Saving youths from menace of tobacco industry interference

Africa, and indeed Nigeria is known for its generally youthful population. However, data show that these youths are endangered as the tobacco industry has targeted them for their 'predatory' tobacco marketing tactics to create profits, thereby breeding a new wave of addiction. According to the World Health Organisation (WHO), the tobacco epidemic is one of the biggest public health challenges the world has ever faced, killing more than eight million people around the world every year. The 2024 WHO Global Report on Trends reveals that children are using e-cigarettes at rates higher than adults in many countries and globally an estimated 37 million youth aged 13 to 15 years use tobacco. It revealed that 22 countries in the African region are on track to achieve a 30 per cent reduction in tobacco use by 2025. However, it emphasised that progress has been stifled by rising numbers of young tobacco smokers due to tobacco industry influence. This year, once again, WHO and public health champions from across th e globe have come together, leveraging the World No Tobacco Day (WNTD) celebrated annually on May 31, to raise awareness about the harmful influences of the tobacco industry on youth. The theme for World No Tobacco Day 2024 is 'Protecting children from tobacco industry interference'. It emphasises the need to protect future generations and ensure that tobacco consumption continues to reduce. WHO report titled 'Hooking the next generation: how the tobacco industry captures young customers' shockingly revealed that the industry works to reach children and youth to replace customers who quit or die. According to the report, internal tobacco industry documents, dating as far back as the 1970s, show that tobacco companies have long considered children and youth to be 'replacement smokers', 'pre-smokers' and a critical market to sustaining their business and the future of their brands. 'The range of products the industry uses to appeal to youth has expanded significantly, from cigarettes, cigarillos and shisha to newer products like e-cigarettes, heated tobacco products and nicotine pouches. 'Flavoured products and additives, sleek designs and child-friendly packaging and imagery make addictive products even more appealing to youth. 'Companies rapidly launch new products that sidestep, or are not included, in current laws, and use every available means to expand their market share before regulations can catch up with them,' it said. The health agency revealed that the industry's tactics include positioning many nicotine products as 'safer' than cigarettes, potentially distracting policy-makers and consumers from the fact that nicotine itself is addictive and harmful, particularly to children and youth. 'For example, e-cigarettes with nicotine are highly addictive and are harmful to health. 'While long-term health effects are not fully understood, it has been established that they generate toxic substances, some of which are known to cause cancer and some that increase the risk of heart and lung disorders. 'Us e of e-cigarettes can also affect brain development, potentially leading to learning and anxiety disorders for young people,' it said. The health agency lamented that the tobacco industry was succeeding in its efforts to create a new generation of young people who smoke, vape, suck nicotine pouches or use snuff. It noted that evidence from around the world shows an alarming uptake by children of some products, such as e-cigarettes. 'History is repeating, as the tobacco industry tries to sell the same nicotine to our children in different packaging. 'These industries are actively targeting schools, children and young people with new products that are essentially a candy-flavoured trap. 'How can they talk about harm reduction when they are marketing these dangerous, highly addictive products to children?,' Dr Tedros Ghebreyesus, WHO Director-General queried. During a virtual World No Tobacco Day webinar with Journalists, Mr Caleb Ayong, Executive Director, Vital Voices for Africa (VVA), Togo, said tobacco infringes upon children's basic rights to health and welfare, noting that child labour in tobacco production persists in many parts of Africa. Ayong emphasised that 14 of the 17 Sustainable Development Goals would not be achieved with tobacco industry operations, noting that it portends threats to actualisation of universal health coverage, disease prevention, and mental health promotion. 'Tobacco industry targets young people with aggressive marketing, investing billions on the advertisement of its products. It organises parties, concerts, and product placements to specifically lure young and impressionable minds to its products and activities,' he said. He called for collaboration in shielding children from the clutches of tobacco, empower them with knowledge, and advocate for policies that prioritise their health. According to him, journalists hold immense power to ignite change, expose industry lies, and inspire action through their reports, urging them to amplify the voices of youths, unmask tobacco industry's deception, and create a world where every child breathes freely. Similarly, Philip Jakpor, Executive Director of Renevlyn Development Initiative (RDI), said the media plays a strategic role in exposing the tactics of the tobacco industry through incisive reports to elicit policy level interventions 'It is the media that must put our governments on their toes to ensure they do not shirk their primary responsibility of protecting our children,' he said. According to him, the MPOWER package of WHO focuses on six effective measures to reduce demand for tobacco products. 'The W denotes the 'Warn about the dangers of tobacco', which is a role that the media is tasked with carrying out. The media shapes tobacco-related knowledge, opinions and influences individuals and policy-makers. 'For signatories to the WHO-Framework Convention on Tobacco Control (WHO-FCTC) mass media anti-tobacco campaigns are key components of their tobacco control programmes,' he said. Corroborating Jakpor, Mr Achieng Otieno, Being Africa, Kenya, explained that the WHO-FCTC was a blueprint for governments to adopt effective tobacco control and assist curb the global tobacco epidemic. Otieno noted that the goal of the framework was to protect the present and future generations from the devastating health, social, environmental, and economic consequences of tobacco (and nicotine products) consumption and involuntary exposure to tobacco smoke. 'The FCTC plays a vital role in promoting and protecting children's rights concerning tobacco control by advocating for policies and measures to prevent tobacco use initiation, reduce exposure to secondhand smoke, provide access to information and education, and safeguard public health policies from industry interference,' Otieno said. Besides, Mohammed Maikuri of Development Gateway, emphasised that the economic burden of smoking, including health expenditures and productivity losses, was estimated at $1.4 trillion annually, with a significant portion of this cost borne by developing countr ies. Maikuri said treating diseases caused by tobacco was estimated to have cost Nigeria ?526.4 billion in 2019, which was nearly one tenth of all healthcare costs in the country. According to him, Development Gateway, in collaboration with the Nigerian Federal Ministry of Health, supported by the Gates Foundation, leads the DaYTA (Data on Youth Tobacco in Africa) programme, focusing on addressing critical data gaps related to adolescent tobacco use in Nigeria. He said that the initiative aims to gather comprehensive country-level data on tobacco use among young people aged 10 to 17, thereby filling critical evidence gaps and complementing existing data. Maikuri, however, said that Nigeria's performance got worse in a 2021 survey showing that the tobacco industry was intensifying its interference in spite of Nigeria's tobacco control legislation and efforts. Commenting, Ms Oluchi Robert, Tobacco Control Advocate, noted that WHO report had shown Nigeria, the world's seventh most populated country, has bee n recognised by major transnational tobacco companies (TTCs) as a market with enormous income potential due to its large youth population and expanding GDP. Robert lamented that the tobacco industry in Nigeria, like in many other countries, targets children and youths through various tactics including product marketing, advertising, flavoured products and accessibility. 'Tobacco industry covertly engages in product advertisement through product placements in movies, music videos and use of social media to reach the younger audience. 'According to a 2020 cross-sectional study of school adolescents in Lagos, the most frequently reported channel of exposure was through product placements, with 62 per cent reporting exposure in films, TV, and videos. 'Up to 15.2 per cent and 12.6 per cent were exposed to tobacco advertising, promotion, and sponsorship (TAPS) through promotional activities and sponsorships, respectively,' she said. She faulted the easy accessibility of tobacco products to children and youths, through stores or online platforms. The News Agency of Nigeria (NAN) recalled that the Federal Competition and Consumer Protection Commission (FCCPC), worried by the alarming increase in young and underage access to tobacco products, launched the 'Don't Burn Their Future' campaign. FCCPC said over 4.5 million Nigerians aged 15 and above are tobacco users, with more than 26,800 annual deaths attributed to tobacco-related diseases. The Commission emphasised that the campaign was a resolute move to safeguard the health and future of Nigerian youth and to curb the detrimental impact of tobacco products on society. FCCPC underscores the collective responsibility of individuals, communities, and a prioritised healthcare system in fostering a healthier future for the youth. Contributing, Dr Tunji Akintade, said there was a fundamental and irreconcilable conflict between the tobacco industry's interests and public health policy interests. Akintade urged the government to strengthen its tobacco control policies, improve awareness and educate the public and policymakers about the devastating health and social consequences of tobacco use. Experts stressed that tobacco industry interference in health policy was a major reason why youth remain unprotected, or not as protected as they should be. They urged the government to protect current and future generations and hold tobacco and related industries liable for the harm they cause. Source: News Agency of Nigeria

NMA reacts to arrest of alleged fake doctor in Lagos

The Nigerian Medical Association (NMA) has commended the Nigerian Police Force for arresting an alleged fake medical doctor, saying it would strengthen its fight against quackery in the medical profession. Dr Benjamin Olowojebutu, Chairman, NMA Lagos, said this in an interview with the News Agency of Nigeria (NAN) on Tuesday in Lagos. Olowojebutu noted that medical quackery was a dangerous practice that posed a threat to the wellbeing of citizens and delivery of quality healthcare in the state, and country. 'The arrest is a welcome development to the health sector; we would expose these quacks and ensure that Lagos does not suffer further morbidity and mortality from their nefarious activities. 'We are glad that our work on anti-quackery has started yielding progress as we are determined to weed out quacks from the medical profession,' he said. The chairman pledged that NMA Lagos, with support of the Ministry of Health, Health Monitoring and Accreditation Agency (HEFAMAA), and the Police, would eradicate quacks from the state. He said that the association would hold an Anti-Quackery Summit soon, after which it would present a white paper to the Lagos State Government on anti-quackery. Olowojebutu warned hospitals to refrain from employing staff whose certificates and licenses had not been verified by the MDCN toward safeguarding the health of the populace. NAN reports that the Zone 2 Police Command, Onikan, Lagos, on May 7, announced its arrest of a 37-year-old medical practitioner, with suspected forged certificates at Skylink Medical Centre, Elepe-Ikorodu. The police said it arrested the suspect who claimed to be the Managing Director of the health facility based on intelligence gathered by the command through members of the Elepe community concerning the activities of the suspect. It said it recovered two suspected forged certificates of Obafemi Awolowo University, Ile-Ife, Osun State and Medical and Dental Council of Nigeria (MDCN) after conducting a search of the facility. It further revealed that the hospital complex had been sealed, pending the outcome of an ongoing investigation. Source: News Agency of Nigeria

Asaba Specialist Hospital conducts free health screening for staff

The Management of Asaba Specialist Hospital has conducted a comprehensive health screening programme for its staff to promote the well-being of the hospital's workforce. Dr Peace Ighosewe, the Chief Medical Director of Asaba Specialist Hospital, who spoke during the exercise in Asaba, said it was designed to ensure that all staff benefitted from the same services offered to patients. She said that the management prioritised the health and well-being of its staff as the screening was aimed at boosting their morale and productivity as well as commemorating this year's World Day for Safety and Health at Work. The screening included medical tests such as fasting lipid profile, electrocardiogram (ECG), eye screening, diabetes screening, prostate-specific antigen (PSA) Test and Breast Self-Examination demonstration. There was also a lecture series and a staff workout exercise unveiled on May 4, which will henceforth be held on a bimonthly basis. Ighosewe expressed gratitude to the Gov. Sheriff Oborevwori-led a dministration for prioritising the welfare of healthcare workers in Delta State and creating conducive environment for the hospital to flourish. She also extended her appreciation to the Delta State Commissioner for Health, Dr Joseph Onojaeme, for his support and approval of the project. Ighosewe advised other hospitals to emulate the gesture; showing love and care for their workers' health and well-being. She said it would encourage staff to work better and increase harmony among team members. Dr Ngozi Onwueme, a Consultant Cardiologist, commended the management for organising the exercise, stating that many staff members who benefitted were carrying out the tests for the first time. She said that new diagnoses were made and treatment had commenced for some staff members. Staff members who participated in the programme expressed their appreciation for the initiative, which showed that the hospital cared about their well-being. Ogala Priscilla, a staff member, laude the management for the initiative. 'I want to thank the management for this thoughtful screening exercise; we appreciate their efforts,' she said. Ngozi Ossai, a cleaner at the hospital, said she was delighted to be a beneficiary of the medical screening. 'I want to thank the management for including me in the screening; I am very grateful,' she said. On his part, Azubuike Aweni, thanked the management for looking after the well-being of staff members. 'I want to thank the hospital for this kind gesture, most especially the Medical Director, Dr Peace Ighosewe, for her thoughtfulness,'' he said. Source: News Agency of Nigeria

UN tasks ASWHAN board on resource mobilisation, strategies to end AIDS

The UN Women, UNAIDS and others have called on the newly inaugurated Board of Trustees (BOT) members of Association of Women Living with HIV/AIDS in Nigeria (ASWHAN) to mobilise resources and implement strategies to end AIDS as a public health threat by 2030. They made the call at a three-day inaugural BOT meeting and resource mobilisation training for management board members and staff on Monday in Abuja. Ms Patience Ekeoba, the National Programme Officer and Focal Person for HIV/AIDS, UN Women, said that the board members, who have experience on HIV/AIDS, should promote the activities of the association and ensure they became part of decision making in the HIV/AIDS response. She said 'we are hoping that the board will be able to drive resource mobilisation because it has been one of the challenges of the association over the years. 'The board tried a lot in trying to mobilise funds by writing proposals and others in the past. We believe members will be able to bring in their leadership and mobilise fund ing that they need not just for the national level, but at the state and community levels too.' Dr Leopold Zekeng, the UNAIDS Country Director, said the inauguration of the BOT would strengthen ASWHAN activities and address the challenges faced by women and girls living with HIV/AIDS. He said 'achieving gender equality, advancing women's empowerment and fulfilling the sexual and reproductive health and rights of women and girls are crucial to achieving the Sustainable Development Goals and in ending AIDS as a public health threat by 2030. 'Four decades of the HIV response heralded significant success, yet, much more is needed, particularly in terms of ensuring women and girls are not left behind.' He added that by addressing gender inequalities, patriarchy and discrimination, a society where women and girls are less vulnerable to HIV would be created. The country director reiterated UNAIDS's commitment to ensure that women and girls have their rights fulfilled and empowered to protect themselves against HIV with access to treatment, care and support. On his part, Dr Pat Matemilola, a board member and former Coordinator, Network of People Living with HIV and AIDS in Nigeria (NEPWHAN), pledged the network's support to the association and to explore other areas like education, nutrition and others that would promote ASWHAN. He said 'the board of trustees will help to broaden views and make ASWHAN not to concentrate too much or narrow the field too much on HIV/AIDS. 'The fact that ASWHAN is under NEPWHAN has become a limiting factor, so once they are able to break free and launch into other areas that are not strictly HIV, they will make a lot of progress.' Mrs Esther Hindi-Maliki, the National Coordinator of ASWHAN, said with the inauguration of board members, there would be more engagements and advocacies with partners on various thematic areas, apart from HIV/AIDS. She said 'we will mobilise resources because you cannot work without financial and other resources. 'So, we will look for resources to do ou r interventions and implementations and hopefully the future of ASWHAN will be bright. 'And with this Board of Trustees and cooperation of the management will work to ensure that we implement and intensify sensitisation and advocacies with partners.' Source: News Agency of Nigeria

Group seeks holistic approach toward addressing determinants of suicide

The Nigeria Suicide Prevention Advocacy Group has called for a holistic approach to prevent and address the determinants of suicide in the country. Dr Oluwatosin Adekeye, Deputy Director, Clinical Psychology, Ahmadu Bello University Teaching Hospital, Zaria, made the call at the 2nd Virtual Meeting of the Group on the topic: 'Determinants of Suicidality in Nigeria'. Adekeye called for the collaborative efforts of all stakeholders to addressing the determinants of suicide, saying that effective prevention and intervention of requires a multilayered approach. He said that the increasing rate of suicide and its corresponding devastating effects made it pertinent for stakeholders including governments, families, policy-makers and organisations to collectively look at the issue with a view to addressing it. According to him, suicide is a behaviour motivated by the desire to escape unbearable psychological pain. He identified psychological risk factors of suicide to include bulling, social rejection, quality o f life and lack of care, saying that sadness, anxiety and hopelessness were the key causative factors of suicide in Nigeria. Adekeye, who called for increased advocacy on suicide, provision of support through prevention and treatment, emphasised the need for decriminalisation of suicide to pave the way for effective suicide prevention and control in Nigeria. 'Effective prevention and intervention require a multilayered approach that encompasses community engagement, healthcare service enhancement and robust policy support. 'Hence, the need for social support system and education of the populace on the psychological determinants of suicide and how to cope with them,' he said. Speaking, a Consultant Psychiatrist, Prof. Jibril Abdulmalik, identified gender as a biological risk factor for suicide, saying there was a strong genetic history in connection to suicide. Abdulmalik, an Associate Professor of Psychiatry, UCH Ibadan, said that men were at higher risk of suicide than women. According to him, men tend to commit suicide four times more than women. Alhaji Abubakar Bichi, a Social Worker at the Federal Medical Centre, Kano, said that poverty and unemployment had become the major economic factors affecting suicidality in Nigeria. Bichi, also the National President, Association of Medical Social Workers of Nigerian (AMSWON), said the burden of economic pressures such as debt, inability to meet daily needs and uncertainty about future could lead to increased level of stress and anxiety, leading to suicide. He decried that mental health services were barely available in the rural communities, as the country only have six Federal Psychiatric hospitals basically located at the urban cities. 'Mental Health, though, might be a long term health condition, is treatable that an individual with the condition can live a normal life. 'Unfortunately, in many Nigeria communities, mental health issues are often stigmatised and perceived as sign of weakness. 'The social and economic determinants are the major causative f actors of mental health conditions and suicide in Nigeria, hence the need to address them. 'The Government should implement mental health policies and laws and provide the enabling environment for the citizens to be meaningfully engaged. 'Let there be more job opportunities so that people will gainfully be employed and the basic amenities be made available,' Bichi said. Prof. Ibrahim Wakawa, Medical Director, Federal Neuro-psychiatric Hospital Maiduguri, said there was need for a public pronouncement by the Federal Ministry of Health that suicide has became a public health pandemic. According to him, there is need for proper control and monitoring of the means of access to suicide like snipper, by the relevant authorities. He noted that poverty alleviation needed to be really considered a priority if significant achievement would be made in prevention of suicide in Nigeria. Earlier, Prof. Taiwo Sheikh, the Group Coordinator, said that mental health, including determinants of suicide, affect millions of people across Africa, adding that stigma and cultural misconceptions often compound these issues. In his welcome speech, Sheikh, also a consultant psychiatrist, said that insufficient public spending on mental health and suicide prevention was a major barrier to providing assistance to those in need. According to him, effective suicide prevention can only take place through a whole-of-society approach that involves the government, civil society organisations and community leaders. Source: News Agency of Nigeria

Beating non-communicable diseases to safeguard African children

Emeka Ahanonu and Ugo Alilionwu are from the same family. Following frequent hospital admissions in early childhood, they were later diagnosed with sickle cell disease. Their family, living in a village in the eastern part of Nigeria, did as much as they could to manage their condition. With time, cost of medication and care became burdensome for the poor family, coupled with the rising cost of living. Meeting up with medications, hospital appointments, adequate nutrition and observing other conditions necessary to manage the condition became tougher. Sadly, Ahanonu and Alilionwu passed on within an interval of about four years, at the ages of 11 and 14, respectively. In a related development, Chisom Chukwuneke, 17, who was the best candidate in the 2019 West African Senior Secondary Certificate Examination in her school, died after a battle with blood cancer. At her demise, her father, Mr Felix Chukwuneke, wrote, 'As restless and worried as I can be, I promised to do everything humanly possible. We wen t to South Africa. We were happy at your initial recovery, not knowing the war was just to begin.' Young Chukwuneke died in 2020. Again, Onome Eka's family got to know she had Type 1 Diabetes when was 12 years old. Keeping up with her treatment with insulin was an ordeal. It was expensive. Payment was out of the pocket. Getting needed treatment as and when due was difficult. Thus, Eka passed away some months later. However, Akida Abdul, 10, and Emmanuel Anga,15, of Kondoa District in Tanzania have been able to live with SCD and Type 1 Diabetes respectively, having access to a PEN-Plus clinic in their community. In spite of their families' lack of funds for their treatments, the clinic has been able to bridge the gaps in financing, accessibility and other issues that could have limited them from having access to care. The World Health Organization (WHO) approach to addressing severe Non-Communicable Diseases (NCDs) through an integrated outpatient service at first-level hospitals is called integrated PEN -Plus (package of essential interventions for severe NCDs). It aims to mitigate the burden of severe NCDs among the poorest children and young adults by increasing accessibility particularly in low and middle-income countries. On Aug. 23, 2022, the 47 member-states of the WHO/Afro region voted to adopt PEN-Plus strategy to address severe NCDs at first-level referral facilities. According to WHO, NCDs such as cancer, cardiovascular diseases and diabetes, are increasingly becoming the main cause of mortality in sub-Saharan Africa. NCDs, also known as chronic diseases, are non-transmissible diseases of often long duration. Examples of NCDs include mental health conditions, stroke, heart disease, cancer, diabetes, sickle cell disorder, and chronic lung disease. They are driven largely by behaviours that usually start during childhood and adolescence. Such behaviours include physical inactivity, unhealthy diet, tobacco use and harmful use of alcohol. However, sometimes, they are genetic or congenital. The d iseases are accountable for 37 per cent of deaths in 2019, rising from 24 per cent in 2000 largely due to weaknesses in the implementation of critical control measures including prevention, diagnosis and care. In Africa, between 50 per cent and 88 per cent of deaths in seven countries, mostly small island nations, are due to non-communicable diseases, according to the 2022 World Health WHO NCDs Progress Monitor. Globally, it is estimated that one in two disability-affected lives and one in five deaths among adolescents are caused by NCDs. In the Africa, the number of people living with diabetes, for example, is expected to reach 47 million by 2045, up from 19 million in 2019. 'The growing burden of NCDs poses a grave threat to the health and lives of millions of people in Africa: over a third of deaths in the region are due to these illnesses. 'What is particularly concerning is that premature deaths from non-communicable diseases are rising among people younger than 70 years,' said Dr Matshidiso Moeti, WHO Regional Director for Africa. Highlighting the gravity of the situation, Moeti, who joined the International Conference on PEN-Plus in Africa (ICPPA2024) virtually, said it was time to prioritise person-centred approach to NCDs. The four-day conference, from April 23 to April 25, 2024, had the theme, 'Prioritising Person-Centered Approach to Chronic and Severe NCDs - Type 1 Diabetes, Sickle Cell Diseases, and Childhood Heart Diseases.' It was hosted by the Tanzania Ministry of Health and the World Health Organization African Region (WHO-Afro), in partnership with the HELMSLEY Charitable Trust and NCDI Poverty Network. The meeting centred around inequitable access to prevention, diagnosis, treatment and ongoing care, seeking commitment to advocate increased focus on chronic and severe non-communicable diseases within existing healthcare delivery systems. Moeti said: 'The surge in the number of NCDs on our continent over the past two decades is driven by increasing incidences of risk factors, such as u nhealthy diets, reduced mental activity, obesity, and air pollution.' She urged African governments to step up efforts and embrace the PEN-Plus initiative to ensure that targets would be met. 'Severe NCDs such as Type 1 Diabetes, rheumatic heart disease and sickle cell disease, more frequently affect children and young adults, the majority of Africa's population. 'Africa must invest more now in addressing NCDs with adequate and sustained resources. 'We are continuing to invest in reducing the high burden of premature mortality from chronic and severe disease within the context of Universal Health Coverage. 'Despite our member-states' efforts, we have a huge challenge in NCDS in Africa,' she said. According to the official, data from low-income countries shows that 26 per cent of total health spending is due to NCDs, second only to infectious and parasitic diseases. 'This means it is urgent to give these often-neglected diseases the priority and attention they deserve.'' She said that the rapid evoluti on with a higher mortality rate had not been adequately recognised because of inadequate investment and lack of diligence in knowing the diseases. Also, Elke Wisch, UNICEF Representative in Tanzania, who represented the UN Resident Coordinator in Tanzania, noted that children had become at great risk of NCDs. 'Beyond the general picture of NCDs, we also have severe conditions that pose acute stages in individuals affected by these conditions. 'Diseases such as sickle cell anemia, rheumatic heart diseases and Type 1 Diabetes do not only affect adults but also impact children and adolescents in significant numbers here, in Tanzania, and other countries in Africa.'' Wisch said that the diseases, if not priority attention, would remain a cause of mortality in children and adolescents. 'The United Nations system is consciously aware of the profound impact that NCDs have on individuals, families and entire societies and nations. 'These diseases, including cardiovascular diseases, cancer diabetes and chronic r espiratory diseases, pose significant challenges to our healthcare systems and the well-being of our countries.' Recognising the gravity of the consequences of not addressing NCDs, especially for children and adolescents, Mr James Reid of Helmsley Charitable Trust, suggested ways to address the situation. He advised that all efforts and investments in addressing NCDs should be focused on integrating NCD care seamlessly into existing health systems. 'The key to achieving UHC lies in expanding primary healthcare, especially in low-resource and humanitarian settings. 'Collaborative, cross-sector strategies, innovative investments and a focus on integrating NCD care into existing health systems are all keys to achieving health for all,'' he said. He said that successful models such as PEN-Plus had demonstrated the effectiveness of empowering nurses and mid-level providers to integrate NCD care into the ongoing continuum of primary healthcare. Through the PEN-Plus initiative, governments in the African regio n are working on strengthening preventive measures, promoting healthy lifestyles and ensuring access to quality healthcare services at the primary healthcare levels where many people seek healthcare services. Also, SDG 3.4 calls for all member-states to reduce premature deaths from NCDs by one-third in 2030 through prevention, treatment and promoting mental health and well-being. However, a number of low- and middle-income countries are not on track to actualising SDG target 3.4 to reduce NCD mortality. From the Africa Centres for Disease Control and Prevention (Africa CDC), the same indices resonate, with NCDs and other conditions rising and threatening the continent's vision of achieving and building an integrated, prosperous and peaceful Africa driven by its own citizens. However, as highlighted in the AU Agenda 2063, addressing the menace will also involve addressing these conditions with a multi-faceted approach. Dr Mohammed Abdulaziz, Head, Division of Disease Control and Prevention, Africa CDC, af firmed that a multi-faceted and integrated approach to solving some of the major health system obstacles in the delivery of NCDs Treatment and Prevention and Control Plan, was needed. 'Our approach must prioritise the individual and families impacted by NCDs. 'We must ensure equitable access to essential medicines and services for everyone for everyone.'' According to him, as agreed by the AU heads of state, there is need to set up a pool procurement mechanism to strengthen and see if this will help in getting essential medication and access to health products for these high-burden diseases. Also, he stressed the need for the integration of data which should be collected nationally, through surveillance. Achieving these goals, he said, also required bridging the funding gap for Africa for the NCDs programmes across the continent. 'We have no choice but to also push for domestic finance. We know that very few of our countries are reaching the 15 per cent mark budget for health, the Abuja declaration. 'I f we can show to all what we are doing, that our government should, in putting more funding into health, put more in the area of NCDs, it will be good to help us reach that target''. In conclusion, the path ahead toward addressing NCDS requires collaboration, communication, innovation and a human-centred approach. There is need for increased investment toward prevention, research and care for childhood NCDs, with access to equitable care and support given priority attention, leaving no one behind. These can be achieved when governments and leaderships are committed to stepping up efforts and embracing initiatives such as the PEN-Plus initiative, to ensure that targets are met. In so doing, aside adults, African children and adolescents can hope for a brighter future without the scare of living with or sliding into eternity with NCDS, when it could have been prevented or optimally-managed. At present, 20 countries in Sub-Saharan Africa are at various stages of initiating, implementing or scaling up PEN-Pl us. It is estimated that no fewer than 10,000 people are receiving treatment for severe NCDs in PEN-Plus Clinics across 11 Sub-Saharan countries. By 2030, the WHO's goal is for 70 per cent of African region member-tates to have national plans for integrated care, NCD training for health workers, and essential medicines in district hospitals. Source: News Agency of Nigeria