Johannesburg The medical experts gathered from around Africa were here to talk about a continentwide epidemic, but it wasn’t AIDS or malaria — it was diabetes, and the bad habits that often bring it on.
A growing urban middle class is defying the image of Africa as poor, underfed and under-medicated. And with the comforts of middle class life, afflictions familiar in the West are making inroads here too — obesity, diabetes, lung cancer, strokes, heart disease.
A continent that traditionally traveled on foot or by bicycle now increasingly rides cars and buses. More time is spent at desks. Elevators are replacing stairs. White-collar Africans are discovering the gym.
“In the past, we used to exercise without knowing it,” South Africa’s health minister, Aaron Motsoaledi, reminded the recent conference.
“You would walk a long distance to school. You would walk a long distance to work. You would walk a long distance to the shops,” Motsoaledi, 52, recalled of his childhood. “But now I’m an African whose child is dropped at the gate of the school in a car, then picked up at the end of the day and put in front of the TV ….”
In West Africa, Cameroonians who once ate rice only as a holiday treat are loading their plates with it, crowding out the vegetables their parents ate. Down south, Malawians say fast foods are a status symbol.
In Nairobi, Kenya, a sobering chat with his doctor got 27-year-old Robel Demissi to the gym. “My blood pressure had gone up, a bit more than last year, and my weight was 8 kilograms (17 pounds) more. That’s a lot,” he says.
Demissi, a pilot for a Kenyan airline, blames his weight gain on junk food and a workload that leaves little time for exercise. But lest he flunk his physical and lose his flying license, he has taken up a Thai martial art and has lost 15 pounds in two months.
“I never used to have the time to train,” he said, “but now I have two motivating factors to make the time: my job and my life.”
All over the world, these lifestyle diseases tend to go hand in hand with urbanization and industrialization, and the results are felt in rising obesity rates and related illnesses. But they are all the more unwelcome in Africa, which already struggles with AIDS and malaria.
“These countries are really faced with a double burden,” said Dr. Timothy Armstrong, an expert on chronic diseases with the U.N. World Health Organization. How, he wonders, is a doctor treating AIDS or malaria to find time to lecture patients about watching their weight?
Armstrong wants African governments to follow the West’s lead with tobacco taxes and pressure on the food industry to cut salt and sugar content. But awareness often is lacking.
Fatima Macuacua, 31, owns a grocery store in Maputo, capital of Mozambique, and refuses to believe her favorite fast foods could be bad for her.
“Cancer, diabetes, high blood pressure and other diseases are not a big problem for Africans,” she insists. “Maybe for Europeans.”
Besides, the middle class on the world’s poorest continent is still tiny, and for many, issues of food are much more basic than gluten and trans fatty acids. A sharp rise in bread prices triggered riots in Maputo this year.
But free-market reforms have given Mozambique growth rates as high as 10 percent a year, meaning a boom for some, and gyms have sprouted in the capital.
The rise of lifestyle diseases is too recent for solid statistics to exist. Kenyan health authorities say only this year did they start counting cases of obesity and fatal heart attacks and strokes.
But at least the problem is getting attention.
Kenyan cardiologist Elijah Ogola says his own observations convince him there’s a problem and is especially worried about the patterns being set for children, who are less active than their parents were at their age.
“Generally our lives are so crowded that if you can afford to exercise you do not have the time to,” Ogola said in an interview. “You get into a matatu (bus), into the lift (elevator), and sit at your desk.”
Dr. Jean Claude Mbanya, president of the International Diabetes Foundation, said urban planners could help, for example, by designing car-free zones where Africans can rediscover walking.