THE handling of a single serious disease requiring hospitalisation is evidently immensely difficult for anyone without reliable insurance coverage.

Therefore, a recent scientific finding that nearly half of patients admitted to hospitals in Malawi and Tanzania suffer from multi-morbidity, with two or more chronic diseases, was sobering.

It served to highlight the stiff climb these countries, as a small sample in the wider African context and arguably elsewhere, have to scale to put up health outlays that satisfy extensive diagnosis and treatment especially of non-communicable diseases.

Indeed, they add to an already enormous burden of ensuring satisfactory treatment for TB, HIV or malaria.

Top-level experts with the Multilink Consortium working at the Liverpool School of Tropical Medicine (LSTM) with colleagues in leading health institutions in the two countries conducted the research, one of the results being that multi-morbidity is underdiagnosed.

It was reported that this results in avoidable deaths and economic hardships which, to a considerable extent, affects those of working age, spelling disaster to families and life expectations generally.

The scholars see this as clearly calling for urgent improvements in the prevention, diagnosis and disease management practices especially for NCDs.

Reports say that the research, published in Lancet Global Health, analysed 1,007 patients admitted to four hospitals across Malawi and Tanzania and it was noticed that 47 per cent of these patients had multi-morbidity, chiefly hypertension, diabetes and HIV.

HIV is communicable and commonly occurs with tuberculosis and malaria, while the other two are similarly related but, by contrast, are not communicable.

Accordingly, having a compound strategy for prevention or treatment or a disease management outlook for all of them is likely to be especially testing.

These illnesses doubtless increase the risk of severe complications, listed as heart failure, strokes, chronic kidney disease and, ultimately, early death – as patients with multiple chronic conditions faced significantly higher mortality rates within 90 days of hospital admission.

By contrast about 41.7 per cent of these reached this condition compared to 28.3 per cent for those with a single chronic condition and 13.5 per cent for those with no chronic ailments.

This implies that multi-morbidity sharply accentuates the chances of irredeemable deterioration in a patient’s condition.

What may have puzzled some readers is the way the lead authors of the study privileged the substantial economic impact on patients, focusing on Tanzania, as here healthcare costs are not fully covered by the government.

One problem with this observation, though, is to whom it is directed – whether it is to the government owing to the difficulties patients with multi-morbidity face, including loss of income, higher medical expenses and reduced quality of life.

Alternatively it would be intended as a sober reminder of scaling up availability of drugs in public health facilities, which is a bit unlikely.

This is another instance where activists on the healthcare front ought to team up more to underline the need for action rather than standing on middle ground.

Usually activists’ appeals are directed at donor countries or, euphemistically, the development partners, and now that this shield is cracking, a no-man’s land opens up where activists really mean to tell governments to do something about it.

However, as they aren’t essentially local, they have cold feet in making any such emphasis. It’s an urgent note demanding action but with a cover ‘to whom it may concern’.