title: Tracing Africa's progress towards implementing the Non-Communicable Diseases Global action plan 2013-2020: a synthesis of WHO country profile reports.
abstract: Half of the estimated annual 28 million non-communicable diseases (NCDs) deaths in low- and middle-income countries (LMICs) are attributed to weak health systems. Current health policy responses to NCDs are fragmented and vertical particularly in the African region. The World Health Organization (WHO) led NCDs Global action plan 2013-2020 has been recommended for reducing the NCD burden but it is unclear whether Africa is on track in its implementation. This paper synthesizes Africa's progress towards WHO policy recommendations for reducing the NCD burden.
  
  
  
  Data from the WHO 2011, 2014 and 2015 NCD reports were used for this analysis. We synthesized results by targets descriptions in the three reports and included indicators for which we could trace progress in at least two of the three reports.
  
  
  
  More than half of the African countries did not achieve the set targets for 2015 and slow progress had been made towards the 2016 targets as of December 2013. Some gains were made in implementing national public awareness programmes on diet and/or physical activity, however limited progress was made on guidelines for management of NCD and drug therapy and counselling. While all regions in Africa show waning trends in fully achieving the NCD indicators in general, the Southern African region appears to have made the least progress while the Northern African region appears to be the most progressive.
  
  
  
  Our findings suggest that Africa is off track in achieving the NCDs indicators by the set deadlines. To make sustained public health gains, more effort and commitment is urgently needed from governments, partners and societies to implement these recommendations in a broader strategy. While donors need to suit NCD advocacy with funding, African institutions such as The African Union (AU) and other sub-regional bodies such as West African Health Organization (WAHO) and various country offices could potentially play stronger roles in advocating for more NCD policy efforts in Africa.
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. g.n.nyaaba@amc.uva.nl.
authors.forename: Gertrude Nsorma
authors.initials: GN
authors.lastname: Nyaaba
authors.affiliation: Department of Public Health; Academic Medical Centre, University of Amsterdam, PO-box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.affiliation: Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Ghana.
authors.forename: Ama
authors.initials: A
authors.lastname: de-Graft Aikins
authors.affiliation: Non-Communicable Diseases Research Unit, South African Medical Research Council & University of Cape Town, Cape Town, South Africa.
authors.forename: Andre Pascal
authors.initials: AP
authors.lastname: Kengne
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
mesh_terms: D000349:Africa / Q000453:epidemiology; D003140:Communicable Disease Control / Q000458:organization & administration / Q000592:standards*; D003141:Communicable Diseases / Q000453:epidemiology*; D014943:Global Health; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D008507:Medically Underserved Area; D014944:World Health Organization
keywords: Africa; Multi-sectoral NCD strategy; NCD Health Policy; Non-communicable diseases; WHO