CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 5, June 2012
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AFRICA
Mauritius, Niger, Kenya, Zambia and South Africa.
4
However,
according to the latest (2010) global progress report on
implementation of the FCTC, only 50% of parties in the African
region reported implementing a comprehensive ban on tobacco
advertising, promotion and sponsorship.
5
Our job therefore is to
advocate for the full implementation of the FCTC, and at the
same time push for more public-health campaigns to educate
people on the links between tobacco consumption, CVD and
premature death.
Collaboration with the private sector is also imperative. Let us
consider access to healthy food as an example. The factors that
influence an individual’s ability to eat healthily are many, and
are often beyond the control of that individual. In Africa, where
many countries are increasingly experiencing a dual burden
of obesity and malnutrition, strategies are required not just to
affect an individual’s consumption of food but to modify food
production processes.
We can spearhead strategies to reformulate food products,
to distribute healthy food options to those communities most
in need, to promote and foster incentives for fruit and vegetable
consumption, and to educate consumers to drive healthy food
choices among those who have options available to them. We may
face resistance from some corporate leaders, policy makers and
even donors, so advocacy to stress the need for action is required
alongside the development of new and creative partnerships that
meet both health and corporate objectives wherever possible.
We must also campaign for companion strategies for policies to
change food production in the long term.
We must work with healthcare providers to implement
strategies that improve access to care and treatment. Consider
blood pressure: in high-income countries, widespread screening,
diagnosis and treatment have led to an impressive decrease in
mean blood pressure,
1,6
and correspondingly a drop in mortality
from stroke and coronary heart disease is to be expected. Yet in
Africa, more than one in three people (36.8%) are estimated to
have raised blood pressure, and the prevalence is increasing.
1,6
Improving the availability of screening in primary care
and treatment of high blood pressure with affordable essential
drugs, including aspirin and statins, will prove vital to reducing
premature CVD mortality in developing countries. More
research is also needed to understand the burden of hypertension
in the region in order to tailor approaches to addressing it. The
distribution of penicillin to prevent rheumatic heart disease is a
similar strategy that would cost little but have great impact. It is
essential that we tackle these global inequalities in order to meet
the target.
Although we applaud the progress made at the World Health
Assembly, the above examples show the complexity of CVD
management. The global target is a landmark achievement that
obliges action to deliver change for people with or at risk of
NCDs and especially CVD. However, in isolation it is not enough
– further targets are needed to shape a more complete framework
and better guide collaborative, global action against CVD and its
risk factors.
We must keep the pressure on our governments to ensure
the best possible outcomes for the millions of people suffering
from CVDs and to avoid the 17.3 million deaths that occur each
year. Specific targets are being considered for adoption around
reducing the consumption of tobacco, salt/sodium, trans fats, and
harmful levels of alcohol; reducing physical inactivity, elevated
blood pressure, cholesterol and obesity; and ensuring access
to affordable, quality-assured essential medicines, including
multidrug therapy for people who have been identified at high
risk of CVD.
The window of opportunity to change the face of CVD
forever is now and throughout the year, since the final targets
will be agreed by member states in October 2012. We call on the
CVD community to champion the additional targets, and push
world leaders to agree on these promptly. Together we can avert
deaths from CVD using proven interventions, and save lives
around the world.
For further information about the work of the World Heart Federation, please
visit
or follow on twitter: @worldheartfed.
JOHANNA RALSTON,
Chief Executive Officer, World Heart Federation, Geneva,
Switzerland
References
1.
World Health Organization. World Health Statistics 2012. [online]
Geneva: World Health Organization. Available at: <
/
publications/world_health_statistics/EN_WHS2012_Full.pdf>
2.
The United Nations General Assembly. Political declaration of the
High-level Meeting of the General Assembly on the Prevention and
Control of Non-communicable Diseases [online]. New York: United
Nations. Available at: <
admin/user_upload/documents/members-only/Global_Health_Agenda/
UN_Health_Summit_on_NCDs/UN_HLM_NCDs_PD_english.pdf>
3.
World Health Organization. 65th World Health Assembly closes with
new global health measures. Press release, 26 May 2012. Available
at:
-
es_20120526/en/index.html#>
4.
Global Smokefree Partnership. Global map of smokefree laws 2011
[online]. Global Smokefree Partnership. Available at: <
.
globalsmokefreepartnership.org/index.php?section=artigo&id=32>
5.
WHO Framework Convention on Tobacco Control. 2010 Global
Progress Report on Implementation of the WHO Framework
Convention on Tobacco Control [online]. Geneva: World Health
Organization. Available at: <
/
progress_report_final.pdf>
6.
World Health Organization. World Health statistics – A snapshot of
global health [online]. Geneva: World Health Organization. Available
at:
_
WHS2012_Brochure.pdf
