E-DRUG: 50 million Africans to die from heart disease
-----------------------------------------------------------------
[copied as fair use from "The Irish Times on the web"
http://www.ireland.com/newspaper/health/2000/0918/health3.htm
Here's a problem where very affordable, non-patented generic drugs
can make a difference... if we just had good quality health services
and the essential drugs on the shelves... WB]
Monday, September 18, 2000
Heartfelt neglect in Africa
While most resources are directed at treating AIDS, thousands of
Africans are dying from heart disease. David Monagan reports from
a recent conference on the issue
One out of 10 of the half billion people in sub-Saharan Africa is
dying from cardiovascular disease. Their plight seems to go
unnoticed by local governments and international relief agencies
who are preoccupied with the AIDS crisis.
A picture of neglect, with one out of eight people - a large number
of them children - suffering from rheumatic heart disease was
painted by African cardiologists and international physicians at a
recent meeting of the European Society of Cardiology (ESC) in
Amsterdam. Another 10 to 20 per cent of the sub-Saharan
population - as many as 10 million people in Nigeria alone - are
beset with dangerously elevated high blood pressures that lead to
heavy rates of haemorrhagic strokes.
In the sprawling cities of Africa, where cigarette smoking, familial
dislocation and fatty Western diets are on the rise, rates of
hypertension are rapidly becoming doubled, reported Dr Walinjom
Muna, president of the Pan African Society of Cardiology.
"While we in Europe are fighting for minute improvements in
existing therapy, and often increasing the cost of care
unreasonably in these pursuits, there are things happening around
us that are very much more important," Lars Ryden, president of
the ESC, warned at the opening of the first international medical
meeting devoted to heart disease in Africa.
"The AIDS epidemic has taken the wind out of the treatment of non-
communicable diseases like hypertension, along with some of the
momentum we had going in trying to get the policy-makers to
listen to us," said Dr Muna, who is chairman of the department of
medicine at the University of Yaounde in Cameroon.
In a region where the average life span is 47 years - and as low as
27 in AIDS-and warfare-wracked Sierra Leone - Dr Muna said it was
hard to get authorities to focus on the withering long-term impact of
high blood pressure.
But impassioned audience members pointed out that this condition
can be controlled with generic drugs that cost as little as three to
five pence a day.
Cardiologist Dr Edmond Bertrand of Marseille, who spent 30 years
working in the Ivory Coast and Cameroon, noted that huge numbers
of African children are also suffering from the staph infection-borne
rheumatic fever which often leads to a gross swelling of the heart's
pumping chambers and death at an early age. The root organism is
spread through poor sanitation, overcrowded housing and sexual
promiscuity, he said.
In northern Africa, as much as 40 per cent of the population now
has rheumatic heart disease. Although the incidence drops off
closer to the Equator, the sub-Saharan young are
disproportionately afflicted. A quarter of those with rheumatic heart
disease are under 15. Of those who make it to hospital, 95 per
cent already have dangerously swollen hearts; 60 per cent have the
full-blown congestive heart failure that typically afflicts Europeans
at a much older age.
So deep are the health problems of the continent that even Dr
Bertrand's simple plea provoked controversy, with some
remonstrating that emergency room valve surgery is pointless in a
region where only three of 48 countries have any open-heart
programmes at all.
Dr Tony Golby of Johannesburg, South Africa, responded: "I do not
believe that the politicians, the economists, the third-party payers
can force us to stop treating patients, especially when they're
children - no matter what the global view is - at the expense of
saying we can do more with prevention".
Sweden's Dr Ryden, a board member of the World Health
Organisation (WHO), which sponsored the symposium, countered
that only massive regional public health initiatives could restrain the
growing dimensions of the cardiovascular disease problem in
Africa. He promised that the WHO and other international bodies
were determined to bring increased focus to the problem.
"There is no doubt in anybody's mind that none of the sub-Saharan
African countries can afford to treat cardiovascular diseases and
that is the urgent reason why we must do everything possible to
prevent an epidemic from spreading before it is too late," added Dr
George Mensah, of the Cardiovascular Health Branch of the US
Centers for Disease Control in Atlanta, Georgia.
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.