DR. IVAN EDWARDS: Issues of the Heart Africa Can No Longer Ignore

The recent death of Uganda’s State Minister for Defence has highlighted the growing prevalence of heart disease in Africa. This rise, coupled with known risk factors, under-resourced public health systems, economic burdens, and inequitable care, defines this crisis.

Heart disease has remained the leading cause of death globally for the last 20 years. The number of deaths from heart disease has increased by more than 2 million since 2000, reaching nearly 9 million in 2019 (1).

But the story does not end there.

Heart disease is no longer just a Western world issue. It is an African issue and is claiming many lives. Africa is now recognized as a significant contributor to the global burden of cardiovascular disease (CVD). In sub-Saharan Africa, CVD is the second leading cause of death. In 2019, over 1 million deaths were attributed to CVD, accounting for 5.4% of all global CVD-related deaths and 13% of all deaths in Africa. Left unmanaged, many of Africa’s sons and daughters are going to be killed by it. This global burden on Africa’s population is expected to double by 2030. In effect, Africa can no longer ignore heart disease anymore (2, 3).

Several factors are contributing to the rise in heart disease (4):

Rising Prevalence

Cardiovascular diseases (CVDs) are now among the leading causes of death in sub-Saharan Africa. This shift is partly due to demographic changes, such as increased life expectancy and urbanization. As more people live longer and move to urban areas (and live the urban lifestyle), the prevalence of heart disease rises. Living in the city comes with its price (4).

Risk Factors

The rise in heart disease is linked to several risk factors, some of which include the consumption of foods high in saturated fat or sodium, decreased regular physical activity, and smoking. Unfortunately, many Africans have adopted these unhealthy lifestyle habits. It is the “cool thing” to do. Other risk factors that can be mitigated—and are not—are the appropriate management of high blood cholesterol, high blood pressure, high blood sugar, and obesity. Having any three or more of these conditions significantly raises the risk for heart disease. 

Healthcare Challenges

Many African countries struggle with managing or preventing heart disease due to under-resourced public health systems, which hinder effective prevention, diagnosis, and treatment. Moreover, the “brain drain” of medical professionals seeking “greener pastures” poses a significant challenge to the already understaffed healthcare systems in African nations. Efforts to retain clinicians are crucial and warrant further discussion (5).

Economic Impact

The rising burden of heart disease has significant economic implications, leading to loss of productivity and increased healthcare costs. Addressing heart disease is both a health and economic priority. African countries must use their limited resources to build a healthcare sector that provides quality primary and tertiary care.

Inequality in Care

There is a significant disparity in cardiac programs across Africa, with most concentrated in urban areas and often inaccessible to rural populations. The wealthy can simply fly out of the country to get top-level care while the poor struggle to pay for basic care. Since the many unprivileged “have nots” are affected by cardiac issues and are not duly attended to well (versus the few privileged “haves”), the stats pile up in the untreated or undertreated columns. Bridging this gap is essential to ensure equitable care. Access to quality, regardless of class status, has to be accorded to all people, regardless of their ability to pay for it. Care has to be rendered a right and not a privilege.

These factors highlight the urgent need for targeted interventions to combat the rising tide of heart disease in Africa. By addressing these challenges, it is possible to reduce the burden of cardiovascular diseases and improve overall public health outcomes.

References

1. Non-communicable diseases killing more people than ever before: UN health agency | UN News
2. Africa | Where We Work | World Heart Federation (world-heart-federation.org)
3. Tackling the Growing Burden of Cardiovascular Diseases in Sub-Saharan Africa (ahajournals.org)
4. Cardiovascular Disease Healthcare Utilization in Sub-Saharan Africa: A Scoping Review (mdpi.com)
5. The African Brain Drain: Causes, Costs, and Consequences | SpringerLink

Dr. Ivan Edwards is a Ugandan American medical doctor, a USAF flight surgeon at the rank of Lieutenant Colonel, a humanitarian, an entrepreneur, and an international motivational speaker. He lives in the U.S. and often visits family in Uganda.