Health Experts Advocate for Enhanced Cardiac and Neurological Care Infrastructure Across Africa
In response to the escalating burden of non-communicable diseases (NCDs), health professionals are urging a significant strengthening of cardiac and neurological care infrastructure throughout Africa. This call aims to meet the growing demand for specialized services, including cardiology, neurosurgery, and advanced diagnostics, as the continent faces a shift in health challenges.
Epidemiological Transition and Rising Cardiac Diseases
Dr. Hasham Mohamed, a Consultant Interventional Cardiologist at Aga Khan University Hospital (AKUH) in Nairobi, highlighted that Africa is undergoing a notable epidemiological transition. Historically, infectious diseases, malnutrition, and related causes dominated mortality patterns, but non-communicable diseases such as heart disease and cancer are now surpassing them. Mohamed projected that by 2030, cardiac diseases could become the leading cause of death in Africa, emphasizing the urgent need for investment in cardiac care systems.
This shift has prompted increased institutional focus on NCDs at AKUH, with targeted investments in heart and cancer care services to address the rising demand for specialized treatment. The hospital's cardiac services are delivered through both outpatient and inpatient systems. Outpatient care manages patients with less severe conditions, involving clinical consultations and diagnostic evaluations like echocardiography, stress testing, and prolonged heart rhythm monitoring for suspected arrhythmias.
Advanced Cardiac Care and Training Initiatives
The cardiology unit at AKUH comprises full-time faculty cardiologists and affiliated specialists, totaling about ten practitioners. Additionally, the hospital trains cardiologists from across the region, including trainees from Tanzania, Rwanda, Senegal, and Ethiopia, who return home after completing their fellowships, thereby building local capacity.
Inpatient care is reserved for critically ill patients admitted to the Cardiac Care Unit (CCU) or Intensive Care Unit (ICU), particularly emergency cases such as heart attacks, where timely intervention is crucial to prevent complications or death. AKUH has been recognized as a center of excellence for chest pain management and holds international accreditation for meeting global standards in heart attack treatment, ensuring standardized emergency care regardless of the attending clinician or a patient's immediate ability to pay during initial treatment phases.
Innovations in Interventional Cardiology and Device Therapies
Dr. Mohamed described interventional cardiology as a major advancement in cardiac care, involving minimally invasive procedures using catheters inserted through blood vessels to diagnose and treat heart conditions without open surgery. These procedures are performed in catheterisation laboratories equipped with advanced imaging technology. Interventional techniques treat conditions such as coronary artery disease through angiography, angioplasty, and stenting, as well as valve-related diseases and congenital heart defects.
Modern approaches now allow high-risk patients, including the elderly, to undergo procedures like transcatheter aortic valve replacement and be discharged within a short period. The hospital has also introduced advanced cardiac device therapies, such as leadless pacemaker implantation, which eliminates the need for connecting wires, marking a significant innovation in the region's cardiac care. Additionally, electrophysiology services are offered for diagnosing and treating arrhythmias, including catheter ablation procedures that target and eliminate abnormal electrical pathways in the heart, potentially curing certain rhythm disorders in many patients.
Similar minimally invasive catheter-based techniques are used in other medical areas, such as embolisation procedures for treating fibroids and certain cancers by cutting off their blood supply. Dr. Mohamed noted that some forms of hypertension may be reversible if underlying causes are identified and treated, while most cases require long-term management. Newer treatment options, like renal artery denervation, are available for patients with resistant hypertension who do not respond to multiple medications.
Scaling Up Neurological Services
Dr. Beverly Cheserem, a Consultant Neurosurgeon, emphasized the need to scale up neurological services alongside cardiac care, given the rising incidence of neurological disorders, cancers, and other NCD-related conditions. As awareness improves and more patients seek diagnosis and treatment, hospitals must be equipped to manage increasing volumes of complex cases. Institutions like AKUH are specialized centers for advanced care, requiring robust systems, specialized equipment, and multidisciplinary teams.
On capacity, Dr. Cheserem noted that AKUH is designed to scale services as demand for oncology and neurosurgery grows. While some regions handle significantly larger caseloads daily, AKUH is positioned to expand capacity as needed. The hospital has developed systems to accommodate patients from different countries through flexible payment pathways and partnerships, ensuring that financial constraints do not hinder access to specialized care.
Comprehensive Neuroscience Ecosystem
Dr. Cheserem highlighted the strength of AKUH's neuroscience ecosystem, describing it as one of the most comprehensive in the region. It integrates specialists in neurosurgery, neurology, neuroradiology, neuropathology, and rehabilitation, enabling a multidisciplinary approach to complex cases. This integrated model allows the hospital to manage a wide range of conditions, including brain tumours, vascular disorders, and neuroinflammatory diseases, supported by advanced diagnostic tools such as PET imaging and multidisciplinary team (MDT) meetings that guide diagnosis and treatment planning.
In summary, health experts are calling for a concerted effort to enhance cardiac and neurological care infrastructure in Africa to effectively address the growing burden of non-communicable diseases and improve patient outcomes across the continent.
