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Focusing
on a positive impact

Understanding the unmet needs for the prevention, detection and control of diabetes and hypertension in East Africa

By Anne Claire Marrast, Senior Director, Clinical Lead, Actelion (a Janssen Pharmaceutical Company of Johnson & Johnson)

Earlier this month, I traveled to Kenya, Tanzania, and Uganda as part of my Johnson & Johnson Lion Secondment. I was there to better understand the gaps that would need to be closed in order to improve morbidity and mortality due to hypertension and diabetes in East Africa, and to help the Aga Khan Development Network build a framework for prevention, detection and control of these diseases.

The Lion Secondment was launched earlier this year as a new component of the J&J Secondment Program. It enables executive leaders at #JNJ to share their knowledge and provide senior level counsel to NGO partner organizations over a four-month period (on a part-time basis), whilst continuing to fulfill their J&J roles and responsibilities. I was delighted to have been selected as one of the first J&J Lion secondee, and to have the opportunity to share my knowledge and expertise with our partner organizations on these challenging disease areas.

During my visit, I met with multiple stakeholders working for the government, ministry of health, academic institutions, primary to tertiary health care facilities, non-governmental and non for profit organizations such as the non-communicable diseases alliances; the World Health Organization (WHO) and scholastic societies including the Kenya Cardiac Society and the Tanzanian Cardiology Society to learn more about the current situation.

I discovered that Kenya has only 8 endocrinologists for a population of 40 million while type 2 diabetes is on the rise due to changes in food habits and consumption. Ready to eat street food, for example, has poor nutritional quality and a bottle of soda is often cheaper than a bottle of water. This combined with a sedentarily lifestyle, especially for the constantly growing population in urban areas, leads to obesity.

In Tanzania, there are a total of 25 cardiologists and only 3 cath lab for a population of 60 million inhabitants to diagnose and treat coronary artery diseases. Hypertension prevalence ranges between 27 to 32% with a projection of 40% in the near future. Even when treated, more than 20% of patients do not achieve the blood pressure reduction target, leading to an increasing number of cases of left ventricular failure and renal impairment up to end stage renal disease.

If, and when, patients are diagnosed, access to treatment remains a big challenge especially at primary care centers in rural areas which may not have the drugs available on a regular basis. Cost is also an important component of the lack of retention to treatment, and overall care such as attending follow-up visits once diagnosed. As soon as a patient feel better, he or she may choose to focus the family, spending on education, rather than treatment.

Education and awareness of these diseases, and providing simple prevention measures to follow, such as nutritional recommendations are very high on the agenda, to prevent disease occurrence and the need for regular medical checks for early detection. Changing behaviors (e.g. healthy living habits) needs to be enforced to control both diseases in terms of incidence and the prevention of long-term complications. The front-line heath care workers have a major role to play for disease awareness programs, as well primary and secondary prevention care. 

My visit was very beneficial is assessing the situation in East Africa and understanding better how I can support our partner organizations.

About the J&J Global Community Impact Secondment Program

J&J Global Community Impact invests in people on the front lines of care as they change the trajectory of health for the world’s most vulnerable people, their families, and their communities. We are inspired to help create a world where people, no matter their circumstances, have access to quality health care. The Secondment Program, part of the Johnson & Johnson Talent for Good Strategy, is a long-term collaboration between Johnson & Johnson, our employees, and our NGO partners to invest in and build the skills of people on the front lines of care in Europe, the Middle East, and Africa. Through full-time field assignments of up to six months, our employees transfer their knowledge, expertise, and passion to our partners at the heart of delivering care, uniquely give back to society, and change the trajectory of human health. By the end of 2019, 60 J&J employees will have taken part in the program working for 8 NGO partners across 25 countries in the EMEA region. Learn more here.

About the Aga Khan Development Network

The Aga Khan Development Network (AKDN) operates as a network of private development agencies, covering a wide remit of sectors, including health and education, in some of the poorest countries in the world. AKDN has been a partner of J&J Global Community Impact EMEA for over 16 years and shares a long-term commitment to helping communities in the developing world improve local capacities in three critical areas: Nursing and Midwifery, Early Childhood Development, and Community Health Care. The AKDN has been a partner of the J&J Secondment Program since 2014.