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Diabetes in Sub-Saharan Africa—Overview of a Looming Health Challenge
education and empowerment in the form of a peers support system Conclusion
should offer some hope of better diabetes control by improving Diabetes is an emerging public health problem in SSA that must be
compliance and optimising self care practices. addressed and contained. Its current burden may not confer it a high
ranking in the list of health problems of this poor continent; however, it
What if we could prevent diabetes in SSA? Obviously, primary would be counterintuitive to wait for diabetes to move up the list of
prevention of diabetes has to be the cornerstone of antidiabetes efforts priorities before appropriate action is taken. Diabetes research and care
on the continent. This may seem like a tall order; however, on a in Africa will need to build on the current knowledge and technologies
continent that is impoverished, still fighting infections, has to combine available from other parts of the world. However, a direct transposition
control of undernutrition with rising obesity and has high morbidity and may not be a realistic or pragmatic plan as these models will have to
mortality in people who develop diabetes or other chronic diseases, be re-moulded into the specificities of the African context. Country-
every case of diabetes that is prevented will be a welcome relief. specific data on the burden of the disease are urgently required,
Preventive actions need not be individually tailored to target high-risk together with a clear understanding of the extent of national policies
individuals given that optimal treatment for people with diabetes is still for the prevention and care of diabetes. The Diabetes Declaration and
elusive. Prevention programs will have to be broad population-based Strategy for Africa
46
is a starting point that should be used by the
initiatives that will have to be socio-culturally appropriate and involve different countries of the region to bring diabetes to the forefront, and
the local people,
43,44
providing a heath promotion framework that at the same time to facilitate the adoption of a structured and holistic
promotes healthy lifestyles. approach to establishing a diabetes control program. n
The adoption of a World Diabetes Day Resolution by the UN General
Felix K Assah, MD, MPhil, is a doctoral student at the
Assembly
45
is acknowledgment of the fact that diabetes is a real and
Medical Research Council Epidemiology Unit in Cambridge
imminent threat to social and economic development globally. The UN in the UK. His current research concerns objectively
resolution calls for Member States “to develop national policies for the
measured physical activity patterns and metabolic health
in urban and rural Cameroon. Dr Assah qualified from the
prevention, treatment and care of diabetes in line with the sustainable
Faculty of Medicine and Biomedical Sciences of the
development of their healthcare systems, taking into account the University of Yaoundé I in Cameroon.
internationally agreed development goals, including the Millennium
Development Goals.” In SSA specifically, the IDF African Region, the World
Jean-Claude Mbanya, MD, PhD, FRCP, is a Professor of
Health Organization (WHO)-AFRO, and the African Union have jointly
Medicine and Endocrinology in the Faculty of Medicine
issued a Diabetes Declaration and Strategy for Africa.
46
The declaration is and Biomedical Sciences at the University of Yaoundé I in
a call to action for governments of African countries and all partners and
Cameroon. He is President of the International Diabetes
Federation (IDF). He has worked extensively in Africa and
stakeholders in diabetes to prevent diabetes and related non-
worldwide on advocacy for diabetes. Professor Mbanya’s
communicable diseases and to improve quality of life and reduce research has focused on the epidemiology and public
morbidity and premature mortality from diabetes (see ‘The Diabetes
health aspects of diabetes in Cameroon and Africa.
Declaration for Africa—Call to Action’ opposite).
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US ENDOCRINOLOGY 19
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