Changing lifestyles and rising urbanisation are resulting in a rise of non-communicable diseases (NCDs) in Kenya, prompting the government to roll out new initiatives in collaboration with the private sector.
According to some estimates, the NCD proportional contribution to the healthcare burden is forecast to rise by 21% by 2030. Africa is set to see the highest rate of increase in death rates from diabetes, cardiovascular diseases, cancer and respiratory diseases globally over the next decade.
Kenya, which identified the prevention and control of NCDs as a priority issue in its National Medium Term Plan that runs until 2018, and its National Health Strategic Plan, is eyeing further investment from the private sector to help meet its targets.
Rising economic burden
Even though the prevalence of diabetes and other NCDs in Kenya is well below some developed countries, the illness is on the rise. The prevalence of diabetes has grown from 1% of the population to 3.3% over the past ten years, according to the World Health Organisation (WHO). Other agencies put the incidence levels much higher, with the NCD division of the Ministry of Health estimating in November that more than 2m of Kenya’s 45m population is affected by diabetes, with this rate rising up to 10% in cities.
The need to address NCDs has become paramount for those involved in the healthcare system. Dr William Maina, who leads the Directorate of Preventive and Promotive Health Services for the Ministry of Health, noted the growing strain that diabetes and other NCDs are placing on the national health care system.
“We are seeing the burden of NCDs escalate in this country. If you walk into any hospital, you will find more than half the occupancy of hospital beds is due to NCDs. Almost half of deaths reported by hospitals are due to NCDs,” he said, quoted by the WHO.
The proposed allocation for the health sector in 2014/15 is KSh47.4bn ($524m) up from KSh 46.8bn ($517m) in 2013/2014. Although budgetary allocation to the sector has maintained a steady rise nominally, its share of the government’s total budget has remained relatively constant at 4.5%, but below the 15% which it needs to meet as a signatory of the 2001 Abuja Declaration.
According to the Institute of Economic Affairs, the sector’s performance in the recent past has been mixed, posting reduced HIV prevalence rates, reduced infant mortality rates but high maternal mortality rates. The Curative Health Services Programme is expected to take KSh19bn ($210m) or about 40% of the Ministry of Health’s budget in 2014/15.
The government has pledged to increase funding for testing schemes aimed at early detection of diabetes and is launching broader educational programmes to alert the community to the causes and threats of NCDs. It has also moved to subsidise the cost of insulin for diabetics, lowering the price of a vial of the medicine from KSh2,500 ($27.70) to KSh200-Sh500 ($2.20-$5.50) at government hospitals.
Kenya’s Ministry of Health Cabinet Secretary James Macharia acknowledged that the private sector can also play a greater role in directly combating NCDs, both through the expansion of pharmaceutical production in the country and by stepping up investments in private health care facilities.
“We have a big problem with diseases that are non-communicable, in particular cancer, renal diseases and cardiovascular disease,” he told OBG. “All of these are currently being treated abroad. If you have investors come in and implementing the same technologies as in South Africa and India, the majority of people will stop leaving for treatment in those countries and start being treated here.”
One example of a screening programme comes in conjunction with the private sector. An initiative launched in November between the Kenya Diabetes Management and Information Centre (DMI) and pharmaceutical firm Merck Serono is aimed at increasing the visibility and priority accorded to diabetes and other NCDs. As part of the campaign, more than 2000 community members will be screened for diabetes.
The rise in incidence of NCDs has also seen an increasing number of private companies taking out health insurance and investing in programmes to protect the health of their workforce.
Health promotional activities and improved coverage against the potential losses caused by NCDs are increasingly becoming a part of business strategy in Kenya, according to Peter Nduati, the CEO of Resolution Insurance Limited. “Sedentary lifestyles will fuel cancers, diabetes and cardiovascular ailments. Companies must be prepared to handle rising medical bills as these diseases take a heavier toll on young workers,” Nduati told a business forum in October.