So far the data shows the following:
- In South Africa, which accounts for nearly half of all COVID-19 cases and deaths on the continent, 61% of the COVID-19 patients in hospitals had hypertension and 52% had diabetes. And 45% of people aged 60–69 who died from COVID-19 also had hypertension.
- In Kenya, around half of COVID-19 deaths occurred in people with NCDs.
- In the Democratic Republic of the Congo, such patients accounted for 85% of all COVID-19 deaths.
According to a preliminary WHO analysis of 14 African countries, hypertension, diabetes, cardiovascular disease and asthma are the co-morbidities most strongly associated with COVID-19 patients. These conditions require continuous treatment, but with the pandemic and decreasing healthcare capacity NCD services have been disrupted.
In a WHO survey of 41 countries in sub-Saharan Africa,
- 22% of countries reported that only emergency inpatient care for chronic conditions was available.
- 37% of countries reported that outpatient care was limited.
- Hypertension management had been disrupted in 59% of the countries.
- Diabetic complications management had been disrupted in 56% of the countries.
The disruption of services is likely to increase underlying conditions among NCD patients in Africa which will increase the NCD burden as well as their susceptibility to severe forms of coronavirus infection.
WHO has been working with member countries in Africa to increase service availability amidst the pandemic such as through telemedicine and has supported to increase basic care of NCDs. Further the WHO is working with African state governments to increase public awareness about the NCD and COVID-19 risk.
Alcohol – major NCDs risk factor
According to an analysis by Movendi International, alcohol fuels the global NCDs tsunami.
Latest scientific evidence about the global and regional burden of alcohol-related cancers, CVDs, digestive diseases, diabetes and mental ill-health depict a staggering reality:
- 4.2% of all cancer deaths are attributable to alcohol, with Europe and the Americas carrying the biggest burden.
- 3.3% of all CVD deaths are caused by alcohol, with Europe and Africa carrying the heaviest burden.
- 25.2% of all digestive disease deaths are alcohol-attributable, with Africa bearing the biggest burden. Worldwide, 283 million people aged 15+ years had an alcohol use disorder (AUD) and are at risk of alcohol-associated liver disease.
- 5.1% of adults worldwide suffered from an AUD and alcohol dependence (the most severe form of AUD) occurred in 2.6% of people of aged 15+ years in 2016. The regions with the heaviest burden are Europe and the Americas.
Alcohol weakens the immune system and is thus also a risk factor for contracting the coronavirus and more severe COVID-19 progression. Scientists have known for a long time that alcohol consumption is associated with negative health effects related to the immune system. Some of the connections that matter especially in the context of the coronavirus pandemic are:
- Susceptibility to pneumonia,
- Greater likelihood of acute respiratory stress syndromes (ARDS), and
- Slower and less complete recovery from infections due to alcohol use.
Importantly, alcohol consumption does not have to be chronic to have negative health consequences for the immune system.
Recommended policy best buys
The WHO recommends interventions to reduce alcohol use and tobacco use as these significantly increase the NCDs burden. The three best buy policies of increasing alcohol taxes, decreasing availability of alcohol and alcohol advertising bans can help with reducing alcohol use in the African region for long term public health benefits and aid in pandemic recovery.
For instance, the recent NCD control investment case for Zambia shows that over 15 years, the alcohol control policy package would restore over 200,000 healthy life years to Zambians.
Banning alcohol sales to reduce the spread of the virus and to reduce the healthcare burden implemented early on in South Africa when COVID-19 hit the country shows promising results and highlights the benefits of prioritizing alcohol policy solutions in the African region.