Diabetes in sub-Saharan Africa: health care perspectives, challenges, and the economic burden of disease.

The growing incidence of diabetes mellitus in the world is a widespread concern. While there has been improvement in the epidemiology and management of the disease in the developed world, the same cannot be said in sub-Saharan Africa. The disease is getting less attention as is the funding that it merits compared to communicable diseases. Type 2 diabetes is becoming more prevalent due to rising rates of obesity, physical inactivity, and urbanization. In contrast to the developed world, where the majority of the people with diabetes are over the age of 60 years, the sub-Saharan Africa diabetic population is in the economically productive age group of 30 to 45 years. The late diagnosis of diabetes in this region, coupled with inequalities in accessing care, leads to early presentations of diabetic complications. The health care delivery agenda is overwhelmed by poverty, as such diabetes management costs have to compete with other health issues such as antiretroviral drugs for HIV/ AIDS, tuberculosis treatment, and malarial control programs. There is an urgent need to place diabetes on the national health agenda in sub-Saharan Africa and ensure that this agenda is properly positioned and integrated into the health policies and strategies.