Report on Joint Mission of the United Nations Interagency Task Force on the prevention and control of Non-Communicable Diseases
A joint programming mission of the United Nations Interagency Task Force on the Prevention and Control of Non-communicable Diseases (UNIATF) to Ethiopia was held from 13-17 November 2017. Ethiopia is experiencing an increase in non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, diabetes , chronic respiratory diseases, mental neurological and substance problems, injury and eye health and their shared risk factors (tobacco use, harmful use of alcohol, unhealthy diet, physical inactivity, khat use and environmental pollution). Major NCDs (cardiovascular diseases, cancers, diabetes, chronic respiratory diseases) account for 30% of total deaths and the probability of dying prematurely (between ages 30 and 70 years) from one of the four main NCDs is 15%. Injuries account for 10% all deaths in Ethiopia. Mental disorders account for 11% of the disease burden in Ethiopia; major depressive disorder alone is the third leading cause of years of life lost due to disability. National prevalence of high blood pressure is 16%, while the prevalence of high blood sugar is 6%. Recent data suggest that by 2040, NCDs will account for nearly 70% of disability adjusted life years (DALYs) in Ethiopia. There was significant concern from almost all ministries about the impact of NCDs on the country’s economy and productivity.
National health sector strategies for both NCDs and mental health expired in 2016 and are being updated, with plans for an additional multi-sectoral strategy. The Joint Mission learnt that over 97% of individuals diagnosed with high blood pressure do not receive treatment. Of the small proportion receiving treatment, almost half do not have their blood pressure controlled. Those with untreated or ineffective treatment of high blood pressure are at significant risk of premature mortality from heart disease and stroke. Ethiopia’s health workforce (0.7/1000 population) is far below the minimum required (2.3/1000 population) to provide universal health coverage and the current average across Africa (1.6/1000 population). Diagnostic facilities and treatment for NCDs and their risk factors (e.g. hypertension and diabetes) is extremely limited in primary care. The national cervical cancer programme has extremely limited coverage. Only around 60 out of the 311 hospitals in the country are providing mental health services currently and these are mainly concentrated in Addis Ababa. Despite specialist training programmes initiated by the government, there is severe shortage of mental health workforce in most facilities and general health workers in primary care do not receive adequate training and supervision to be able to deliver mental health care.