WASHINGTON, September 4, 2013 -- In the last two decades, the global health landscape has undergone rapid transformation. People around the world are living longer than ever before, and the population is getting older. The number of people in the world is growing. Many countries have made remarkable progress in preventing child deaths. As a result, disease burden is increasingly defined by disability instead of premature mortality. The leading causes of death and disability have changed from communicable diseases in children to non-communicable diseases in adults. Eating too much has overtaken hunger as a leading risk factor for illness. While there are clear trends at the global level, there is substantial variation across regions and countries.
Nowhere is this contrast more striking than in Sub-Saharan Africa, where communicable, maternal, nutritional, and newborn diseases continue to dominate. Dramatic progress has been made in reducing the loss of life from many types of communicable diseases and conditions of early childhood, especially diarrheal diseases and lower respiratory infections. These diseases still account for the most health loss in the region, but their relative burdens are much lower today than 20 years ago.
This publication summarizes the Global Burden of Disease 2010 study findings and highlights the regional findings for Sub-Saharan Africa. It also explores intraregional differences in diseases, injuries, and risk factors. The overall findings for Sub-Saharan Africa are:
- The Sub-Saharan Africa region has made overall progress in reducing mortality and prolonging life since 1970; however, some countries showed elevated rates of death within certain age groups and for sexes, between 1990 and 2010. Mozambique, for example, has seen rising mortality rates among women aged 25 to 29.
- In the last 20 years, the region has succeeded in decreasing premature death and disability from some communicable, newborn, nutritional, and maternal causes, especially from diarrheal diseases and lower respiratory infections. Throughout the region, deaths from measles and tetanus have substantially declined since 1990. Malaria and HIV/AIDS accounted for more health loss in 2010 than in 1990, but both diseases peaked between 2000 and 2005 in most countries.
- Although their relative burdens have declined, communicable, newborn, nutritional, and maternal causes such as diarrheal diseases, lower respiratory infections, and protein-energy malnutrition remained the top drivers of health loss in most Sub-Saharan Africa countries, especially in lower-income countries like Niger and Sierra Leone.
- Between 1990 and 2010, disease burden from many non-communicable causes increased, particularly stroke, depression, diabetes, and ischemic heart disease among upper-middle-income countries in the region.
- As many countries in Sub-Saharan Africa have become more developed, road injuries have taken a growing toll on human health. Many countries experienced increased levels of interpersonal violence, especially in the Democratic Republic of the Congo and Lesotho. In Somalia and Sudan, past and ongoing conflicts have resulted in higher levels of health loss due to war.
- In most of Sub-Saharan Africa, a larger percentage of healthy years were lost due to disability in 2010 compared to 1990. The leading causes of disability in the region, such as depression and low back pain, were largely consistent with the leading causes at the global level; however, communicable diseases like HIV/AIDS and malaria accounted for a larger proportion of disability in Sub-Saharan Africa than the world as a whole. In 2010, nutritional deficiencies, especially iron-deficiency anemia, accounted for nearly twice the health loss in Sub-Saharan Africa than they did globally; this trend was primarily driven by lower-income countries and was not seen in upper-middle-income countries in the region, such as Mauritius and the Seychelles.
- Under-nutrition and household air pollution were among the leading risk factors for premature death and disability in Sub-Saharan Africa. In most countries, substantial progress has been made in reducing risks like childhood underweight, suboptimal breastfeeding, and vitamin deficiencies, such that their burdens have declined between 30% and 50% in the last 20 years. Nonetheless, these risk factors remain among the top three contributors to health loss throughout the region, especially among lower-income countries.
- Alcohol use, high blood pressure, and smoking were also top contributors to health loss in many countries in Sub-Saharan Africa. Among upper-middle income countries in the region, such as Gabon and South Africa, high fasting plasma glucose and high body mass index accounted for more health loss. In lower-income countries, such as the Central African Republic, childhood underweight was the primary risk factor that drove larger health burdens.