Ray of hope for sub-Saharan Africa's paratransit: Solar charging of urban electric minibus taxis in South Africa

Sub-Saharan Africa (SSA) has a disproportionate burden of both infectious and chronic diseases compared with other world regions. Current disease estimates for SSA are based on sparse data, but projections indicate increases in non-communicable diseases (NCDs) caused by demographic and epidemiologic transitions. We review the literature on NCDs in SSA and summarize data from the World Health Organization and International Agency for Research on Cancer on the prevalence and incidence of cardiovascular diseases, diabetes mellitus Type 2, cancer and their risk factors. We searched the PubMed database for studies on each condition, and included those that were community based, conducted in any SSA country and reported on disease or risk factor prevalence, incidence or mortality. We found few community-based studies and some countries (such as South Africa) were over-represented. The prevalence of NCDs and risk factors varied considerably between countries, urban/rural location and other sub-populations. The prevalence of stroke ranged from 0.07 to 0.3%, diabetes mellitus from 0 to 16%, hypertension from 6 to 48%, obesity from 0.4 to 43% and current smoking from 0.4 to 71%. Hypertension prevalence was consistently similar among men and women, whereas women were more frequently obese and men were more frequently current smokers. The prevalence of NCDs and their risk factors is high in some SSA settings. With the lack of vital statistics systems, epidemiologic studies with a variety of designs (cross-sectional, longitudinal and interventional) capable of in-depth analyses of risk factors could provide a better understanding of NCDs in SSA, and inform health-care policy to mitigate the oncoming NCD epidemic.

Air quality in cities of Sub-Saharan African (SSA) countries has deteriorated with the situation driven by rapid population growth and its attendant increased vehicle ownership, increased use of solid fuels for cooking and heating, and poor waste management practices. Industrial expansion in these cities is also a major contributor to the worsening air pollution. Exposure to ambient air pollution is a major threat to human health in SSA with 176,000 deaths and 626,000 DALYs in the region attributable to ambient air pollution exposure. These estimates are however likely to be much higher than reported due to the limited data emanating from the region. Recently, the adoption of the World Health Assembly resolution on air pollution and health, and Sustainable Development Goals are a welcome boost for urban air pollution control efforts in SSA. In this article, we have outlined within the broad framework of these international policy instruments, measures for addressing urban air pollution and its associated health impacts in SSA sustainably.