Non-communicable diseases to be leading cause of death in Ghana by 2030 – Prof. Laar

Ernest Senanu Dovlo, Accra – Professor of  Public Health at the University of Ghana, Prof. Amos Laar has said non-communicable diseases (NCDs) will be the leading cause of death in Ghana by 2030.

According to Prof. Laar who doubles as principal investigator for the Advocating for Health Project, this prediction backed by research is driven by unhealthy food environments in the country.

Speaking at a sensitisation workshop for journalists in Accra on October 28, Prof Amos Laar charged journalists to be vocal on issues concerning Sugar Sweetening Beverages (SSBs) causing havoc to many silently.

“Driven by unhealthy food environments, NCDs are predicted to become the leading cause of death in Ghana by 2030. Concerned, we aimed to address the problem of NCDs through effective public health policy measures,” Prof Laar said.

Non-communicable diseases; the case of Ghana

Non-communicable diseases (NCDs), also known as chronic diseases, are non-transmissible diseases of often long duration. Examples of NCDs include mental health conditions, stroke, heart disease, cancer, diabetes, hypertension and chronic lung disease among others.

Globally, it is estimated that one in two disability-affected life years and one in five deaths among adolescents are caused by NCDs.

As NCDs are driven primarily by behaviors that often start during childhood and adolescence including physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, they have the potential to impact child and adolescent health and bring about negative health outcomes in adulthood. Estimates suggest that approximately 70 percent of the premature deaths that occur among adults stem from health-related behaviors originating from childhood and adolescence.

Since the founding of Ghana’s current national health system, key actors in the health policy-making process has tended to be the same actors that play key roles in health agenda setting, design, adoption, implementation, and sustainability in Ghana. The main governmental actors have been the Ministry of Health (MOH) and key agencies such as the Ghana Health Service (GHS).

Lately, however, other actors such as multilateral agencies, bilateral/development partners, and local faith-based health service delivery actors, such as the Christian Health Association of Ghana (CHAG) have emerged.

The local civil society, and a few lay advocates, although wielding minimal influence, advocate for financial resources to be made available for priority interventions.

Despite some successes in terms of such advocacy, a number of challenges continue to confront Ghana’s health policy formulation and implementation – especially prioritization and resource allocation.

Although the sector considers NCDs an emerging public health problem, longstanding health challenges such as infectious diseases, maternal, neonatal, and newborn deaths, malaria, and sanitation continue to receive a significant proportion of health system allocation.

Creating a Favorable Environment and Stakeholder Buy-In For Food-Related Fiscal Policies in Ghana

The Advocating for Health Project is a collaboration between Academia led by the School of Public Health, University of Ghana, Legon, and Civil Society Organizations (CSOs) in Ghana led by Ghana NCD Alliance (GhNCDA), Ghana Public Health Association (GPHA) and Ghana Academy of Nutrition and Dietetics (GAND).

The project is scholarly activism and advocacy driven to create a favourable environment and stakeholder buy-in for food-related fiscal policies in Ghana.

This is because Ghana is experiencing a surge in non-communicable diseases (NCDs) amidst food insecurity, micronutrient malnutrition, and infectious morbidities. It has been estimated that over one-third of all adult deaths are due to NCDs.

Tax-related NCD prevention interventions exist for alcohol and tobacco, but those linked to unhealthy diets such as sugar-sweetened beverages (SSBs) tax does not exist. Reducing sugar consumption through effective taxation on SSB is however considered an effective intervention.

SSBs tax

Currently available, albeit with patchy implementation, are several evidence-based interventions to reduce the burden of NCDs among populations. These include the World Health Organization (WHO) ‘Best Buys’ (e.g., increasing excise taxes and prices on tobacco products, and alcoholic beverages), so-called due to their cost-effectiveness and feasibility for combating NCDs in LMICs.

Reducing sugar consumption through effective taxation on sugar-sweetened beverages is considered an effective intervention.

In Ghana, stakeholders across multiple agencies have endorsed the WHO Best Buys for controlling exposure to harmful products such as alcohol, tobacco, and unhealthy diets. Tax-related NCD prevention interventions exist for alcohol and tobacco, but those linked to unhealthy diets such as sugar-sweetened beverages (SSBs) tax do not exist.

The relevance and urgency of this initiative derive from our scanning, and appreciation, of the local context. The Ministry of Health is also currently engaging both state and non-state actors on the potential development of a food-based double-duty policy bundle to assure healthier diets in Ghana. Thus, the time is right for the proposed evidence-based advocacy.

Benefits of health taxes

Health taxes generally addresses Public Health concerns of implementing countries. It serves as a source of revenue generation and helps correct market failure as the costs of the negative health outcomes are often not fully borne by actors.

It also helps in correcting information failures as consumers have inadequate knowledge or understanding of the long-term health consequences among others.

Nigeria’s Sugar-Sweetened Beverage Tax

In 2021, the Federal Government of Nigeria introduced a Sugar-Sweetened Beverage (SSB) tax. It is embedded in the Finance Act of 2021, which levies a ₦10 tax on each litre of all non-alcoholic and sugar-sweetened carbonated drinks.

At least 54 countries — five in Africa — have introduced an SSB tax and while the primary focus should be on the health benefits of imposing a sugar tax, the secondary benefit is the use of the funds as a source of domestic resource mobilisation, particularly in low- and middle-income countries where the fiscal space is very tight and the health sector is underfunded.

It is against this background that stakeholders including Academia led by the School of Public Health, University of Ghana, Legon, and Civil Society Organizations (CSOs) in Ghana led by Ghana NCD Alliance (GhNCDA), Ghana Public Health Association (GPHA) and Ghana Academy of Nutrition and Dietetics (GAND) are pushing for SSBs Tax in Ghana.

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