They are looking for new solutions for Africa
The African countries south of the Sahara are in the middle of a double medical challenge. Medical care must handle infectious diseases such as malaria, Ebola and HIV, while so-called lifestyle diseases are rising sharply. Uppsala University is now taking an initiative to find new paths to solutions.
A growing middle class in African countries has led to the rapid spread of lifestyle diseases such as diabetes, high blood pressure and obesity. “We must seek solutions to the health problems in the African countries beyond the traditional scientific approach I learned in medical school at one point in time,” says Stefan Swartling Peterson, Professor of Global Health. “We know that two out of three women and children die unnecessarily because known medical knowledge is not reaching them. This is not primarily a medical problem; a better vaccine isn’t going to do much good if it isn’t used,” he continues.
To find paths forward, Uppsala University is launching an education and research environment called “Health, Politics and Culture in Africa”, which aims to be a dynamic environment at the interface between the humanities, social sciences, medicine and pharmacy. The research environment will work with interdisciplinary seminars for researchers, doctoral students and undergraduates, common research applications and partnerships with researchers in African countries. “Health care is a political issue that affects people’s daily lives. Politics, especially municipal politics, will be essential in this realm,” says Sten Hagberg, Professor of Cultural Anthropology. “The challenges posed by health issues require us to work together and see different perspectives. For example, growing democracy presents opportunities to require better food control, which is in turn a condition for better health.”
The specific problems of managing lifestyle diseases in African countries are numerous and include adapting diet, implementing lifestyle changes and adjusting attitudes towards affluence. The challenges also include other aspects, such as access to clean water, refuse collection, climate change and social and economic inequalities.
A clear correlation exists between the places in the world that have had problems with starvation; today, the same areas struggle with a sharp rise in problems with overweight and lifestyle diseases. Immigration to the growing cities has resulted in a transition from undernourishment to overweight in only one generation.
A sedentary lifestyle, fatty foods and the notion that a large body represents success are some of the problems. Naturally, attitudes about the body are related to earlier struggles with starvation. A thin person was often perceived either as poor and unable to afford food, or as having HIV.
“How can we understand and discuss what prosperity is? It’s hard for us to come in and say it’s a problem, now that they get to eat well, look good and live well,” says Stefan Swartling Peterson.
Another problem, of course, is economic resources. Health care in Uganda, for example, has about one half of a percent of the resources per person compared with Sweden. “We know that the solutions to health and development challenges can’t just be exported to Africa by foreign experts. The most important thing is therefore to create opportunities for us to learn from African researchers about the challenges they are facing and to understand more about how and where we can contribute to their work. Uppsala University has opportunities here to further build upon a strongly Swedish tradition of solidarity and respect for our African colleagues,” says Eren Zink, coordinator and cultural anthropology researcher.
The new research environment is based at the Forum for African Studies in the Department of Cultural Anthropology and Ethnology. The initiative is financed by strategic funds from the Vice Chancellor, with joint funding from the disciplinary domain boards for the humanities, social sciences and medicine and pharmacy. “We want to connect the faculties in the spirit of the UN’s development agenda, because the solution is much bigger than the scientific disciplines. This is about tackling shared problems for human survival. Even in Sweden, we have much to learn and to gain from working with countries in Africa,” says Stefan Swartling Peterson.
FACTS: Diabetes in Sweden and the world
Every year, 5 million people die of diabetes worldwide, which is the equivalent of one person every six seconds every day, all year.
For comparison, every year worldwide:
- 1.5 million people die of HIV/AIDS
- 1.5 million people die of tuberculosis
- 0.6 million people die of malaria
Around 47 percent of people with type 2 diabetes worldwide are undiagnosed. In Africa, that number is 67 percent. 79 percent of people who die of diabetes die prematurely (under the age of 60) in sub-Saharan African countries.
415 million people are believed to have diabetes worldwide. If that trend continues, 642 million people will have diabetes by the year 2040, an increase of over 50 percent in 24 years. The greatest increase is expected to take place where the economy has gone from low to middle-income. 75 percent of people with diabetes currently live in low and middle-income countries.
About 8 percent of people have diabetes in South Africa, a middle-income country. But prevalence varies significantly within the population, from approximately 4 percent of the white population to approximately 13 percent of the black population. Prevalence is rising sharply, especially among people in shanty towns.
In Uganda, a low-income country, approximately 7 percent of people have type 2 diabetes in rural areas and 20 percent have prediabetes. However, many medical centres lack sufficient test equipment and the figures are thus probably too low.
In Sweden, approximately 5 percent of people have diabetes and 6 percent have prediabetes. But diabetes is rising in Stockholm County and prevalence differs sharply between the various areas. In socioeconomically vulnerable areas of Stockholm County, prevalence reaches 23 percent among the elderly (65 years and older).
The UN’s new development goals
Last autumn, the UN adopted 17 new global sustainable development goals for 2030. One of the goals is to ensure a healthy life and promote well-being at all ages.