Epidemiological Change and Chronic Disease in Sub-Saharan Africa offers new and critical perspectives on the causes and consequences of recent epidemiological changes in sub-Saharan Africa, particularly on the increasing incidence of so-called ‘non-communicable’ and chronic conditions. Historians, social anthropologists, public health experts and social epidemiologists present important insights from a number of African perspectives and locations to present an incisive critique of ‘epidemiological transition’ theory and suggest alternative understandings of the epidemiological change on the continent. Arranged in three parts, ‘Temporalities: Beyond Transition’, ‘Numbers and Categories’ and ‘Local Biologies and Knowledge Systems’, the chapters cover a broad range of subjects and themes, including the trajectory of maternal mortality in East Africa, the African smoking epidemic, the history of sugar consumption in South Africa, causality between infectious and non-communicable diseases in Ghana and Belize, the complex relationships between adult hypertension and paediatric HIV in Botswana, and stories of cancer patients and their families as they pursue treatment and care in Kenya. In all, the volume provides insights drawn from historical perspectives and from the African social and clinical experience to offer new perspectives on the changing epidemiology of sub-Saharan Africa that go beyond theories of ‘transition’. It will be of value to students and researchers in Global Health, Medical Anthropology and Public Health, and to readers with an interest in African Studies.

Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population. In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health. This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011.

The closure of the Millennium Development Goals (MDGs) in 2015 prompted the need for a book of this kind. An interdisciplinary group of global health scholars contribute to the understanding of the emerging and fast-growing problem of the dual burden of communicable and non-communicable diseases (NCDs) in Africa. This book is timely, as the international community has moved from the MDGs to adopt the Sustainable Development Goals (SDGs) as the blueprint for a new human development agenda. Contributions and case studies are situated in the revised Epidemiologic and Nutrition Transition Model to capture the current situation, referencing communicable and NCDs on the African continent. The case studies encapsulated aim to help minimize negative health outcomes and improve population health, well-being, and equity in the future. This book will be significant in policy circles to assist international organizations, governments, and United Nations agencies. It aims to chart the future for health in Africa in light of recently adopted SDGs. This book is also a useful complementary reader for global public health related courses.

Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.

This paper looks at the way in which the pattern of disease is changing in developing countries, and the implications this has for the way in which primary health care (PHC) programs should be designed and managed. In the absence of an accepted methodology for discussing health management issues, it attempts to develop a conceptual framework suited to analyzing an environment of dynamic change. It applies this framework first to the management of primary health care programs provided by governments, and then to the role of the non-government sector in primary care. The paper draws broad clients. If the general approach adopted seems useful, the conceptual framework needs next to be applied to a series of specific country cases to test its validity and refine it, and to adapt the general conclusions to local cultural, administrative and political conditions.

Noncommunicable diseases (NCDs) are by far the major cause of death in lower-middle, upper-middle, and high-income countries; by 2015, they will also be the leading cause of death in low-income countries. In addition to mortality, NCDs account for nearly half of the disease burden measured in disability-adjusted life years (DALYs) in low- and middle-income countries, and large increases in NCD-related DALYs are projected. Addressing this challenge will require policy makers to design and implement economic, health, and social policies to address the links between NCDs and poverty and to minimize the health and economic losses among the population. Public Policy and the Challenge of Chronic Noncommunicable Diseases provides a framework that policy makers can use to formulate their strategies. The authors point out that the most effective policy response will be twofold: to develop programs to avoid the looming NCD burden of disease to the extent possible-for example, through public health interventions and improved health care-and simultaneously to prepare to address the health system and economic pressures that will arise from the increase in NCDs due to the aging of populations. This book will be of interest to governments, international organizations, universities, and research institutions focusing on health care, economic policy, public health, and poverty reduction strategies. Book jacket.

"The essays in this collection are written to make readers (re)consider what is possible in Africa. The essays shake the tree of received wisdom and received categories, and hone in on the complexities of life under ecological and economic constraints. Yet, throughout this volume, people do not emerge as victims, but rather as inventors, engineers, scientists, planners, writers, artists, and activists, or as children, mothers, fathers, friends, or lovers - all as future-makers. It is precisely through agents such as these that Africa is futuring: rethinking, living, confronting, imagining, and relating in the light of its many emerging tomorrows"--