Rwandan Non Communicable Disease Alliance (RNCDA), a non-communicable diseases civil society, is advocating for an inclusive universal health coverage by leveraging on the commonalities between non-communicable diseases and infectious diseases. The advocacy follows different figures around the world which indicate that people living with non-communicable diseases are more susceptible to COVID-19 pandemic and have been the most impacted. Dr Eric Nyirimigabo, the projects development officer at RNCDA, says that there is need for health systems strengthening to help non-communicable disease patients, as infectious disease outbreaks are predicted to increase in frequency in the future due to factors like climate change, to which they are most prone. “There is commonality between non-communicable diseases and infectious diseases. There is increased susceptibility to infectious diseases such as coronavirus in individuals with non-communicable diseases. For instance, some have higher risk of getting infected with tuberculosis,” he says. Dr Cyprien Iradukunda, a medical doctor who caters for Covid-19 patients at Kanyinya Covid-19 Treatment Center, by using different studies, explains how Covid-19 pandemic as an infectious disease impacts non-communicable disease patients. “Evidence shows that people living with non-communicable diseases are at high risk of infectious diseases such as Covid-19. Such diseases weaken the body’s immune system and expose them to infectious diseases like coronavirus pandemic. A study in Italy indicated that 98 per cent of Covid-19 deaths had high blood pressure, diabetes, active cancer, liver disease, chronic renal failure and others,” he says. He adds that 73 per cent had hypertension. In South Africa, which accounts for nearly half of all cases and deaths on the continent , 61 per cent of the Covid-19 patients in hospitals had hypertension, 52 per cent had diabetes while 45 per cent of people aged 60 to 69 who died from Covid-19 also had hypertension. In Kenya, around half of Covid-19 deaths occurred in people with NCDs while in the Democratic Republic of the Congo, such patients accounted for 85 per cent of all Covid-19 deaths. Rwanda’s situation Dr Iradukunda says that although Rwanda is still conducting a survey on how the Covid-19 pandemic impacts non-communicable disease patients; he already has experience as a medical doctor who caters for Covid-19 patients at Kanyinya Covid-19 Treatment Center. “In my experience, I have realised that two-thirds of patients who are put under intensive care or Covid-19 deaths had non-communicable diseases. However, a survey will, in general, indicate how Covid-19 pandemic impacts non-communicable disease patients,” he says. Most of them, he says, had comorbidities such as diabetes, hypertension, gout, high blood pressure, stroke and others. Impact of Covid-19 on NCD programme delivery World Health Organization (WHO) assessment indicated that fewer lower income countries have included the continuity of NCD services in national COVID-19 plans. Only 42 per cent of low-income countries report NCD service inclusion compared to 72 per cent of high-income countries. Almost half of countries, in this assessment, report disrupted services for cardiovascular emergencies (including heart attack and stroke) and over half of countries reported disruptions to cancer treatment, while almost two-thirds reported disrupted hypertension management (64 per cent). It shows 62 per cent of countries reported disruptions to diabetes treatment. In a WHO survey of 41 countries in sub-Saharan Africa, hypertension management has been disrupted in 59 per cent of the countries, while diabetic complications management has been disrupted in 56 per cent of the countries.
