Challenges in Addressing Mortality from Communicable and Noncommunicable Diseases in Sub-Saharan Africa.

Given the growing double burden of disease from the coexistence of communicable and noncommunicable diseases in Sub-Saharan Africa (SSA), this paper investigated mortality in Ghana, Cameroon, South Africa, and Kenya in relation to the epidemiological transition. Using life table techniques, we demonstrate the magnitude and toll of the double burden by assessing the change in life expectancy from the absence of communicable or noncommunicable diseases in these countries for the year 2009. Eliminating communicable diseases increased life expectancy at birth by 11.63 years in Ghana, 14.01 years in Kenya, 18.44 years in Cameroon, and 20.59 years in South Africa. Eliminating noncommunicable diseases increased life expectancy at birth by 10.22 years in Ghana, 14.15 years in Kenya, 16.57 years in Cameroon, and 8.46 years in South Africa. Further, when dichotomized by sex, the increase in life expectancy from removing communicable diseases was 1.05 times the increase of eliminating noncommunicable diseases for females and 1.21 for males in Ghana; 0.86 times the increase of eliminating noncommunicable diseases for females, but 1.42 times for males in Cameroon; 3.18 times the increase of removing noncommunicable diseases for females and 3.26 times for males in South Africa; 1.08 times the increase of eliminating noncommunicable diseases for females, but 0.90 times for males in Kenya. Our findings suggest that noncommunicable and communicable diseases warrant equal attention and resources, and caution over-reliance on descriptive constructs like the epidemiological transition framework to explain and prioritize policies and programs in combatting life-threatening diseases. [ABSTRACT FROM AUTHOR]