Lives of hundreds of millions of people globally are affected by the four non-communicable diseases (NCDs) – cardiovascular and lung diseases, cancer and diabetes.
A reminder may be timely, however, that as many people are affected by mental and neurological disorders (MNDs), including depression, anxiety disorders, bipolar disorder, schizophrenia and dementia. Kenya is ranked sixth with the highest number of depression cases among African countries by a World Health Organization report (2016).
These conditions cause suffering; cut lives short and threaten social and economic development. The figures are striking. According to WHO, NCDs are the major killers of our time, causing 70 per cent of deaths worldwide. Each year they kill 15 million people between the ages of 30-70. Over 300 million people suffer from depression and around 50 million live with dementia. Close to 800, 000 people die of suicide, the second leading cause of death in 15- 29 age bracket.
NCDs and MNDs frequently co-occur: They can be precursors and consequences of one another, and have severe impacts. People who suffer from common mental disorders – depression and anxiety disorders – are at higher risk of developing heart diseases and diabetes.
In parallel, people with heart diseases have a higher risk of developing depression. The prevalence of depression among people with heart diseases is up to three times higher than in the general population. People with heart diseases and depression have a much worse prognosis in terms of survival and quality of life. NCDs are responsible for about a fifth of all years lived with disability, and major depression and anxiety disorders are among the leading causes of years lived with disability.
The government’s response to tackle NCDs and promote mental health and well-being has generally been slow, uneven, and inadequate and fragmented, despite world leaders’ global commitments to address these challenges. Both NCDs and MNDs arise from a combination of common genetic and biological, psychosocial and behavioural, social and environmental factors. Risk factors for NCDs such as sedentary behaviour, unhealthy diets and harmful use of alcohol are also risk factors for MNDs.
Integrating NCD and mental health services into primary care requires training and support for health workers in diagnosis and treating and establishing links to secondary care. An integrated approach can improve accessibility and affordability, reduce fragmentation, improve efficiency, prevent duplication of infrastructure and services.
Nairobi
