Photo: WHO/Chris de Bode
Cardiovascular diseases are a leading cause of death in Africa.
In sub-Saharan Africa, the leading cause of death in those over the age of 45 continues to be cardiovascular diseases. Interventions would not only save lives, but could also alleviate the huge financial burden measured in both health care costs and loss in productivity. In a Fogarty-supported study recently published in the British Medical Journal's Heart, Dr. Thomas A. Gaziano of Brigham & Women's Hospital reviews existing literature on cardiovascular diseases and provides guidelines to produce cost-effective interventions.
In the article, "Economic Burden and the Cost-Effectiveness of Treatment of Cardiovascular Diseases in Africa," Gaziano makes recommendations for management of major cardiovascular risk factors through changes in lifestyle and drug therapies. He provides a framework for the development of guidelines to prevent cardiovascular diseases, taking into account the particular political, economic, social and medical circumstances of sub-Saharan Africa.
Although screening for cardiovascular diseases is population-based, once individuals are identified as high-risk they require personal interventions for the management of their elevated risk, according to Dr. Gaziano. He suggests that these guidelines will be cost-effective if the approach targets high-risk individuals and relies on easily identifiable screening tools such as limited laboratory testing and opportunistic screening for hypertension and high cholesterol.
In another scenario he provides information on a program that was a combination of legislative, voluntary industry and mass media participation to reduce salt consumption--thus reducing the risk of cardiovascular diseases and the associated costs of treatment.
Gaziano also evaluated the cost-effectiveness of other specific interventions for ischaemic heart disease, congestive heart failure, stroke, diabetes, and rheumatic heart disease.
Cardiovascular diseases place an enormous financial burden on sub-Saharan African countries, both in direct costs of treatment and indirect costs of reduced workforce productivity. As a result, over a ten-year period Tanzania and Nigeria alone will lose $2.5 billion and $7.6 billion respectively, according to the WHO.
The majority of cost estimates for the sub-Saharan Africa region used in this study come from the WHO-CHOICE (Choosing Interventions that are Cost-Effective) program and the Disease Control Priorities Project (DCP2) in Developing Countries, a Fogarty-sponsored endeavor.
Economic burden and the cost-effectiveness of treatment of cardiovascular diseases in Africa. T A Gaziano. Heart. 2008; 94:140-144.
To learn more visit: http://heart.bmj.com/cgi/content/full/94/2/140