African Region (AFR)

Noncommunicable diseases (NCDs) have traditionally been associated with affluent of

lifestyles in developed nations. However, at the dawn of the new millennium, NCDs now

pose a huge health challenge in Africa, and Swaziland is no exception. It calls for urgent

action from both the Government of Swaziland and non-state actors to address the risk

factors for NCDs and their determinants. While Swaziland finds itself facing an increase

in NCDs, maternal and child morbidity and mortality, HIV and AIDS, TB and malaria also

remain a huge public health concern.

A social determinant of health approach reveals that the health outcomes of individuals,

families and communities are influenced by the social and economic conditions in which

people are born, grow, live, work and age, and the systems put in place to deal with illness,

disability and premature death. This case study was conducted to identify how actions of

various sectors could be harnessed to address key determinants of noncommunicable

diseases including their risk factors.

A secondary analysis of government policy papers, strategic plans and WHO guidelines

was conducted in addition to key informant interviews. The study examined the presence

of intersectoral actions across progragrammes and sectors namely, health in all policies,

good governance for health, leadership and stewardship roles, adequate financing,

health literacy and community empowerment. The key findings are that there is an

unnoticed, unrecorded and unabated increase of noncommunicable conditions mainly

diabetes mellitus, cardiovascular disease, hypertension, respiratory problems and HIVrelated

cancers like Kaposi’s sarcoma. The associated major risk factors are alcohol and

tobacco consumption, physical inactivity and unhealthy diet. It is concluded that a rise in

noncommunicable conditions in Swaziland requires an intersectoral approach to ensure

effective and sustainable prevention and control.

Cancer research in Africa will have a pivotal role in cancer control planning in this continent. However, environments (such as those in academic or clinical settings) with limited research infrastructure (laboratories, biorespositories, databases) coupled with inadequate funding and other resources have hampered African scientists from carrying out rigorous research. In September 2012, over 100 scientists with expertise in cancer research in Africa met in London to discuss the challenges in performing high-quality research, and to formulate the next steps for building sustainable, comprehensive and multi-disciplinary programmes relevant to Africa. This was the first meeting among five major organizations: the African Organisation for Research and Training in Africa (AORTIC), the Africa Oxford Cancer Foundation (AfrOx), and the National Cancer Institutes (NCI) of Brazil, France and the USA. This article summarizes the discussions and recommendations of this meeting, including the next steps required to create sustainable and impactful research programmes that will enable evidenced-based cancer control approaches and planning at the local, regional and national levels.

The African Breast Cancer - Disparities in Outcomes (ABC-DO) study is a multi-country sub-Saharan African study of determinants of breast cancer outcomes. The number of women diagnosed with breast cancer per year is rising rapidly in Africa, and the consequences of poor survival are worsened by the young age of women affected. ABC-DO will recruit women from four public hospitals in Nigeria, Uganda, South Africa, and Namibia and examine the full journey of breast cancer patients, both pre- and post-diagnosis, in order to identify modifiable determinants of survival, to be able to prevent avoidable deaths from breast cancer in African women.

Introduction: Non-communicable diseases, and especially cancers, are recognized as an

increasing problem for low- and middle income countries. Effective control programmes

require adequate information on the size, nature, and evolution of the health problem which

they pose.

Methods: We present estimates of the incidence and mortality of cancer in Africa in 2012,

derived from “Globocan 2012”, published by the International Agency for Research on Cancer.

Results: There were 847,000 new cancer cases (6% of the world total) and 591,000 deaths (7.2%

of the world total) in the 54 countries of Africa in 2012, with about three quarters in the 47

countries of sub-Saharan Africa. While the cancer profiles often differ markedly between

regions, the most common cancers in men were prostate (16.4% of new cancers), liver (10.7%)

and Kaposi sarcoma (6.7%); in women, by far the most important are cancers of the breast

(27.6% of all cancers) and cervix uteri (20.4%).

Conclusions: These results are based on the best data currently available, and provide a

reasonable appraisal of the cancer situation in Africa. Nevertheless, there are still deficiencies in

surveillance systems, particularly in Sub-Saharan Africa and, specifically, of their most vital

component, population based cancer registries. With the number of annual cancer cases and

deaths likely to increase by at least 70% by 2030 there is a pressing need for a coordinated

approach to improving the extent and quality of services for cancer control in Africa, and better

surveillance systems with which they can be planned and monitored.