This report draws on a comprehensive review of the literature and on input from policy makers, researchers, and practitioners to address four questions: (1) how is the growing burden of non-communicable diseases (NCDs) and road traffic injuries (RTIs) changing the epidemiology of Sub-Saharan Africa? (2) What determines and drives this burden, and what are the commonalities with communicable diseases? (3) What is the rationale for public intervention? (4) How could resource-constrained governments approach NCD prevention and treatment and road safety in a comprehensive, effective and efficient way? The data show that action against NCDs and RTIs in Sub-Saharan Africa is needed, together with continued efforts to address communicable diseases and maternal and child health as well as to reach the Millennium Development Goals (MDGs). The report suggests that NCDs and RTIs should not be tackled separately as a vertical program, nor should they displace communicable diseases as priorities. Instead, given resource constraints, and some shared determinants, characteristics, and interventions, there is scope for an integrated approach focusing on functions (prevention, treatment, and care) rather than on disease categories. Examples are cited of potential opportunities to integrate and add NCD prevention and treatment into existing services and programs. Proven, cost-effective, prevention interventions are clearly needed, many of which (such as tobacco and alcohol taxes, road safety measures, and fuel-efficient ventilated cook-stoves) require action beyond the health sector. These can deliver broader development benefits in addition to their benefits for health. Selective, evidence-based actions to reduce NCDs and RTIs will address the changing disease burden in Africa and achieve a more sustainable improvement in health outcomes, more efficient use of resources, and better equity across patients and populations.
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