journey from Galamba (North of Kampala) through Birembo( South of Kampala)/ ©️France 24.

 

Recently, he led, on foot, a six-day long and arduos journey, colloquially called, “ The M7 Trek” from Galamba (North of Kampala) to Birembo ( South of Kampala), an estimated 120-mile distance (195 Kilometers) which, according to Official Government Communication, was purposed to retrace his Guerilla Army’s steps towards Power Capture, more than three decades ago.

As he has done in the past, the President, seized the opportunity to pass on health advice to youthful participants. While lambasting their peers back in Kampala for unhealthy eating, with little or no physical activity, the President, lauded youthful participants for having withstood the daunting exercise, which he suggested, is important for curbing, the surge in Non Communicable Diseases(NCDs).

The President revealed that a hallowing 40% of the Country’s Population, estimated at 40 million people – which as a matter of fact, is youth dominated, was suffering from NCDs.

” Over 40% of the Population is in hospitals for ‘ eating too much’ …” He said.

The subtance of this message, was diluted by some sections of the Media, that relayed it to the Public in the most literal sense, attracting, as would be expected, ignorant trolls and mockery, especially, on Social Media.

But the President’s preaching, properly contextualised, would provide a starting point in finding solutions, to the scourge of NCDs, ravaging the Country.

The Four Leading NCDs are as a result of behavior or lifestyle./ Illustration ©️International Federation of Pharmaceutical Manufacturers’ Association.

What are NCDs?

According to the Ministry of Health, NCDs, are diseases incapable of direct transmission from one person to another. And, although, could be hereditary, they are largely, a result of “ behavior” or “ lifestyle.” These diseases, include; Cardiovascular diseases( Heart diseases), some Cancers, Chronic Respiratory diseases, Stroke, Diabetes, Mental Health issues, among others.

According to the World Health Organization( WHO), NCDs, are a result of 4 Major factors; Tobacco Use, Harmful use of Alcohol, Unhealthy Diets and Physical Inactivity – all behaviors or lifestyles, call them – behavioral risk factors. These factors, contribute, to 4 major, metabolic changes, that eventually exacerbate, the risk of contracting NCDs. These changes are; raised blood pressure, overweight (obesity), high blood glucose levels and high levels of fat in a person’s blood.

High blood pressure contributes 19% of global deaths, followed by Obesity( being Overweight) and then, raised blood glucose.

MAGNITUDE OF NCDs IN UGANDA

Due to scanty information and data, from Uganda’s Health Ministry, it is difficult to paint a clear, full, total and complete picture, of the NCDs magnitude, in Uganda. There is poor documentation and little( almost negligible) research, on NCDs in Uganda. The funding of surveys, in this field, is almost, non existent. Indeed, the last survey carried out, by the Ministry of Health, was in 2014.

Nonetheless, the available data and information, from the WHO, the 2014 NCD survey and a few researchers, paints a dark picture of the NCDs magnitude, in Uganda.

According to the 2014 NCD survey by the Ministry of Health, 33% of total annual deaths were due to NCDs, especially, Cardiovascular diseases, Cancer, diabetes, and Chronic Respiratory diseases. The Uganda Non Communicable Diseases Alliance(UNCDA) in a report by The New Vision, puts a more human image to this statistic, by saying, 100,000 people die per year, in Uganda, due to NCDs.

Globally, the WHO, says 41 Million People, die annually, due to NCDs ( approximately, 71% of all deaths) – and most of these( 85%) occur, in Low and Middle Income Economies(LMICs) like Uganda. Of these, 15 million ,die when they are, somewhere between the ages of 20 and 69 ( Premature deaths). It should be noted, at this point, that Uganda has one of the youngest populations in the World.

Cardiovascular diseases contribute to most of these deaths at 17.9 Million, followed by Cancers at 9 Million, then Respiratory diseases at 3.9 Million and diabetes at 1.6 Million. These four, account for 80% of all Premature deaths, meaning, contrary to belief, that the aged are more likely to suffer these diseases, they can also attack the Young.

Tobacco use, contributes 7.2 Million annual deaths ( Including Passive users), unhealthy diets( excess salt/sodium/fats) 4.1 Million, Harmful Consumption of Alcohol 3.3 Million and 1.6 Million deaths due to absence of Physical Inactivity.

SOCIOECONOMIC IMPACT OF NCDs

Poverty, has affinity for NCDs. According to Jeremy, Schwartz and David in their “ Looking at Non Communicable diseases in Uganda through a Local Lens,” NCDs impede poverty reduction initiatives in Low and Middle Income Countries such as Uganda, by increasing the household costs toward health care. Health Care costs drain household resources. These costs range from lengthy and extensive treatment to loss of breadwinners.

Vulnerable people, like the Youth, and Socially disadvantaged people, who constitute the bulk of Uganda’s Population, get sicker and die soonest, than people of higher social standing, largely, because, the former are at great risk of exposure to Harmful Products, such as tobacco or unhealthy dietary practices and have limited or no access to quality healthcare services.

What can be done?

First, the State must make provision for adequate resources for research and containment of the NCD scourge. An NCD needs assessment – “ Assessment of the Capacity of Ugandan Health Facilities, Personnel, and Resources to prevent and Control NCDs” by Rogers H, as a Thesis, for Master of Public Health at Yale School of Health, found that a paltry 0.01% of the total Ministry of Health budget, is dedicated to the NCD programme, despite the fact that, the number of Ugandans sick from NCDs, is on the rise, thus making the NCDs scourge, a major Public Health Threat. As a result, there is general lack of awareness among Political Leaders – Save Museveni for this Purpose and Policy Makers, of the magnitude of NCDs in Uganda and their risk factors leading to low funding for NCDs interventions.

I note, the recent interventions in curbing NCDs resulting from tobacco use, through the enactment of the “ Tobacco Law” and introduction of the National Day of Physical Activity. The Education Policy, also encourages physical activity in education facilities. There are efforts to enact, the Alcohol Consumption Law. However, without solid national policy, standards, and guidelines to direct the Prevention and Control of NCDs, implementation of Laws and Policies will always be non existent.

The State, must do away, with neoliberalism – putting the Private Sector, at a much higher pedestal than the Public, and promote social Justice, in accordance with the National Principles and Directives of State Policy which encourage equal distribution of resources to allow the marginalized access to quality health care. According to the Uganda Cancer Institute( quoted from Jeremy, et al) one Cancer Patient, needs 6 Million for drugs alone, to complete the recommended 6 cycles of treatment. This certainly, cannot be afforded, by the average Ugandan.

In 2013, the Diabetes Association, reported that,cases of the NCD (diabetes)would increase because many Ugandans were not reporting for Diagnosis. Thus, the State, should  bolster, management of NCDs, through early detections, screening and providing access to palliative care.

Conclusively, the bulk of these diseases are preventable. Thus the State must engage in low cost initiatives to reduce the risk factors. Like Museveni, there must be promotion of Physical Activity- a walk, ride, and physical exercise facilities should be put in place in schools, offices, et cetera. Unhealthy diets – excess sugar, fats, and salt diets, must be discouraged. Harmful Consumption of Alcohol and Tobacco must be discouraged.

 

 

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