- Your Excellency Cabinet Minister, personally representing His Excellency the President of the Republic of Congo;
- Honourable Members of Parliament of the Republic of Congo;
- Excellencies Members of Government of the Republic of Congo;
- Honourable Ministers of Health and Distinguished Heads of Delegation of the 46 countries of the WHO African Region;
- Your Excellency Dean of the Diplomatic Corps, Excellencies Ambassadors accredited to the Republic of Congo;
- Distinguished Officials of State Institutions and authorities;
- Representatives of Bilateral and Multilateral Cooperation Agencies;
- Coordinator of the United Nations System and Representatives of Agencies of the United Nations System;
- Representatives of National and International NGOs;
- Distinguished Guests;
- Dear Colleagues Members of Staff of WHO, Dear Members of the Press;
- Ladies and Gentlemen,
The World Health Organization is highly honoured by the presence, in our midst, in this conference room, of His Excellency the Cabinet Minister at the Office of the President of Congo, personally representing His Excellency Mr Denis Sassou N’Guesso, President of the Republic of Congo. We appreciate the importance that His Excellency the President of the Republic of Congo attaches to the health of the African peoples; and we are grateful to the Government and People of Congo for their hospitality and support which have made it possible to organize this ministerial consultation on noncommunicable diseases in Africa.
Permit me to thank all ministers, heads of delegation and experts of Member States of the African Region for accepting my invitation and travelling to Brazzaville. I express cordial greetings to all the delegations of partners, international organizations, nongovernmental bodies and civil society representatives who have taken part in this historic event.
- Excellencies,
- Ladies and Gentlemen,
The series of events that have taken place in the past few years in regard to noncommunicable diseases and their risk factors took a new dimension in 2010 when the United Nations General Assembly decided to put this topic on its agenda at the Summit of Heads of State and Government in 2011. Today, therefore, we are at a defining moment as we gather here in Brazzaville to hold the present meeting. I am highly tempted to identify those series of events as a rallying call just as in our traditional African setting; a warning sign of great danger that can imperil society. Today, noncommunicable diseases pose a threat to the world at large and Africa has not been spared.
For a start, I would like to cite the noncommunicable diseases that would be discussed at our meeting. They include cardiovascular diseases, diabetes, chronic respiratory diseases, cancers, sickle-cell disease, mental diseases, violence and injuries.
The first question one may ask is to know how noncommunicable diseases became a threat to health worldwide and in the African Region? Although many possible explanations account for this, there is one reality noted everywhere in the world. The reality is that lifestyles have changed in the aftermath of the major breakthroughs in science, technology and development. Whereas modernity has brought improvements in the quality of life of humankind, it has also promoted lifestyles that are not always conducive to good health.
For example, large-scale production in the automobile industry coupled with technological progress have provided to the world faster means of transport that are increasingly accessible to a growing number of people. This has contributed to a considerable reduction of walking, with attendant physical inactivity for a sizeable proportion of the population. Current figures show that nearly a half of the adult population do not do adequate physical activity.
Furthermore, development and technological progress have made it possible nowadays to produce and preserve large quantities of foods that have a high content of sugar, salt and fat and to distribute them on a large scale. The power of commercial advertising is much utilized these days to stimulate demand for such products, and children and the youth are increasingly targeted by these advertisements. Research has shown that frequent consumption of such foods leads to overweight and even obesity with adverse impact on some key organs of the human body such as the heart, the blood vessels, the kidneys, the pancreas and the liver.
- Excellencies,
- Ladies and Gentlemen,
Believe me, I am not advocating for a return to tradition. What I am trying to do is to make a link between change in lifestyles and the rapid increase in the prevalence of noncommunicable diseases that pose so much threat to health in the world in general and in the African Region in particular. In the majority of traditional African societies, alcohol production was limited and its consumption reserved for some occasions and some age groups. However, because of technological advancement, large-scale production of alcoholic drinks especially drinks with a high content of alcohol has soared to unprecedented levels. Alcohol is therefore available almost everywhere, accessible at all times, even to vulnerable populations such as the youths. Unfortunately, alcohol consumption is increasing in magnitude with an adverse impact on health. The number of acts of suicide and violence including road traffic accidents attributable to alcohol abuse has kept increasing worldwide including in countries of our Region.
A recent survey has shown that average alcohol consumption per capital in countries of the African Region is around 6.2 litres of pure alcohol, equivalent to the global average. However, the study also shows that only three out of 10 people drink alcohol in our Region, implying that only 30% of the African population account for this level of drinking.
- Excellencies,
- Ladies and Gentlemen,
It is known today that tobacco use is a serious threat to health. Smokers expose themselves to increasing risk of cardiovascular diseases and cancers. In African tradition, tobacco use was reserved for elderly people. Today, due to technological progress and the vast tobacco industry, cigarettes have invaded the entire world. Because of commercial advertising, all strata of society are affected by tobacco use, the youth being its worst victim.
Notwithstanding global efforts already made through the adoption of the Framework Convention on Tobacco Control, the lucrative trade in tobacco seems to continue to flourish in our Region, affecting the health of populations that are sometimes unaware of the attendant dangers. The available data shows that 6% to 36% of adults smoke cigarettes in our Region.
- Excellencies,
- Ladies and Gentlemen,
Change in lifestyle has been the main factors underlying noncommunicable diseases that pose a threat to the world and hamper the development of low- and middle-income countries. Permit me, at this stage, to share with you briefly some data on the magnitude of noncommunicable diseases in the African Region.
High blood pressure is more common in our Region than anywhere else in the world. Studies have shown that the proportion of the adult population with high blood pressure is as high as 40% in some localities. Regrettably, nearly 90% of people with high blood pressure are unaware of their situation because people do not regularly do blood pressure checks. This situation exposes many individuals to a high risk of complications such as strokes and heart attacks. Available data shows that 35 million people suffer from cardiovascular diseases in our Region, causing an estimated one million deaths annually.
According to available data more that 10 million people were estimated to have diabetes in the African Region in 2010. That figure may double by 2030 and would then represent the highest increase compared with other parts of the world.
As was the case for high blood pressure, more than a half of the people suffering from diabetes have never checked their blood sugar levels and only discover they have the disease when it has already reached a stage of complications such as problems of vision, renal insufficiency, disorders of blood circulation in the veins, leading to amputations of the lower limb.
- Excellencies,
- Ladies and Gentlemen,
Projections indicate that the number of cases of cancer may double by 2030, increasing from about 700 000 cases to 1 600 000 cases annually at a lethality rate of over 80%. The reasons for this very high lethality rate are weak early detection and inadequate means of management. The commonest cancers in the African Region include cancers of the cervix, the breast, the prostate and cancers of infectious origin such as Kaposi’s sarcoma, liver cancer and bladder cancer.
For its part, road traffic accidents claim 235 000 lives each year in the African Region. This figure accounts for 20% of global deaths due to road traffic accidents although the African Region has only 2% of registered automobile vehicles in the world.
Concerning mental diseases and neurological disorders, current figures show that 1%-3% of the population are affected. Data also show that more than a million people commit suicide worldwide. That is a signal to us that mental health should be given priority.
Sickle-cell disease, linked to haemoglobin anomaly, is a very common genetic disease in several countries of our Region. The prevalence of sickle-cell trait may be up to 40% of the population in certain communities. Each year, over 500 000 babies die of sickle-cell disease, and 60%-80% of them die before the age of five years. In most cases, the parents are unaware that they are carriers of the sickle-cell traits, either for lack of information or for lack of screening facilities in peripheral health centres. Obviously, that is a major public health problem.
Given the situation described above the question to ask is what action has been taken to prevent or control these scourges. At the global level, the sign of awareness was noted 10 years ago with the adoption by the Fifty-third World Health Assembly of the global strategy for the control of noncommunicable diseases. Much earlier, in 1971, President Richard Nixon had sounded an alarm bell about the increase in cancer cases in the USA. In the African Region, the Regional Committee has adopted several regional strategies on mental health, cardiovascular diseases, cancers, sickle-cell disease, control of tuberculosis and harmful use of alcohol. Again in the African Region, noncommunicable diseases figure among the priorities set forth in the Strategic Directions for WHO 2010–2015. I have also instructed the WHO Regional Office cluster in charge of disease control to develop a strategic plan for control of noncommunicable diseases covering a period of at least five years. The first draft of this plan is included in your files. I would like to request you to provide your comments, if possible, to enable us to finalize the plan.
At the country level, almost all Member States have designated a focal point for the control of noncommunicable diseases. It would be desirable for each country to develop an integrated control plan and to have a structure within the ministry of health dedicated to the control of NCDs. Furthermore, health systems should provide better response to the control of noncommunicable diseases.
Concerning the control of tobacco use, 41 countries of our Region have ratified the Framework Conventions on Tobacco Control but only a few countries have produced a legislation for its comprehensive enforcement. A regional strategy for reducing harmful use of alcohol was adopted in 2010. To date, only 12 countries have legislation in this area.
In addition, human and financial resources allocated to the control of noncommunicable diseases remain inadequate. Efforts to raise awareness of the populations about these diseases and their risk factors are also inadequate. There is need to strengthen legislative frameworks and regulatory measures to protect vulnerable populations. The multisectoral and multidisciplinary dimension of the control of noncommunicable diseases deserve increased attention. In the light globalization, we should together influence lifestyles positively, reduce the impact of risk factors and thereby reverse current trends.
- Excellencies,
- Ladies and Gentlemen,
Under the Chairmanship of Professor Elira Dokekias, Director-General of Health of the Congo, highly qualified experts from your countries together with experts from WHO and other cooperation agencies attending this meeting have done an excellent job in the past few days.
This meeting is an occasion for exchanges and should enable us to adopt a common declaration reflecting the consensus of Member States of the African Region on noncommunicable diseases. That declaration should be the African Region’s contribution to the global conversation and should serve as the basis for negotiation at the Moscow ministerial meeting and the High-Level Summit of the United Nations General Assembly in New York this year. To conclude, permit me to recall the slogan of our meeting: “United Against Noncommunicable Diseases: The Time to Act is Now”.
I thank you for your kind attention.