Kenya is improving its efforts towards controlling the rising burden of non-communicable diseases (NCDs) in the country through investment in research and development and the use of technology.
Recent efforts by British-Swedish biotechnology company AstraZeneca and the Ministry of Health could help improve the situation.
The company has donated innovative screening equipment to the Kenya Medical Research Institute (KEMRI), Kenyatta National Hospital (KNH), the University of Nairobi (UON) and the Aga Khan University Hospital (AKUHN) to be used in the detection, screening and treatment of NCDs.
The equipment, the organisations say, will enable recipient institutions to conduct research on the use of non-invasive technology to predict the risk of hypertension, diabetes, eye conditions and other medical conditions through retinal scanning.
“Access to healthcare is a key sustainability pillar for AstraZeneca and we are continuously leveraging science to strengthen the resilience and sustainability of healthcare systems. This ensures that Kenyans receive the highest attainable standard of NCD care in a sustainable, affordable and accessible manner,” Ashling Mulvaney, Vice President, Global Sustainability and Access to Healthcare, at AstraZeneca told Nation.Africa .
According to the World Health Organization (WHO), NCDs kill 41 million people each year, equivalent to 71 per cent of all deaths globally.
Each year, more than 15 million people die from NCDs between the ages of 30 and 69 years, with 85 per cent of these "premature" deaths occurring in low- and middle-income countries.
Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancer (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million).
Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from an NCD.
2030 Agenda for Sustainable Development
Non-communicable diseases also threaten progress towards the 2030 Agenda for Sustainable Development, which includes a target of reducing premature deaths from NCDs by one-third by 2030. Poverty is closely linked with NCDs.
The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries, particularly by increasing household costs associated with health care.
Vulnerable and socially disadvantaged people get sicker and die sooner than people of higher social positions, especially because they are at greater risk of being exposed to harmful products, such as tobacco, or unhealthy dietary practices, and have limited access to health services.
Unfortunately, healthcare facilities in Africa and other Less Developed Countries are often lacking basic diagnostic tools.
Some NCD symptoms also manifest very late, making early diagnosis difficult. The inability to diagnose early or well enough means that patients end up spending more and having complicated cases.
This is the situation that AstraZeneca seeks to improve through partnerships. Due to the scope and complexity of the problem, however, attention and investments from multiple stakeholders across several key areas — from awareness to prevention, and diagnosis to treatment — are needed, as well as recognition of the existing gaps and imbalances.
“One of the most established partnerships, which launched in Kenya in 2014, is AstraZeneca's Healthy Heart Africa (HHA) programme which leverages local partnerships to tackle the high burden of hypertension,” Ms Mulvaney says.
“Covid-19 impacted global access to healthcare. We had to pause some HHA activities as the focus shifted to the pandemic. But now coming back into the post-pandemic period, we see more engagement in NCDs, making people more aware of their health status and working more closely with our partners”.
HHA is currently implemented in nine countries including Kenya, Ethiopia, Tanzania, Ghana, Uganda, Côte d’Ivoire, Senegal, Rwanda, and Nigeria.
Since its inception, HHA has conducted over 27.1 million screenings, trained over 9,100 healthcare workers; and activated over 950 healthcare facilities in Africa to provide hypertension services, with the establishment of secure supply chains for low-cost, high-quality branded antihypertensive medicines where applicable, and identified over 5.3 million elevated blood pressure readings.
“What we have to look at are quantifiable and qualifiable elements. We can’t put the price on saving patients’ lives. Looking at HHA, there is a need to focus on disease awareness and education and guideline training for the sustainability of the programme and also for making medicines affordable,” Ms Mulvaney notes.
So far, she adds, the firm has delivered over 27 million screenings and identified over 5 million people with elevated blood pressure.
The gap in adequately trained primary care physicians for delivering evidence-based care in primary care is a major hurdle in controlling this NCD epidemic.
In addition, the number of specialists is also insufficient in underdeveloped countries due to limited training opportunities. There is therefore an urgent need to train primary care physicians in evidence-based NCD management to provide services such as screening, diagnosis, management and follow-up of uncomplicated cases at primary care.
The role of capacity building of healthcare personnel cannot be overstated. A recent study published in the BMC Health Services Research Journal found that a large-scale capacity-building intervention improved primary healthcare professionals’ knowledge, skills and clinical practice on NCD risk detection and reduction.
The study is titled Capacity building of health care professionals to perform inter-professional management of non-communicable diseases in primary care.
AstraZeneca manages other access to healthcare programmes alongside HHA. These include the Youth Health Programme, aimed at engaging and empowering the youth alongside education on avoiding alcohol and smoking and encouraging healthy eating.
“We also have PUMUA, which is focusing on respiratory care, particularly asthma. Within PUMUA, what we have done is look at capacity building and healthcare strengthening by sharing and deploying over 300 nebulizing stations across the country. When we look at the risk factors of NCDs, age and social status don’t matter although initially, older people were more vulnerable,” Ms Mulvaney explains.
