?Individuals in Nigeria can greatly diminish their chances of experiencing diabetes and hypertension with thoughtful food choices ? Nestle

What Nigerians suffering from non-communicable diseases may urgently need are cost-effective medications, and the authorities seem to be turning to Western nations for assistance in reducing the burden of expensive medication on patients, despite their screening efforts. ODIMEGWU ONWUMERE explores in this article that Nestle Nigeria has recommended focusing on embracing a balanced diet that includes a variety of nutrient-dense foods while controlling portion sizes and seasonings to improve overall health, and by making thoughtful food choices, people in Nigeria can significantly reduce their risk of developing diabetes and hypertension

With concerns over the escalating prevalence of diabetes and hypertension, which had reached exceeding 90% and 50% for treatment and control rates, respectively, by December 2023, the Nigerian Health Commissioners Forum introduced an initiative on Monday, October 14, 2024, to conduct screenings for hypertension and diabetes on 10 million Nigerian individuals.

This prediction arose as specialists in 53 investigations that encompassed a sample of 78,949 individuals from Nigeria in 2020 calculated a prevalence of hypertension adjusted for age of 8.6% in 1995, equating to 4.3 million individuals aged 20 years. Age-adjusted frequency rose to 32.5% (27.5 million people) in 2020.

In all this, what Nigerians suffering from non-communicable diseases may urgently require is affordable medications, and the authorities appear to be looking to western countries to alleviate the impact of high drug costs on patients. Meanwhile, the sub-national health promotion initiative aimed at raising awareness among Nigerians, known as ?Project 10 Million ? Know Your Number, Control Your Number,? was presented by NHCF Chairman Dr. Oyebanji Filani, who also serves as the Ekiti State Health Commissioner.

However, the specific strategies for ensuring access to affordable drugs for Nigerians were not clearly outlined. Instead, he stated, ?NCDs, like high blood pressure and diabetes, present a significant health concern, accounting for around 27 percent of all yearly fatalities in Nigeria.?

According to him, the probability of mortality from these ailments between the ages of 30 and 70 is calculated at 17 percent, highlighting the critical requirement for intervention. ?The initiative will give precedence to marginalized communities, guaranteeing that at-risk demographics receive fair access to necessary healthcare services. Individuals can access any public healthcare facility or community outreach location for screening,? he added.

However, experts have noted that the Merck Foundation?s programme, focusing on enhancing accessibility to fair and high-quality cardiovascular, endocrinology, hypertension, and diabetes care in Africa, Asia, and Latin America, is gaining acknowledgement following the introduction of its recent Merck Foundation Media Recognition Awards for ?Diabetes and Hypertension.?

High Cost of Medication

Nevertheless, further efforts are required as patients continue to face challenges in affording expensive medications.

Hypertension, characterized as persistent elevated blood pressure, is the primary avoidable risk factor for heart disease and the foremost contributor to mortality worldwide. Some of the patients reported experiencing discrimination in the workplace and educational institutions from both educators and classmates.

Throughout the nation, the costs of the majority of common medications required for health management have risen by more than 200 percent, which is not a laughing matter in ongoing awareness initiatives.

For instance, during our investigations for this study, several individuals mentioned that a single hypertension pill they were previously purchasing for approximately N600 to N700 and a diabetes medication for a similar cost are currently being sold at a high rate of N5,000 per tablet.

Some of these individuals are retirees, and those who are employed earn less than $100 monthly. Therefore, handling the illness appears to be a daunting challenge that they have experienced firsthand.

This outcry has not gone unnoticed by certain health professionals who have advocated for prompt improvement of the affordability of medications. For example, a specialist in endocrinology at the federal medical center in Abeokuta, Ogun State, Dr. Olubiyi Adeshina, expressed significant concern regarding the escalating prices of diabetes treatment in Nigeria, underscoring the substantial financial burden it imposes on patients.

Speaking at the Talabi Diabetes Center 4th Annual Ogun Youth Diabetes Camp closing event at the Youth Development Center, Olusegun Obasanjo Presidential Library in Abeokuta in August, he disclosed that an average individual with diabetes in Nigeria now needs between N70,000 and N100,000 per month for treatment, which exceeds many individuals? monthly earnings.

In 2023, the cost per tablet of medication was N5000. Adeshina associated the dramatic increase in medication expenses with the recent devaluation of the naira, highlighting that insulin, formerly priced at approximately N6,000 to N8,000, now varies from N13,000 to N18,000, contingent upon the required dosage in 2024.

Health System Challenges

During the patients? outcry, public presentations have highlighted that the primary obstacles to enhancing hypertension outcomes in Nigeria encompass health system difficulties such as insufficient funding for non-communicable diseases (NCDs), inadequate incorporation of NCD care into primary health services, recurrent shortages of medications, restricted health insurance accessibility, and a constrained workforce capacity for managing hypertension.

Furthermore, the World Health Organization?s (WHO) core technical package offers strategies for health systems to enhance cardiovascular health care in primary healthcare facilities, but Nigeria has not followed suit. Dating back to 2012, the prevalence of non-communicable diseases (NCDs) has been escalating, with health professionals noting that Africa bears a disproportional share of this upsurge.

In their assessment at that time, which has escalated to a critical level today, they stated that cardiovascular ailments and diabetes accounted for 48% (18.2 million) and 3.5% (1.33 million), respectively, of the 38 million deaths attributed to non-communicable diseases in 2012; regrettably, 28 million of these fatalities occurred in low- and middle-income nations.

Effects of Urbanization

Investigation disclosed that with the progression of urbanization, dietary patterns altering, and populations aging, Nigeria has also experienced a rise in adults living with diabetes, from 209,400 in 2000 to 3. 6 million in 2021? only South Africa exhibited a higher prevalence in 2021.

Diabetes accounts for approximately 4.5% of fatalities in individuals under 60 years old in Nigeria, leading to common issues such as hyperglycemic emergencies, diabetic foot ulcers, chronic kidney disease, and stroke. One out of every five adult deaths under the age of 70 is attributed to non-communicable diseases (NCDs), with cardiovascular diseases and diabetes mellitus representing 7% and 2%, respectively, of the 2.08 million NCD-related deaths recorded in 2014.

Approximately 27% of fatalities in Nigeria can be attributed to diabetes, cancer, cardiovascular, and chronic respiratory ailments. These four prominent non-communicable illnesses (NCIs) are the primary contributors to global mortality, with a significant number of fatalities taking place in low- and middle-income nations (LMIs).

Per data, diabetes, defined by increased blood sugar levels, impacts 537 million adults (ages 20-79) globally. The figure is projected to increase by 46% in 2045. However, initiatives to address non-communicable diseases in Nigeria were revived in 2021 after the Brazzaville statement on NCDs and the subsequent governmental proclamation at the 66th United Nations General Assembly on the prevention and management of NCDs.

These statements establish the foundation for the global WHO NCD Action Plan 2013-2020, which has since been prolonged until 2030, and the struggle could be losing its momentum.

Improving Health Outcomes with Die

It is anticipated that government officials will reduce the price of medications. But, prior to doing so, there are recommendations indicating that diet has a vital impact on the prevention and control of these ailments, providing a potent instrument for enhancing health results.

Experts said that a nutrition plan abundant in fruits, vegetables, whole grains, and lean proteins is crucial for preventing and controlling diabetes and hypertension. For example, consuming leafy vegetables such as ?ugu? and spinach, which are rich in potassium, can assist in controlling blood pressure.

In the same vein, incorporating fiber-dense options like legumes, okra, and whole grains such as millet and local rice aids in controlling blood glucose levels. As indicated in public discourses, in contrast to North America and Europe, the incidence of hypertension is increasing in West Africa. With a shift from natural foods to packaged foods in Nigeria, dietary choices serve as a primary catalyst for hypertension.

In order to address this issue, the national dietary recommendations in Nigeria were instituted; however, their conversion into practical resources for healthcare providers continues to pose a difficulty. At present, there are no straightforward dietary evaluation instruments that are succinct and appropriate for integration into clinical practice without necessitating thorough data examination, yet still offering tailored dietary assistance to individuals.

Nonetheless, in central and western Africa, Nestle is committed to offering both children and adults the necessary nutrients required for optimal growth and progress. In the year 2022, Nestl? provided individuals in this area with 89.5 billion portions of goods enriched with a minimum of one of the four primary micronutrients individuals lack (iron, iodine, zinc, and vitamin A) to assist them in bridging the gaps related to micronutrient deficiencies, specifically iron deficiency.

The corporation's recent launch of Nido milk and soya in Nigeria forms part of the company?s dedication to providing improved nutrition at an affordable rate and enhancing accessibility throughout the area. This demonstrates how cost-effectiveness can be incorporated into nutritional remedies, guaranteeing that crucial nutrients are accessible to everyone, irrespective of economic circumstances.

Acknowledging that accessibility also impacts affordability, Nestl? utilizes locally obtained soybeans for the production of Nido milk and soya in Nigeria. In this manner, the corporation not only backs local farming but also guarantees that the merchandise is easily accessible to customers in the area.

This regionalized method of manufacturing and procurement decreases shipping expenses, decreasing the cost of the item for the final customer. Victoria Uwadoka, director of corporate communications, public relations, and sustainability at Nestl? Nigeria, stated that through mindful dietary selections, individuals in Nigeria can greatly diminish their chances of experiencing diabetes and hypertension.

?It is centered on adopting a well-rounded diet that incorporates an assortment of nutrient-rich foods while regulating portion sizes and flavorings to enhance general well-being,? she said.

?Onwumere is Chairman, Advocacy Network on Religious and Cultural Coexistence (ANORACC).

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