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Submitted by Dr. O'Guido on
Editor, It is both tragic and ironic that the two classes of diseases resonate among themselves, each one adding to the burden of the other. This is more so in the third world where even the provision of potable water which was supposed to be realized by 1978 is still but a mirage. Poverty is fueled by uncontrolled population growth, as the poor segments of society tend to have more children to help in odd jobs to earn income. the indiscriminate onslaught of HIV has further complicated the equation. The solution lies at the very basics. Medical care and management of NCDs is much more expensive than for CDs yet governments are pouring scarce donor funds into the former while ignoring the latter. If we were to provide clean, running water and safe disposal of waste matter to each and every household that alone would have a great impact on morbidity/mortality across both spectra of diseases. In 2002, in an unpublished letter to major news houses in Kenya, I argued that putting PLWHA on ARVs on its own would not impact the progression of the disease, in the absence of supportive social structures and amenities that would over long-term relief. In current medical practice in Africa we are becoming overwhelmed by the imposition of diseases of affluence ( diabetes, hypertension, cardiovascular diseases etc) on a population already on its knees from diseases of poverty( malnutrition, anemia, diarrhoeal diseases etc) together with convergence of HIV/AIDS, cancers and Road traffic accidents. Serious thought needs to be given to the integration of lifestyle modification in school curricula so that children grow up knowing the consequences of poor life style habits. Education, prevention then treatment ought to be the order of care rather than the current treatment, prevention then education. thank you.