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Policymakers need to react to the chronic disease epidemic before it’s too late, says Francis Omaswa.

Africa needs to swap disease-based health systems for wellness-seeking systems in order to meet the coming epidemic of lifestyle-based diseases, according to Francis Omaswa, chancellor of Uganda’s Busitema University and founder of the UN Global Health Workforce Alliance.

Low- and middle-income countries account for 90 per cent of the 14 million people who die prematurely every year from non-communicable diseases such as diabetes, cancer and heart disease, according to the WHO.

Speaking on the sidelines of the annual meeting of the Tropical Health and Education Trust (THET) in London on 24 October, Omaswa said researchers needed to document the rising epidemic of non-communicable diseases in Africa in order to be able to convince policymakers of the need to act.
How big is the problem of non-communicable diseases in Sub-Saharan Africa?
It is growing, and it depends which country you are in, but non-communicable diseases are slowly getting equal to and are likely to overtake infectious diseases maybe in the next decade or so.
You really need to start now thinking about non-communicable diseases particularly about prevention, prevention, prevention. We have a rapidly growing urban population who are more sedentary, they are on a diet which is just like the Western diet and we really can do something about this now ‒ provided that there is understanding by our leaders that this epidemic is one which something can be done about.

What science do we need?
We need evidence, we need epidemiological information [on patterns of disease] first and foremost to document the extent of the rising epidemic, and then to use that epidemiological information to raise awareness and to influence policy.

Also we need studies on behaviour and how to get people to accept and recognise that some of the things they do, the choices that they make, should be pro-health rather than anti-health as it is now. Then we need to do a lot of work in schools to get the children as they grow up to understand how they can promote their own health and how to avoid getting into the trap of non-communicable diseases.
What will happen if we ignore this epidemic?
We had a terrible life expectancy drop with HIV; we are recovering from that, but it is going to be stunted if we don’t get on top of non-communicable disease. And then [in relation to] this talk about universal health coverage, the cost of treating a non-communicable disease is much higher than that of treating infectious disease, and we will just not have the wherewithal to address the epidemic which is coming.
Apart from advising politicians, what other capacity do countries such as Uganda need in order to tackle this epidemic?
Health systems should be wellness-seeking health systems rather than disease-based health systems. Wellness health systems are health systems which are encouraging people to take advantage of the natural health we are born with, and to make sure that we do not interfere with those internally built health-promoting mechanisms. If you are hungry, you eat; if you are tired, you rest; if you are hot, you sweat. That is what we should be encouraging people to respond to. Your body is your best doctor. If you obey your body you are very unlikely to fall ill.

The health system which is wellness-seeking is the health system of the future and it is the one we should be advocating for African governments to adopt.
Are African governments receptive to this message?
It is our job to package and present these messages to our political leaders and our government so that they see in these messages votes for themselves.