New data released at the inaugural Diabetes Frontier Africa event indicated that sub-Saharan Africa will see a 156% increase in diabetes prevalence over the next 30 years – the largest projected increase globally.

Middle East and North Africa are projected to have 112% growth – the second highest projection – meaning that Middle East and Africa will have over 108 million diabetes sufferers by 2045.

Africa is already ravaged by infectious diseases such as HIV and TB, but non-communicable diseases (NCDs) such as diabetes are expected to rise at an even sharper rate. NCDs place undue pressure in healthcare infrastructure, worker productivity and by effect economic development.

Experts who gathered at the Cape Town event last week noted the projections with concern, stating that more needs to be done at regional, state and community levels to curb the threat.

“Africa desperately needs responsible activism by patients as was done with HIV,” said former President of the International Diabetes Foundation (IDF), Professor Jean Claude Mbanya.

Professor Mbanya added that the price of diabetic medicines such as insulin will continue to be unaffordable for the average African if diabetes patients and affected families do not raise their voices. He noted that advocacy by HIV patients resulted in affordable antiretroviral medication throughout Africa, something that diabetes patients should aim for.

South African representative for the World Health Organisation (WHO), Dr Rufaro Chatora, noted that Africa has a myriad of challenges in providing effective healthcare both at the prevention and treatment levels.

“The fight against NCDs in Africa is not just a Ministry of Health issue, it involves Finance, Economics as well as the members of parliaments that serve affected areas,” said Dr Chatora.

Dr Chatora added that African governments, in particular, need to take the threat of NCDs more seriously and set goals to prevent their spread as this will be the most effective approach to stemming the alarming growth.

Commenting on the lifestyle challenges on the continent, Director at Kenya Diabetes Management and Information Centre, Dr Eva Njenga, highlighted that Africa’s urbanisation trend is not currently geared toward healthy living.

“In Nairobi a cyclist is more likely to get run over than to improve their health. Despite the fact that cycling would not only increase public health but also reduce congestion and pollution, the local government has shown no interest in developing cycling lanes,” said Dr Njenga.

She added that positive perceptions of obesity, sedentary pursuits and consuming unhealthy food all add to the increase in NCDs. Not only are negative lifestyle choices admired but there is often a stigma associated with not being overweight after marriage or pregnancy.

This cultural bias is partly to blame for why 69.2% of adults with diabetes in Africa are undiagnosed. They are only diagnosed when they experience diabetic complications such as impaired vision, nerve damage, cardiovascular and kidney diseases.

“In order to have healthy populations, Africa can no longer focus on isolated illnesses, we need a focus on holistic health,” said Dr Njenga.

Diabetes stigma was also highlighted as a major social challenge to positive management of the disease.

“Because diabetes is linked to a bad lifestyle, many suffers are blamed for their obesity or lack of activity. This stigmatisation of diabetes patients does little to encourage them to live a healthier lifestyle,” said National Manager of Diabetes South Africa, Margot McCumisky.

She added that the association of diabetes with impotence in men and infertility in women also created a disincentive in potential patients being tested.

McCumisky said that only through collaboration between all stakeholders at the patient level, healthcare and governmental levels will African communities be able to effectively help people.

In closing the event, Professor Mbanya noted that a large proportion of the increase in African diabetic prevalence will be in adolescent children, a result of the intergenerationality of diabetes.

“If we will not be diabetes activists for ourselves then we should do it for our grandchildren who will have to deal with the massive burden of high prevalence and low funding for healthcare,” concluded Professor Mbanya.

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