Reliable statistics on health, life-expectancy and disease incidence in Africa are not readily available. The WHO 2007 report ranks the quality of cause-of-death information for most of Africa as low or non-existent. In this regard, Africa does not compare well to the rest of the world, and for much of Africa there is no information.1 2 The poor quality of the available information renders definitive comment and prediction problematic.

The publication of the landmark global burden of disease report in 1996 drew attention to the potential impact of degenerative cardiovascular diseases as causes of future morbidity and mortality in developing countries.3 Since then, there has been considerable speculation and discussion about the impact of the epidemiological transition on the health and healthcare needs of the people of Africa. In this issue, Dr George Mensah4 reviews the historical evidence for the rarity of ischaemic heart disease (IHD) in Africa, the factors considered to have contributed to a rise in the incidence of IHD in Africa, the opportunity afforded to interrupt that rise and the very serious consequences if such a rise in incidence is not addressed appropriately (see page 836). His call mirrors that of others who consider that IHD and other chronic degenerative diseases in people living in developing countries receive insufficient attention.5 6

These are important issues for those of us practising, teaching and …