Addressing NCDs in Kenya by eliminating key risk factors

“It not just about diagnosis, but diagnosis will precede treatment and we can diagnose people and not get them on treatment which is a mistake, we can diagnose people and get too many people on treatment which is a mistake, and we can diagnose and treat but pay too little attention to prevention, which of course is a mistake… none of these pieces by itself is sufficient." — John Peabody, CEO Qure Healthcare

Noncommunicable diseases (NCDs), also referred to as chronic diseases, are known to cause more than 41 million deaths each year globally.

These diseases, which rob people of their most productive years, include cardiovascular diseases, respiratory diseases, diabetes, and cancer among others. NCDs are largely caused by avoidable risk factors including use of tobacco products, harmful use of alcohol and consumption of unhealthy diets.  

Deaths caused by NCDs are highly preventable and actions need to be taken in order to rise above them. This is the reason why this year’s Global Week for Action on NCDs was all about accountability; pushing for progress of the commitments made towards addressing NCDs and monitoring how governments are using resources channeled to this sector.

Much has been said in the past and it is now time to call on governments to take action on NCDs’ prevention and control by among other things, addressing the factors that intensify their prevalence and creating robust health systems that are accessible, affordable, efficient and equitable It is time to maximise on what has been proven to work.

Given that NCD risk factors are modifiable, prevention of NCDs is possible to some extent. It is a key intervention in this fight and a lot of efforts should be directed to it.

Use of tobacco products, which is the leading risk factor for most NCDs and the greatest preventable cause of death globally, should be countered so as to prevent the progress of tobacco related NCDs.

The government of Kenya has committed to the fight against tobacco use in the country by being party to the World Health Organization Framework Convention on Tobacco Control.

Kenya has also recognized the need to advocate for the scale up and full implementation of tobacco control laws as a way of countering use of tobacco and nicotine products in the 2015-2020 National Strategy for the Prevention and Control of NDCs.

The country is also committed to the global target of reducing the use of tobacco by 30 per cent by 2025 and to attain this, there is need to translate these commitments into action. Maybe a good place to start would be delisting tobacco products from the list of essential food products during Covid-19 pandemic.

Another action would be to deregister the nicotine pouch Lyft as a pharmaceutical drug. This new product is highly addictive and readily accessible to young people as it is being sold in almost all points of sale.

It is time for the government to implement the provision of the Tobacco Control Act, 2007, which provides for the protection and promotion of the interest of tobacco growers by providing viable alternative crops.

This action will not only help tobacco growers but also counter the negative effects on the environment and help eradicate extreme hunger and abject poverty.

Harmful use of alcohol has overtime become a major risk factor for NCDs such as liver cirrhosis, heart disease and cancer. Yet it is listed as an essential food product during Covid-19 pandemic here in Kenya. Besides increasing the risks of NCDs, high intake of alcohol also causes road traffic accidents and instigates violence and crimes.

Consumption of unhealthy diets in Kenya has also led to a rise in NCDs particularly cardiovascular diseases. It is estimated that about 25 per cent of hospital admissions in the country are due to cardiovascular diseases.

At this rate there is need for the country to align itself with the global action plan to eliminate industrially produced trans-fatty acids, which increase the amount of harmful cholesterol in the blood stream. The government should meet the efforts seeking to address the growing problem of cardiovascular diseases in Kenya led by the International Institute for Legislative Affairs. These efforts were recently recognized in the Progress Report on Global Trans Fat Elimination 2020 released on 9 September 2020.

Prevention and control NCDs risk factors translate to timely interventions which saves Kenyans from incurring expenses, most of the times, out-of-pocket- expenses to treat these diseases. By investing in preventing and control measures, the government makes a huge economic investment.

For instance, in the recently launched report prepared by the appointed mental health taskforce, it is noted that, ‘for every shilling invested in mental health, the country gets five shillings back in benefit’.

Maximising prevention and control measures is not solely a government job, multisectoral partnerships are vital. The private sector and civil societies need to join forces with the government to build a strong sustainable health system that is able to detect and treat NCDs.

Working together to fight NCDs means aligning priorities, which is understandably a hard thing to do at the beginning. Think of one government department that is tasked with the responsibility of fighting alcohol abuse and another that is responsible to licensing alcohol business.

Also think of a private company producing ultra-processed foods and a civil society determined to fight the prevalence of foods containing trans-fatty acids. Yet all these groups need to come together to fight a common evil ─NCDs. This is extremely difficult but with strategic plans and overall goals in place, it is achievable. In Kenya, the Vision 2030 which perceives a high quality of life for all its citizens is one of such goals that can help bring together stakeholders in the fight against NCDs.

Being accountable in the prevention and control of NCDs risk factors will help the country realise the Social Development Goal (SDG) that targets to reduce a third of premature deaths caused by NCDs. We therefore call upon the government to accord NCDs the action they deserve and help Kenyans realize their right to highest attainable standard of health.

Celine and Elizabeth works with the International Institute for Legislative Affairs