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A total of 33% of deaths annually in Uganda are due to non-communicable diseases (NCDs), according to the World Health Organisation, and for every Ugandan, the probability of dying prematurely from one of the four main NCDs is 22%.

Now, looking at Uganda’s capital city, Kampala, which habits five million people daily during the day and two million at night, means that this population is at risk of contracting NCDs, according to Dr Alex Ndyabakira, the head of air quality management at the Kampala Capital City Authority (KCCA).

Ndyabakira says KCCA examined the threat of NCDs and injuries to the people in the city and came up with different strategies.

“There are things like air pollution, for instance, that are universal risk factors for all NCDs, including cancers, heart disease, hypertension and poisoning," Ndyabakira says.

Delegates that represented different Cities around the World during the Partnership for Health Cities Summit in Cape Town earlier this month.

The burden of NCDs is clearly on the rise. Data from medical records and different studies show an exponential increase in NCDs, especially cardiovascular diseases (CVD), cancers, diabetes, chronic obstructive pulmonary diseases (COPs), and mental illness.

This increase has been facilitated by a series of habits and lifestyle factors that many Ugandans have been trapped in, including unhealthy diets, harmful use of alcohol, tobacco use, and substance abuse, and increasing physical inactivity, among others.

The other contributing factors include; Age due to improved life expectancy, poor health-seeking behaviour, psycho-social stress, and Family genetic factors.

“We work within the national framework of all guidelines as put forward by the Ministry of Health, but we also have city-specific guidelines according to the urban health strategy to secure the lives and livelihoods of the people living. One of them is addressing air pollution.

Air pollution being a universal risk factor for all NCDs, we set up a network to ensure we know how it is progressing. And in line with that, we can know which areas are polluted and which are safe ones," Ndyabakira said.

Kelly Larson, the injury prevention director at Bloomberg Philanthropies.

According to him, they also made sure this information is available on the KCCA website for anyone around the world to know.

"We have also worked on other initiatives like addressing the city transport system, setting up smoke-free zones in the city, asking the Government to increase taxes on harmful products like tobacco,” Ndyabakira added.

According to the 2014 Uganda National NCD Risk Factor Survey Prevalence of key NCD risk factors and diseases were found as follows:

• 26.8% of Ugandans were engaged in harmful alcohol consumption with about 10% living with alcohol related disorders. Uganda is ranked 5th globally in Alcohol consumption by Volume
  
  
• 10% of Ugandans either smoke or chewing tobacco and related substances and the risk is high among the teenagers
  
  
• 24.3% of adult Ugandans had raised blood pressure that needed treatment yet 76.1% of these did not know that they had high blood pressure.
  
  
• 1.4% of adult Ugandans were diabetic, the proportion was up to 3% in urban centres
  
  
• 5% of Ugandans were physically inactive
  
  
• 20% of Ugandans were either overweight (14,5%) or obese (4.6%)
  
  
• 88% of Ugandans were not consuming adequate amounts of vegetables and fruits despite Uganda being blessed with a wide variety of these.
  
  Partnership for Healthy Cities

With most of the global population now living in urban settings, cities and their leaders play a critical role in developing, implementing and enforcing policies to create healthy environments for healthier populations.

The Partnership for Healthy Cities, supported by Bloomberg Philanthropies in partnership with the World Health Organisation and Vital Strategies, is a global network of 73 cities whose mayors have committed to prevent NCDs including Kampala.

Kelly Larson, the injury prevention director at Bloomberg Philanthropies, which invested $3b in 2023 in the fight against NCDs and injuries, said by supporting efforts around the world to reduce non-communicable disease and injuries, eight out of 10 deaths globally are from NCDs and injuries.

DR. Alex Ndyabakira, the head of air quality management Kampala Capital City Authority (KCCA).

“This partnership for Healthy Cities is an opportunity to have cities take the lead in addressing the burden of NCDs and injuries. And we're just very excited to support cities as they lead the way on NCDs and injuries,” Larson says.

According to Larson, they have invested in 700 cities and 150 countries around the world to ensure better, longer lives for the greatest number of people focusing on creating lasting change in five key areas: The arts, education, environment, government innovation, and public health.

Ariella Rojhani, the director of the Partnership for Healthy Cities, Vital Strategies, believes this has already yielded some results. She says they work with government to help them with initiatives and policies that can bring down mortality rates of NCDs and injuries.

“I'm really proud of the number of policies that we've adopted in the last seven years of this programme. There's a demand for it from people in communities that they want healthier food and they do prefer to pay for clean water than they do for Coca-Cola. We have four cities in West Africa that are adopting nutrition standards for food served in schools, hospitals, and other public settings. We have seen cities set up good transport systems, tobacco free zones, and air pollution monitors” Ariella says.

Dr. Etienne Krug the director of the Department for Social Determinants of Health at the World Health Organization expressed how big NCDs are a burden to the world. He urged stakeholders to invest more in fighting against NCDs and injuries.

“We’ve seen with COVID, it spreads faster when there is a high density of populations. So infectious diseases are definitely an issue. But the biggest challenge people in cities face, as was just said, is noncommunicable disease.

KCCA Executive Director Dorothy Kisakka shows an air monitoring equipment in Kampala.

80% of all deaths in the world. And these are eminently preventable. People in cities are highly exposed to some risks.

That's why we're very excited to work with cities on promoting cycling and walking, healthy diets, tobacco food zones, etc. We at WHO are building up our urban health programs because we recognize that we have to just publish the research agenda” Etienne explains.

NCDs, including heart disease, stroke, cancer, diabetes, and chronic lung disease, are collectively responsible for 74% of all deaths worldwide.

More than three-quarters of all NCD deaths and 86% of the 17 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries.