Stellenbosch 肆客足球 (SU) this week welcomed leading global experts in cardiovascular research and medicine to the highly anticipated Nobel Symposium on Progress and Challenges in Cardiovascular Medicine held at the Stellenbosch Institute for Advanced Study (STIAS).
Cardiovascular disease (CVD) is the leading cause of death worldwide, and while high-income countries have seen reduced mortality due to advances in prevention and treatment, the burden is shifting dramatically to low- and middle-income countries, particularly sub-Saharan Africa.
Part of the Nobel in Africa series, the symposium seeks to evaluate current research on disease mechanisms and explore effective strategies for controlling the growing health crisis posed by CVD. The fourth instalment of the Nobel in Africa symposium series, organised in partnership with the Royal Swedish Academy of Sciences and the Nobel Foundation, kicked off on a high note, setting the stage for an impactful week of discussions and knowledge exchange.
The opening session on Monday was graced by the presence of esteemed guests, including representatives from the Nobel Foundation, the Wallenberg Foundation and senior leadership from SU and the Council for Scientific and Industrial Research (CSIR).
Convened by prominent figures including Prof G?ran Hansson from the Karolinska Institute in Sweden and Prof Jan Nilsson from Lund 肆客足球, the event not only emphasises scientific dialogue but also aims to inspire young scientists and students from the African continent.
In his opening address, Hansson, who is also Secretary-General of the Royal Swedish Academy of Sciences, shared the challenges the organisers faced in bringing the symposium to fruition, including multiple Covid-9 pandemic-related postponements.
Prof Edward Kirumira, director of STIAS, encouraged participants to seize networking opportunities throughout the week. “The Nobel in Africa symposium series bring some of the best minds from around the world to your doorstep. You would have had to make many international and local trips to see all the participants gathered here. Take every single opportunity throughout this week to have those career shaping conversations," Kirumira urged participants.
Uniting leading minds
The symposium is more than an academic gathering, Prof Sibusiso Moyo, Deputy Vice Chancellor: Research, Innovation and Postgraduate Studies at SU said. “It is a testament to the collaborative strength and expertise of both South Africa and Sweden. Through this partnership, we are uniting leading minds from across the globe to address the challenges of cardiovascular medicine."
The first keynote address was delivered by Prof Abdallah Daar, Emeritus Professor of Clinical Public Health, Global Health, and Surgery at the 肆客足球 of Toronto. Daar highlighted the evolving landscape of cardiovascular diseases in the 21st century, pointing out the rise of both traditional and newly identified risk factors.
He noted that while long-known factors such as unhealthy diets, physical inactivity, tobacco use and alcohol consumption remain significant contributors to CVD, emerging risks like air pollution, climate change and the lingering effects of 肆客足球 are also reshaping global health dynamics. Additionally, social isolation, loneliness and lack of sleep, which might not traditionally be associated with heart disease, are increasingly recognised as critical risk factors, Daar pointed out.
He also delved into the diabetes and obesity epidemics, highlighting their critical roles in the rise of cardiovascular diseases worldwide. He expressed concern about the dramatic surge in diabetes cases, especially in low- and middle-income regions, where access to healthcare remains a challenge.
“One in eight people in the world are now living with obesity," Daar stated. “In 2022 this amounted to a billion people in the world being obese. Additionally, 43% of people are overweight. The increase worldwide of obesity amongst adults has more than doubled since 1990 and has quadrupled among children and adolescents. We know that once children become obese, it's almost impossible to stop it in the future," Daar warned.
Ultra processed foods have become almost unavoidable in our food chain, he added. “There is now evidence emerging to link ultra processed foods to heart disease. Artificial sweeteners containing erythritol specifically, are linked to blood clots and increased risk of cardiovascular diseases from there. The danger of low fibre diets we've known for a long time because high fibre diets remove cholesterol from the body and lower fibre diets don't. More recently, we have become aware that systemic autoimmune disorders are also risk factors for cardiovascular disease," Daar said.
One of the most promising developments he mentioned was the introduction of Glucagon like peptide-1 (GLP-1) receptor agonists, a new class of medicines initially developed to treat diabetes but now widely used to combat obesity. This medication has shown promise not only in weight management but also in reducing the risk of cardiovascular disease, Parkinson's disease and even addiction. However, their high cost and growing demand have led to shortages, raising concerns about equitable access, particularly in lower-income countries.
African perspective
Prof Ntobeko Ntusi, President of the South African Medical Research Council, presented an African perspective on cardiovascular disease. He outlined the unique challenges the continent faces, such as the high prevalence of hypertension, cardiomyopathy and rheumatic heart disease, which disproportionately affect younger populations.
“What we've noted over the last 20 years is that the burden of cardiovascular disease and subsequent mortality from cardiovascular disease has continued to increase at an unabated rate in all regions in Sub Saharan Africa," Ntusi said.
He stressed that while high-income countries have focused on atherosclerotic diseases, Africa is grappling with heart failure and other forms of CVD that strike earlier in life and disproportionately affects working-age populations, further exacerbating the socio-economic challenges faced by many African nations. Environmental risk factors, such as air pollution, and metabolic factors, especially uncontrolled hypertension, contribute significantly to the rising CVD burden.
“In Sub Saharan Africa, the prevalence is highest in women at just under 50% and about 35% in men. You can see here the disconnect between our scientific knowledge and our ability to manage hypertension effectively. Only about 50% of people who are hypertensive have been screened, and of those, only about a third have been treated. And of those who are treated, less than 10% are treated to target," Ntusi said.
He also referred to the compounding effect of infections such as HIV on cardiovascular health in Africa. For example, HIV-associated cardiomyopathy has emerged as a significant concern, further complicating the continent's fight against heart disease. Ntusi called for increased collaboration between African researchers and their global counterparts to develop tailored solutions that address the unique epidemiological landscape of the continent.
- Nobel in Africa is a STIAS initiative in partnership with SU under the auspices of the Nobel Foundation and the Royal Swedish Academy of Sciences with funding from the Knut & Alice Wallenberg Foundation. Through the initiative, STIAS organises a series of symposia with leading researchers in the category fields of the Nobel Prize, namely Physics, Chemistry, Economic Sciences, Physiology/Medicine and Literature.
PHOTO: Prof Sibusiso Moyo, Elana Africa (MC of the opening session), Prof Jan Nilsson, Prof Ntobeko Ntusi, Prof Abdallah Daar and Prof Edward Kirumira.
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