**3.2 Voluntary global targets**


Unfortunately, during various evaluations of the progress made in the implementation of the commitments made by the States, the observation was disappointing: most of them had not reached the desired level in the process of implementation of the States commitments [30].

*Lifestyle and Cardiovascular Risk Factors: Urban Population versus Rural Population… DOI: http://dx.doi.org/10.5772/intechopen.96881*

To this end, seven main obstacles to the implementation of these commitments have been identified, namely:

1.lack of political will, mobilization, capacity and action;


internationally agreed development goals, through strengthened international

2.To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for the prevention and control

4.To strengthen and orient health systems to address the prevention and control of noncommunicable diseases and the underlying social determinants through

3.To reduce modifiable risk factors for noncommunicable diseases and underlying social determinants through creation of health-promoting

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases…*

people-centred primary health care and universal health coverage;

evaluate progressin their prevention and control.

cancer, diabetes, or chronic respiratory diseases;

5.To promote and support national capacity for high-quality research and development for the prevention and control of noncommunicable diseases;

6.To monitor the trends and determinants of noncommunicable diseases and

1.A 25% relative reduction in the overall mortality from cardiovascular diseases,

2.At least 10% relative reduction in the harmful use of alcohol, as appropriate,

5.A 30% relative reduction in prevalence of current tobacco use in persons aged

8.At least 50% of eligible people receive drug therapy and counselling (including

Unfortunately, during various evaluations of the progress made in the implementation of the commitments made by the States, the observation was disappointing: most of them had not reached the desired level in the process of

3.A 10% relative reduction in prevalence of insufficient physical activity;

4.A 30% relative reduction in mean population intake of salt/sodium;

6.A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national

9.An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable

glycaemic control) to prevent heart attacks and strokes;

diseases in both public and private facilities.

implementation of the States commitments [30].

cooperation and advocacy;

of noncommunicable diseases;

environments;

**3.2 Voluntary global targets**

15+ years;

**172**

circumstances;

within the national context;

7.Halt the rise in diabetes and obesity;


#### 7.lack of accountability.

This explains, in most states in SSA, a situation of inertia in the implementation of the recommendations and commitments made by the leaders of these states, with multiple consequences: absence of administrative and legal reforms to support the fight against NCDs, lack of support for national programs, where they exist, scarcity of basic epidemiological data on NCDs, lack of support for healthcare establishments for the management of NCDs, etc.

In this context, it is understandable why in SSA states, there are no national registers of NCDs, nor large-scale general population data on NCDRFs or CVRFs, and even less on CVDs; healthcare establishments are not equipped for the correct management of NCDs or CVDs. These states for the most part do not have structures for universal health coverage to promote accessibility for all to quality care. Comparative information on NCDs and their RFs between rural and urban areas is not sufficiently documented, apart from a few small series.

In view of this gloomy picture of CVDs in SSA, one of the priority actions should concern the carrying out of large national surveys of the prevalence of CVRFs so as to make basic epidemiological data available. This would make it possible to identify evidence on the possible differences between the different environments, urban and rural, and to draw the necessary consequences in terms of prospects for the control of CVDs.

#### **4. Conclusion**

CVDs are one of the major current public health problems in SSA and globally. They are among the main causes of morbidity and mortality in SSA, but data on their geographical and sociological distribution, especially in rural and urban areas, are still incomplete. The first existing epidemiological surveys seem to indicate that they are more firmly established in urban areas than in rural areas, probably linked to the difference in lifestyles between these two areas. SSA states need to take the option of launching vast epidemiological and clinical research programs aimed at making basic epidemiological data available, taking into account the sociological specificities of African society. This knowledge, documented in the form of scientific evidence, would make it possible to consider with relevance and effectiveness measures to combat this new epidemic in developing countries.

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases…*

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