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The Ireland Africa Alliance for Non Communicable Disease

A group of professionals with a special interest in supporting best practice for Non Communicable Disease in Africa joined forces in 2020 to raise awareness of the burden of NCDs in Africa. Our aim is to enhance international commitments; empower and influence local stakeholders; and support our group members already implementing projects in Africa. The group acknowledge the complexity and heterogeneity of African healthcare and as an initial focus, plan to build on members’ existing contacts and networks.

Mission Statement

Our vision is the prevention and management of NCDs with a view to improving the quality of life of Africans and reducing premature death there.

Objectives

i. To partner with local professionals to ascertain local needs
ii. To raise awareness of NCDs and their effect on populations
iii. To influence national policies on NCD prevention and management in Africa
iv. To highlight international best practice
v. To focus on diabetes, obesity, cardiovascular and respiratory disease
vi. To promote education of professionals and the public at local and national level to evnhance best practice
vii. To undertake technical collaboration to support the management of NCDs

Background

The words non communicable diseases (NCDs) came into common usage in global health statistics in the early 1990s as a description of a medical condition which is life long, not transmitted from person to person and characterised by long duration and generally slow progression.

In Ireland, NCDs are more commonly referred to as chronic diseases. NCDs cause premature illness, inability to function, and reduce quality of life. Most NCDs develop over a time with no signs or symptoms visible to the person, but once manifested cause a protracted period of impaired health.

Although often thought of as characteristic of rich countries, NCDs now disproportionately affect more people in poorer nations with over three-quarters of the NCD burden falling on people living in low-and middle-income countries. Some 86% of deaths attributable to NCDs are among those aged under 70 in these regions.

Unless addressed, the world will lose $30 trillion by 2030 in the treatment of NCDs, representing 48% of global GDP which will further push millions of people below the poverty line . The most commonly referred to NCD’s are those with highest premature mortality i.e. cancers (9.3 million), diabetes (1.5 million), cardiovascular (17.9 million) and respiratory disease (4.1 million).

Their rise reflects a parallel rise in global obesity driven by low quality, hypercaloric diets and reduced population wide exercise dating from the late 1970s. These lifestyle patterns lead to a state of insulin resistance and the “Metabolic Syndrome”, a collective term for the NCDs that reflects the belief that they are all different manifestations of the same disease.

Growing Challenges

In Africa, the growing prevalence of NCDs is resulting in new healthcare challenges alongside the already existing high burden of chronic communicable diseases such as human immunodeficiency virus (HIV), malaria, tuberculosis, cholera, dysentery and haemorrhagic fevers like Ebola in addition to the latest Covid-19 challenge.

The WHO estimates that NCDs will rise by 27% over the next 10 years in Africa, resulting in 28 million additional deaths. That compares with a global rise of 17% over the same period. By 2030, deaths from NCDs in Africa “are projected to exceed deaths due to communicable, maternal, perinatal and nutritional diseases combined.” 

Management of NCDs

Management of NCDs includes prevention, detection, screening and treatment of these diseases, and providing access to palliative care for people in need. Evidence shows that such interventions are excellent economic investments because, if provided early to patients, bring health and cost benefits to populations, communities and patients.

Clinical preventive strategies include intervening before disease occurs (primary prevention), detecting and treating disease at an early stage (secondary prevention), and managing disease to slow or stop its progression (tertiary prevention).

These interventions, combined with a focus on reducing/managing the risk factors associated with NCDs can substantially reduce the incidence of chronic disease and the prevalence of disability and death associated with NCDs .

NCDs as a global priority

A United Nations declaration, issued on Sept 20, 2011, the Global Action Plan for the prevention and control of NCDs 2013–20 (GAP) clearly acknowledges the economic and epidemic scale of the challenge. 

The UN declaration has called on high income countries to support vulnerable countries to implement a number of affordable preventative measures addressing four risk factors: tobacco control; alcohol restraint; healthy diet and regular exercise. However, the declaration is not a binding document and relies on the citizens of each country to encourage their governments to put into action the declaration which they signed.

Irish response to the UN Global Action Plan

Ireland has a history of supporting low income countries through Irish Aid. To date, the official policy supports humanitarian aid for communicable diseases, maternal health and disaster relief. Currently, NCDs are not included in that policy, although it must be acknowledged that improving maternal health may reduce the future incidence of NCDs.

Founding Group Members

• Prof Richard Firth – Former Physician/Endocrinologist Mater, National Maternity, Rotunda, Coombe hospitals. Founding HSE National Clinical Lead in Diabetes. Former President, Irish Endocrine Society. Opening the first NCD Centre in West Africa.
• Dr Anna Clarke – Former Research and Advocacy Manager, Diabetes Ireland
• Prof Ronan Collins – Age Related Medicine and Stroke Physician. HSE Clinical Lead, National Stroke Management Programme
• Prof Francis Finucane – Endocrinologist/Diabetologist and Obesity Specialist. Director of Weight Management Programme at University Hospital Galway.
• Dr Catrina Heffernan – Lecturer, Munster Technological University, Multiple high level international representative roles.
• Drs Joe Gallagher and Dr Peter Harrington – Gorey/Malawi Health Partnership
• Prof Siobhan Jennings – HSE Consultant in Public Health Medicine. Public Health Lead on the Acute Coronary Syndrome National Clinical Programme. Public Health Lead in the new Prevention of Chronic Disease Programme.
• Annette Kennedy – Commissioner on WHO Independent High Level Commission on NCDs at WHO, Geneva. President International Council of Nurses.
• Nazife Lawani – Assistant Médical, CHP Badou, Togo. Diplômé en Soins Diabétiques à l’UCD Dublin. Surveillant Général du CHP Badou. Point Focal VIH du District de wawa. Prestataire de soins à la Médecine Pédiatrie au CHP Badou .
• Dr Daniela Lehwaldt – Academic lead for Nursing, School of Nursing, Psychotherapy and Community Health, Dublin City University.
• Dr Máire O’Connor – Former Specialist in Public Health Medicine and spokesperson on COPD in the Faculty of Public Health, RCPI.
• Dr Michael O’Toole – Former Faculty Member, Centre for Global Health, TCD.
• Prof David Weakliam – Global Health Programme Director, HSE. Board Member, ESTHER Alliance for Global Health Partnerships.
• Dr Ray O’Connor – Senior Research Fellow and Adjunct Senior Clinical Lecturer at University of Limerick Graduate Entry Medical School, Assistant Programme Director of the HSE West GP training scheme and practicing General Practitioner.
• Dr Angie Brown – Consultant Cardiologist, National CVD Prevention Coordinator  and Medical Director of the Irish Heart Foundation

Current Projects by Group Members in Africa to combat NCDs

Professor Richard Firth is in the process of opening a COVID-delayed NCD/Diabetes Centre in Togo in a refurbished building using funds raised privately from Irish donors. The group will assist him in exploring further development of the service.

Drs Joe Gallagher and Dr Peter Harrington have an established collaboration through the Gorey-Malawi Health Partnership which is the clinical partner of the gHealth Research Group. The partnership is developing strategies for the management of asthma in an urban and rural primary care centre in Malawi which will be relevant to all contexts in Malawi. The partnership will see the development of a research centre, a fellowship opportunity and data generation to benchmark improvements. Much of African healthcare is delivered in primary care settings with little or no management of NCD’s.

Contact Us

To contact us for more info, please input your contact information and the details of your query on the form here and a member of our group will be in touch with you shortly. 

At the Irish Global Health Network we make every effort to ensure that we are partnering with organisations whose values and principles align with our own. With this being said, all views and activities of Incubator organisations are theirs alone and do not necessarily represent the views of the Irish Global Health Network.