Richard Walker is a Consultant Geriatrician at North Tyneside General Hospital, and Honorary Professor of Ageing and International Health at Newcastle University. He has a research interest in non-communicable diseases in sub-Saharan Africa (SSA) and is Associate International Director for SSA for the Royal College of Physicians, London. He is the Clinical Lead for the Northumbria / Kilimanjaro Christian Medical Centre health link and Chair of the Movement Disorders Society African Task Force. In this blog article he discusses the growing challenge of ageing in Africa.
The ageing population in Africa is exploding. In Nigeria alone, for example, there are now more than 6 million people aged over 65 years. Despite this, worryingly, services are particularly ill prepared to meet the needs of this group. Compounding this challenge is the fact that there’s a real lack of Geriatrics’ teaching in undergraduate medical curricula in SSA. Furthermore, we found that there’s very few ‘Geriatricians’ in SSA outside South Africa, with most countries having none at all.
Healthcare in Africa is no longer just about infectious diseases. Stroke is now the second leading cause of death worldwide and hypertension is the leading risk factor for mortality worldwide, with most of the deaths occurring in low and middle-income countries (LMICs). People are now talking about the double impact of infectious diseases and non-communicable diseases (NCDs) in countries where health services focused on acute treatment, are ill equipped to cope with increasing demand. However, the widespread initiatives in relation to HIV, which has now become a chronic disease, may provide a blueprint for how care might be provided for other chronic conditions in the future.
In light of this, there is a huge need to share expertise in the care of chronic disease with African healthcare professionals. Last September, I took on the role of Associate International Director for SSA for the Royal College of Physicians, London (RCPL). This comes at an exciting time for developments in SSA. There is a now 4-year programme for training in Neurology and Oncology in East Africa (Tanzania, Kenya, Uganda and Rwanda) funded by the East African Development Bank (EADB) that runs in conjunction with the British Council and the RCPL. I was part of the Faculty for the first Neurology one week course (held in Nairobi last September) for 20 doctors from Kenya and Tanzania, and more recently, for a course in Moshi, Northern Tanzania. The courses include 3 areas of specific interest to Geriatricians, namely stroke, Parkinson’s Disease and dementia.
In May, I was in Accra, Ghana, on behalf of the RCPL, for a review meeting for the end of the MPACT Training Initiative run in West Africa for the last 3 years by the West African College of Physicians (WACP) in conjunction with the RCPL and funded by Ecobank. These one week training courses in Nigeria, Ghana, Senegal and, most recently, Sierra Leone, focused on the major infectious diseases including HIV, malaria and TB as well as emerging threats, such as Ebola. They have been very well received and the RCPL and WACP are keen to continue this initiative, potentially focusing on NCDs in recognition of the fact that these are becoming a major issue in places such as SSA.
This got me thinking – perhaps the BGS and its members, as a world leading authority on Geriatrics, might be interested in becoming more involved with training in Geriatrics in SSA and other LMICs in the future? Perhaps this could be delivered or facilitated in-country? Or perhaps the Medical Training Initiative (MTI) programme? The MTI, facilitated by the RCP, enables overseas doctors to be employed and paid on Tier 5 visas in the UK for up to 2 years. Perhaps this could be used to enable interested doctors to spend time working in the UK and to develop their experience in the field?