The Continuing Epidemiological Transition In Sub Saharan Africa

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.

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.

In sub-Saharan Africa, older people make up a relatively small fraction of the total population and are supported primarily by family and other kinship networks. They have traditionally been viewed as repositories of information and wisdom, and are critical pillars of the community but as the HIV/AIDS pandemic destroys family systems, the elderly increasingly have to deal with the loss of their own support while absorbing the additional responsibilities of caring for their orphaned grandchildren. Aging in Sub-Saharan Africa explores ways to promote U.S. research interests and to augment the sub-Saharan governments' capacity to address the many challenges posed by population aging. Five major themes are explored in the book such as the need for a basic definition of "older person," the need for national governments to invest more in basic research and the coordination of data collection across countries, and the need for improved dialogue between local researchers and policy makers. This book makes three major recommendations: 1) the development of a research agenda 2) enhancing research opportunity and implementation and 3) the translation of research findings.

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 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.

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.

This book examines issues concerning how developing countries will have to prepare for demographic and epidemiologic change. Much of the current literature focuses on the prevalence of specific diseases and their economic consequences, but a need exists to consider the consequences of the epidemiological transition: the change in mortality patterns from infectious and parasitic diseases to chronic and degenerative ones. Among the topics covered are the association between the health of children and adults, the strong orientation of many international health organizations toward infant and child health, and how the public and private sectors will need to address and confront the large-scale shifts in disease and demographic characteristics of populations in developing countries.

This book discusses the current state of cancer pathway as it is relevant to sub-Saharan Africa and highlights differences in epidemiology and the underlying problems with management. It outlines the current practice and opinions in all forms of cancer, also highlighting future prospects. Starting by providing background information on the epidemiology and genomic variations, the book then goes on to look at Infection-related cancers and continues to prostate GI, breast cancer and ovarian and cervical cancer. The last part of the book focuses on delivery of affordable and accessible care. Palliative services and primary and transnational research, as well as clinical trials are also discussed. Written by a team of authors based in the UK, Nigeria, South Africa and the US. this book offers an overview of the current state and challenges of cancer care in sub-Saharan Africa, and it would be valuable to policy makers, researchers, funding organisations, and can be an adjunct to standard text books for students, residents and established doctors.