**7. Conclusions**

There are concerns about the rising burden of CVD in SSA, adding to the prevalent infectious diseases in the region. The increase in CVD is due to behavioural and metabolic risk factors resulting from the epidemiologic transition in the region. The intersection between poverty and CVD cuts through primordial, primary prevention and secondary prevention interventions. In the context of poverty in SSA, CVD prevention is a challenge due to competing demands to address the never conquered infectious diseases. With a weak healthcare system and out of pocket payment for the costs of CVD care, a significant proportion of individuals with CVD and their households are pushed into poverty. Besides, CVD affects a younger and productive population in SSA than in the rest of the world.

Consequently, CVD-related loss of productivity will push an additional number of individuals into poverty. Because of this, appropriate strategies are needed to address the rising burden of CVD across SSA, and these should include activities to address poverty issues. Activities include providing available funding and resources for effective screening for NCDs, especially CVD and diabetes, given high rates of patients not being diagnosed. Alongside this, improving the access and availability of medicines, especially where co-payments are an appreciable issue among patients. Multiple channels exist, including activities of donors as well as increasing local production. Alongside this, enhance educational input, especially

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

for patients with low educational levels, to improve adherence rates to suggested lifestyle changes and prescribed medicines, which can be appreciable concerns. This includes a more significant role for pharmacists and nurse practitioners in SSA ambulatory care clinics to help diagnose and manage CVDs. Access and other schemes can also help to enhance the affordability of chronic medications to prevent and manage CVDs, building on current schemes. Should there continue to be high poverty levels and lack of healthcare, including medicines, CVDs will continue to be a growing issue. This is not in the best interest of any key stakeholder group or higher income countries seeking to benefit from growing African populations. We will continue to monitor the situation.
