2494 Simvastatin advert(pth)RR 24/10/06 1:09 pm Page 1 C M Y CM MY CY CMY K CARDIOVASCULAR JOURNAL OF AFRICA Vol 18, No. 5, September/October 2007 281 Editorial Poverty and human development A perspective on cardiovascular disease in sub-Saharan Africa This issue of the Cardiovascular Journal of Africa is a contri- the underprivileged rural populations in transition when they bution to the Council of Science Editors’ global theme issue came face to face with new life styles while trying to resettle in on poverty and human development. the adopted community. They increasingly became victims of The poverty-stricken nations of the world lie largely between hypertension, coronary artery disease and the emerging meta- latitudes 15° south and 30° north of the equator, in particular in bolic syndrome comprising obesity, hypertension and diabetes. tropical and subtropical areas. Endemic diseases are rife in these In this issue we draw attention to some of these cardiovas- regions, some of which are malaria, schistisomiasis, helmin- cular situations and conditions, which may either be the conse- thiasis, hydatid disease, amoebic dysentery, spirochaetosis and quence of, or at the very least associated with poverty and the rickettsia. Other diseases of uncertain origin are also common, adaptation of persons in transition from one culture to another. such as cardiomyopathies. Conditions such as hypertension, the pattern of heart failure, An in-depth study on the annual per capita income of the prevalence of chronic heart disease, and perspectives on countries in relation to their environmental temperature rang- malnutrition and underdevelopment related to heart disease are es, with its implications for global warming, confirms¹ that described in the articles. Vascular risk factors relating to stroke the poorer nations are in the warm tropical and subtropical and coronary artery disease, including data on cut-off points for climates. Another article clearly illustrates that poverty is largely abdominal obesity have been studied and are presented. What is entrenched in areas with a tropical climate and lack of access described in specific African states applies in general through- to the sea.² out the subcontinent. Disease is considered to be a causative factor of a nation’s Only large-scale educational drives and the eradication of poverty but low productivity, lack of education and other disease can bring a fertile subcontinent with abundant natural factors are also thought to play a role. However, it is possible resources to a point where it can be self-sufficient and develop that disease is also the historical background for all the other the people to their full potential. These programmes of educa- suggested factors leading to the impoverishment of those living tion and the reduction or eradication of disease in the impover- in tropical and subtropical climates. ished world will have to be engaged in rapidly if there is to be In these regions, disease has resulted in poor physical and any hope of achieving healthy lives with average life expectancy mental development of the people. Sickness has weakened in these populations. them, making them subjects of slavery and exploitation for cheap labour, and foreign countries have stripped them of their AJ BRINK natural resources. The industrial revolution passed them by and Editor, Cardiovascular Journal of Africa the modern levels of unprecedented technological development could not be acquired due to lack of education and opportunity. References A constant vicious circle of physical and educational backlogs leading to an inability to maintain health and compete for 1. Horowitz John K. The income−temperature relationship in a cross- section of countries and its implications for global warming. (February survival with the more affluent nations has left sub-Saharan 14, 2001). U of Maryland Working Paper No. 01-02. Available at Africa in dire straits. SSRN: http://ssrn.com/abstract=260990 or DOI: 10.2139/ssrn.260990. The other major adverse influence on these populations 2. Sacks JD, Mellinger AD, Gallup JL. Tropical climate and lack of access occurred in those who were in transition from a rural setting to sea trade have hurt the poorest nations. But new aid programs point to more developed city environments. A cultural shock awaited the way to prosperity. Sci Amer 2001; 284(3): 71. Composite