CRACKING genetic responses to the changing environment in Africa would open a new frontier in the drive against rising non-communicable diseases (NCDs) on the continent.
Africa has a problem. Generally, the continent has the greatest burden of disease and lowest density of health-care professionals in the world. And African countries are aware.
For Zambia, Vice-President Inonge Wina recently acknowledged that Zambia is experiencing an increase in NCDs and that for many years communicable diseases such as HIV and AIDS, malaria and tuberculosis posed challenges to the health systems while the country was also at risk of emerging diseases.
“The abuse of alcohol and other substances by young people has the potential to ruin the future generation of the country. It is our collective responsibility to ensure that healthy lifestyles are adopted at all levels. I call upon Government institutions, private sector, NGOs, civil society and service clubs to embrace the obligation and responsibility of wellness by encouraging individual, family and collective action,” Mrs Wina said.
Although infectious diseases, maternal, child, and neonatal health are improving, the burden of non-communicable diseases has been steadily increasing in the past few decades.
Africa is home to about 16 percent of the world’s population. That’s 1.2 billion people.
But the continent is disproportionately burdened by a double health challenge: infectious diseases and a recent increase in non-communicable diseases.
Non-communicable diseases such as hypertension, cardiovascular diseases and diabetes are on the upward march due to an ageing population, a transition to increased urbanisation, dietary changes, a more sedentary lifestyle and an increase in the prevalence of obesity.
Non-communicable diseases result in deaths everywhere in the world. But in Africa they are also a major reason for premature deaths, which is people dying between the ages of 40 and 70.
In South Africa there is more than a 25 percent chance of dying prematurely from non-communicable diseases.
For the rest of the continent it ranges between 15 percent and 24 percent. This compares to the average of less than 15 percent for the United States and Europe.
The non-availability of research on the non-communicable diseases has translated into a great cost for Africa.
“Africa has little idea of the stage of life at which these diseases manifest. Not much research has been done and Africa is largely ignorant of the phenotypes of diabetes in Africa and how diabetes interacts with other conditions to contribute to morbidity and mortality. There is urgent need for research on infectious and non-communicable disease whose burden mostly affects women and children,” chairman of the Executive Board and Family Board of E. Merck KG Frank Stangenberg-Haverkamp said.
Professor Stangenberg says there is urgent need to research on how to prevent and treat non-communicable and infectious diseases in Africa adding that little knowledge exists about how best to strengthen health systems to cope with the double burden of infectious disease and non-communicable diseases.
Merck is a leading science and technology company based in Germany.
It is known that there is little research capacity within Africa. There is a shortage of faculty and research leaders, inadequate facilities and infrastructure, and few career opportunities for budding researchers.
Fortunately, there is now widespread acknowledgement that African researchers are best placed to ask questions that are relevant to African issues, and there is a slow move away from parachuting research questions in from high-income countries to address Africa’s problems.
United Nations Educational, Scientific and Cultural Organisation (UNESCO) deputy director general Getachew Engida says, “The good news is that Africa has the potential to engage in scientific research and what is needed is the commitment from researchers and policy-makers in order to realise the dream. Statistics have shown that only 3 percent of professionals in Sub-Saharan Africa engage in research and that is why Africa’s research contribution globally is very low.
Africa’s research contribution to the global output is only 0.05 percent.”
Mr Engida says lack of scientific research in Africa hindered the continent’s success to attaining the Millennium Development Goals (MDGs).
“Now is the time to engage in scientific research in order for Africa to achieve meaningful success on the Sustainable Development Goals (SDGs). There is need to strengthen research infrastructure, provide support and train young researchers, and offer them opportunities to present their research to peers and international experts in challenging but encouraging environments,” Mr Engida says.
The new world order of research seems to be to fund individuals to become leaders in their fields. This strategy might work for researchers in high-income countries, hot-housed in institutes with a culture of research, but it could be less beneficial for would-be researchers in Africa, who have had less exposure to good quality research.
It is known that the health-care successes in Africa have largely been driven by donor aid, providing vertical solutions to specific problems; however, health experts say that non-communicable diseases require complex care and strong health systems. Such are few and far between in Africa.
Kenya Ambassador and Permanent Representative to UNESCO Professor George Godia says Africa lacks resources to conduct primary research to inform precision public health approaches.
These resources include money, people, infrastructure and electronic public health records. All are critical.
“Implementing a precision public health approach is costly and it needs to be reviewed and updated continuously as understanding deepens and the environments that people live in change. Before Africa can boast its own examples it will first need to generate knowledge and data. This will take time which means that a precision public health approach to tackle disease won’t be yielding immediate results,” Prof Godia says.
Medical research cannot be done in a vacuum. For individuals to flourish they need support from mentors and colleagues, and they need help to formulate their ideas.
For Africa, the challenge is huge. There is sparse data on genomics and gene-environment interactions in African populations.
Scientists still do not know how populations with a particular genetic variant spectrum react to changes in the environment, such as an increase in poverty or lifestyle change during urbanisation, and what the likely impact of a particular genetic variants is.
In such a situation, scientists are prone to using interpretations based on research conducted elsewhere. In fact, people’s genetic background could have a profound effect on the way people react to their environment and to treatments. Only then will Africa begin to know how to treat the diseases more effectively. PUBLISHED IN THE ZAMBIA DAILY MAIL ON DECEMBER 11, 2016. LINK: https://www.daily-mail.co.zm/?p=88752
