We often hear of divides in Africa: religious disagreements exacerbated by border disputes; electoral unrest caused by divisive political...
We often hear of divides in Africa: religious disagreements exacerbated by border disputes; electoral unrest caused by divisive political rivalries; and acrimonious debates regarding the appropriate roles for men and women within households and in society. We hear less often about people and institutions bridging social, political, and cultural divisions. As many countries on the continent undergo urbanization, see their populations adopt different lifestyles, and experience the aging of their societies, international organizations have pledged to end one particularly significant division in Africa – the divide between communicable and non-communicable diseases (NCDs). As Patricio Marquez, World Bank’s Lead Health Specialist for Southern and Eastern Africa writes on “Africa Can…End Poverty” blog: “Frequently, both communicable diseases and NCDs can co-exist in the same individual, and one can increase the risk or impact of the other. Some infections cause or are related to NCDs; for example cervical cancer, a leading killer of women in Africa, is caused by the human papilloma virus.” Pink Ribbon Red Ribbon (PRRR) supports bridging this divide, and we are encouraged by the World Bank’s recent partnership with us to integrate activities to address communicable and non-communicable diseases in Botswana. In November 2012, with support from the World Bank and Pink Ribbon Red Ribbon, the government of Botswana took a step to close the gap between communicable and non-communicable diseases by announcing that funds from the World Bank, through the country’s National AIDS Coordinating Agency (NACA) – an agency typically focused on HIV, a communicable disease – will be used to combat cervical cancer in the country. This allows HIV-positive women whose lives are being saved through ART to receive timely cervical cancer screening and treatment, thus preventing them from dying from another preventable disease. Infection with HIV weakens the immune system and reduces the body’s ability to fight infections such as HPV infection that may lead to cancer. Cervical cancer is 4-5 times more common among women living with HIV than those who are HIV-negative. Integrating HIV and cervical cancer screening and treatment services, that is services for both a communicable and non-communicable disease, is an effective and efficient method of responding to both diseases. Many of the same techniques and entry points that are mobilized for HIV prevention, treatment, care and support can be successfully combined to screen and treat cervical cancer. Mr. Marquez’s post goes on to note the progress being made in Botswana and Zambia, where facilities have already adopted the cost-effective “see and treat” single-visit approach to combat cervical cancer. The World Bank funds, through NACA, will leverage the existing HIV platform in Botswana to support primary prevention with an HPV vaccination demonstration project, a nationwide scale up of secondary prevention and treatment services, and data management including cancer registries. This announcement embodies a number of PRRR’s core principles, one of which is that health should be a partnership of mutual accountability involving a variety of partners, that countries should lead and own their responses, and that fragmentation costs lives and wastes resources. PRRR is delighted to have facilitated this support through raising awareness of our efforts to World Bank staff and then working with the Bank and key stakeholders in Botswana. These efforts will enable integration of women’s cancer control into existing platforms, strengthen countries’ capacities to deliver comprehensive cancer control and address other chronic diseases, and improve data management. The World Bank’s support (also illustrated by another blog post here) adds a prominent voice and actor to the global partners already committed to bridging the divide. At PRRR, we hope other organizations follow the World Bank’s lead and become additional building blocks to strengthen the bridge between communicable and non-communicable diseases.
This post was written by Doyin Oluwole, MD, FRCP, the founding Executive Director, Pink Ribbon Red Ribbon, and Matthew Crommett, MHS, Program Analyst, Pink Ribbon Red Ribbon, based at the George W. Bush Institute.
