Ethiopia working with UN to strengthen national NCD response (A WHO feature)

25 Décembre 2017

Addis Ababa, Ethiopia, December 25 (Infosplusgabon) - All of government action is needed to prevent and control the health and development impacts of noncommunicable diseases (NCDs) in Ethiopia, the Minister of Health has told the United Nations Interagency Task Force on NCDs during its recent mission to the country.

The Task Force was informed that in recognizing the threat posed by NCDs, Ethiopia and the United Nations system in Addis Ababa has prioritised action on cardiovascular and lung diseases, cancers and diabetes as part of the 2016-2020 UN Development Assistance Framework for the country.

“NCDs are a major threat to Ethiopia’s health and prosperity,” Ethiopian Minister of Health Professor Yifru Berhan Mitke told UN NCDs Task Force members. “We must continue to address maternal and child health as well as communicable diseases, but we must also protect our population from NCDs and ensure access to quality prevention and treatment services.”

"NCDs are a major threat to Ethiopia’s health and prosperity."

Ethiopia is facing a rapid rise in NCDs and the main common risk factors causing these conditions, namely tobacco use, harmful use of alcohol, unhealthy diet, physical inactivity and environmental pollution. The country is also witnessing an increase in mental disorders and injuries.

Today, NCDs account for 42% of deaths in Ethiopia. By 2040, they are projected to account for almost 70% of the country’s disease burden, up from 17% in 1990. Especially worrying is that most NCD deaths in Ethiopia, as elsewhere, are premature (i.e. before age 70), according to the UN World Health Organisation,

“The impacts of NCDs in Ethiopia are great, in terms of lives lost, human suffering and the costs to the labour force and economy,” said the World Health Organization’s Dr Nick Banatvala, lead of the Task Force, which visited Ethiopia from 13-17 November.

The Mission was conducted to support the government’s efforts to tackle NCDs, mental health and injuries from multiple causes including road traffic accidents and included representatives from WHO, United Nations Development Programme, World Bank, United Nations Population Fund, and United States Centers for Disease Control and Prevention.

Professor Mitke said it was a priority for the health ministry to support other government departments to work jointly to address NCDs. “We recognise that many of the solutions to NCDs lie in the domain of sectors beyond health, for example finance, urban planning, housing, education, and labour,” the Health Minister explained.

WHO said key NCD risk factor trends in Ethiopia indicate a problem that will worsen without urgent action. National prevalence of high blood pressure is 16%, with rates in some parts of the country as high as 25%. Only 4.8% of adults use tobacco, but rates are higher among youth and projected to increase. Harmful use of alcohol among adults is around 12.4%, and the booming alcohol industry in the country means this number could surge, too.

“We recognise that many of the solutions to NCDs lie in the domain of sectors beyond health...,” Prof. Mitke said

Ethiopia continues to confront undernutrition, but overweight and obesity are increasing in urban centres, where levels of physical inactivity are three times higher than in rural settings. Nearly all Ethiopian adults (97.2%) do not consume enough fruits and vegetables. Adult use of khat (15.8%), a shrub native to East Africa sometimes used as a stimulant that potentially poses a major issue for mental health.

During the visit, the Task Force members identified concrete steps different sectors can take to address NCDs and advance their core interests simultaneously.

Discussions, which centred on how NCDs impact the national development agenda and multiple sector-specific objectives, were held with the Office of the First Lady, the Minister of Cabinet Affairs at the Prime Minister’s Office, and high-level government officials from a number of different line ministries.

The Task Force also met with the United Nations Country Team (UNCT), United Nations Economic Commission for Africa (UNECA), development partners including United States Agency for International Development (USAID), Department for International Development (DFID), the African Development Bank (AfDB), and civil society representatives.

NCDs impact Ethiopia’s development on multiple fronts, from lost productive capacities to out-of-pocket spending impoverishing families and children dropping out of school to care for a sick relative.

With support from the Task Force, the government identified priority actions in a number of areas, including ensuring that early diagnosis and treatment of NCDs, mental disorders and injuries are included in basic health service delivery, in the context of universal health coverage (UHC).

“There are clear opportunities to integrate action on NCDs within UHC, including expanding the national cervical cancer programme and developing the capacity of health care workers, including health extension workers, on NCDs and mental health,” said Roy Small, UNDP Policy Analyst and one of the Task Force members.

An important approach is to maximize the impact of existing government and development assistance efforts on NCD-linked areas, from pilot projects to reduce hypertension to programmes on basic service provision to communicable disease platforms and partnerships.

Dr Banatvala stressed that Ethiopia, like all countries, cannot simply treat its way out of NCDs – primary prevention is critical. A major concern to the Joint Mission was that the 2017 WHO Tobacco report indicates no excise tax on tobacco products in Ethiopia, despite a global recommendation of a 70% excise tax.

An immediate focus on increasing tobacco excise taxes would reduce tobacco consumption, provide a revenue stream for government, and make clear Ethiopia’s political commitment to act on NCDs ahead of the Third-high Level Meeting on NCDs in 2018.

The Mission team found Ethiopia to have significant political commitment to develop both an NCD multisectoral plan and an NCD coordination mechanism. These planning and governance steps, together with inclusion of NCDs, mental health and injuries in the Health Sector Transformation Plan and the Third Government Transformation Plan (GTP3), would set Ethiopia up for success.

The UNCT with the support of its regional and global offices plans to map how it can provide catalytic technical support to the Government to implement the Mission’s recommendations, working also with international development partners to identify required resources.

“NCDs impact Ethiopia’s development on multiple fronts, from lost productive capacities to out-of-pocket spending impoverishing families and children dropping out of school to care for a sick relative,” said Ms. Ahunna Eziakonwa-Onochie, UNDP Resident Representative and UN Humanitarian Coordinator in Ethiopia.

The UN Development Assistance Framework 2016-2020 includes specific attention to NCDs for these very reasons, in addition to the direct health burdens. As a UN family, we are committed to supporting whole-of-government and whole-of-society efforts to address NCDs in line with Agenda 2030.”

In relation to this, Dr. Akapaka A. Kalu, WHO Representative to Ethiopia, said it was important to define the roles of different sectoral ministries, relevant government offices, development partners and the UNCT in accelerating the NCD agenda.

“The United Nations Interagency Task force can support the government and UN Country Team to hold a high-level summit to secure commitment from all relevant stakeholders for a whole-of-government and whole-of-society approach to NCDs in Ethiopia, with high-level political leadership,” DR. Kalu said.

FIN/INFOSPLUSGABON/IYT/GABON 2017

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