Message of the WHO Regional Director for Africa, Dr Matshidiso Moeti, on World Health Day, 7 April 2017

World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of the World Health Organization. This year, the theme is “Depression, let’s talk” to draw attention to the global burden of this common mental disorder.

About 322 million people around the world are affected by depression. It is the leading cause of disability worldwide, and a major contributor to the overall global burden of disease. In the African Region, close to 30 million people suffer from depression.

We are all at risk: it affects people of all ages, from all walks of life, in all countries. Stigma and fear of social isolation are significant barriers to seeking help. There’s an urgent need to prevent and treat those affected by this serious and complex mental health condition. Simply talking about depression can help prevent it by breaking down stigma. Seeking help by talking with trusted people can be a first step towards recovery.

Early recognition of the symptoms is key to preventing depression from becoming a chronic illness. WHO defines depression as an illness characterized by persistent sadness, loss of interest and ability to perform daily activities for a period of over two weeks. It is associated with feelings of guilt or low self-worth, disturbed sleep or appetite, tiredness and poor concentration. Major causes of depression include loss of loved ones or relationships, poverty, unemployment, physical illnesses, alcohol abuse, drug use, and traumatic situations such as violence and war.

At worst, depression can lead to suicide, which is the second leading cause of death in 15 – 29 year olds globally. Depression varies by age, peaking in older adults aged 55-74 years, but also occurring in children and adolescents. Left untreated, depression can be recurrent, long-lasting and debilitating. It impairs an individual’s ability to cope with daily activities, and can have devastating consequences for relationships with families and friends.  

Resources to prevent, identify and treat mental health problems such as depression are very scarce. The African Region has a critical shortage of qualified professionals for mental health, with just one psychiatrist per one million people and a similar number of psychologists. The mental health workforce of psychiatric nurses, occupational therapists and social workers is woefully inadequate. Lack of availability of psychotropic medicines, proper information with well-structured psychotherapy and other effective measures for primary healthcare services to treat depression is cause for concern.  

WHO has published guidelines to help countries to increase and improve healthcare services for people with mental health disorders through care provided by health workers who are not specialists in mental health. These include the mental health Global Action Programme and intervention guide, and the Global Mental Health Action Plan (2013-2020).  With proper care, psychosocial assistance and medication, millions of people in the Region with depression could begin to lead normal lives, even where resources are scarce.

As we commemorate World Health Day, I call on countries to support mental health programmes by allocating adequate human and financial resources to respond to this growing burden. I appeal to Member States to include mental health in their national health development agenda. The Brazzaville Declaration on Noncommunicable Diseases states the necessary steps for achieving this. More broadly, governments, partners and civil society can work together to bring depression out of the shadows in the Region. WHO is committed to supporting countries to address it as an important public health problem.

Developing community-based services which focus on depression - and talk out against stigma - will encourage more people to seek treatment. This can be done by having conversations about depression the same way we do with any other disease. School-based programmes which provide counselling and support persons with depression and their families, as well as early detection and prevention especially among children and youths, are also strategies to keep depression at bay.

Individuals, families, caregivers and communities can take steps to help prevent depression by avoiding stressful situations, alcohol abuse and drug use. Maintaining a proper diet and physical activity can improve wellbeing and can prevent depression. Depression is preventable and treatable if diagnosed early. Let’s talk about it.