Epidemiological Change And Chronic Disease In Sub Saharan Africa

Epidemiological Change and Chronic Disease in Sub-Saharan Africa offers new and critical perspectives on the causes and consequences of recent epidemiological changes in sub-Saharan Africa, particularly on the increasing incidence of so-called ‘non-communicable’ and chronic conditions. Historians, social anthropologists, public health experts and social epidemiologists present important insights from a number of African perspectives and locations to present an incisive critique of ‘epidemiological transition’ theory and suggest alternative understandings of the epidemiological change on the continent. Arranged in three parts, ‘Temporalities: Beyond Transition’, ‘Numbers and Categories’ and ‘Local Biologies and Knowledge Systems’, the chapters cover a broad range of subjects and themes, including the trajectory of maternal mortality in East Africa, the African smoking epidemic, the history of sugar consumption in South Africa, causality between infectious and non-communicable diseases in Ghana and Belize, the complex relationships between adult hypertension and paediatric HIV in Botswana, and stories of cancer patients and their families as they pursue treatment and care in Kenya. In all, the volume provides insights drawn from historical perspectives and from the African social and clinical experience to offer new perspectives on the changing epidemiology of sub-Saharan Africa that go beyond theories of ‘transition’. It will be of value to students and researchers in Global Health, Medical Anthropology and Public Health, and to readers with an interest in African Studies.

The closure of the Millennium Development Goals (MDGs) in 2015 prompted the need for a book of this kind. An interdisciplinary group of global health scholars contribute to the understanding of the emerging and fast-growing problem of the dual burden of communicable and non-communicable diseases (NCDs) in Africa. This book is timely, as the international community has moved from the MDGs to adopt the Sustainable Development Goals (SDGs) as the blueprint for a new human development agenda. Contributions and case studies are situated in the revised Epidemiologic and Nutrition Transition Model to capture the current situation, referencing communicable and NCDs on the African continent. The case studies encapsulated aim to help minimize negative health outcomes and improve population health, well-being, and equity in the future. This book will be significant in policy circles to assist international organizations, governments, and United Nations agencies. It aims to chart the future for health in Africa in light of recently adopted SDGs. This book is also a useful complementary reader for global public health related courses.

Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population. In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health. This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011.

This paper looks at the way in which the pattern of disease is changing in developing countries, and the implications this has for the way in which primary health care (PHC) programs should be designed and managed. In the absence of an accepted methodology for discussing health management issues, it attempts to develop a conceptual framework suited to analyzing an environment of dynamic change. It applies this framework first to the management of primary health care programs provided by governments, and then to the role of the non-government sector in primary care. The paper draws broad clients. If the general approach adopted seems useful, the conceptual framework needs next to be applied to a series of specific country cases to test its validity and refine it, and to adapt the general conclusions to local cultural, administrative and political conditions.

Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.

The essays in this collection are written to make readers (re)consider what is possible in Africa. The essays shake the tree of received wisdom and received categories, and hone in on the complexities of life under ecological and economic constraints. Yet, throughout this volume, people do not emerge as victims, but rather as inventors, engineers, scientists, planners, writers, artists, and activists, or as children, mothers, fathers, friends, or lovers – all as future-makers. It is precisely through agents such as these that Africa is futuring: rethinking, living, confronting, imagining, and relating in the light of its many emerging tomorrows.

The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.

The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.