The article: ‘What can be done to reduce cancer deaths in Uganda’ (Daily Monitor, June 23), was a compassionate appeal that must be heeded.

The author raised many foundational issues about the escalation of cancer in Uganda. He left many concepts unexplained. First, the increasing incidence of cancer and other non-communicable diseases in Uganda should be discussed within the liberal market orientation – the commodification of social spaces, healthcare and rapid consumer cultural transitions. Underneath these are major behavioural changes inspired by the industry that makes available harmful products such as alcohol, cigarette, ultra-processed foods, etc.
I was recently surprised when I saw four extremely obese kids with their equally super obese parents walking out of a fast food outlet on Kampala Road with four full buckets of deep fried chicken.
Many associate fast foods with class and stature.

The increasing propensity among consumers for fast foods in the Fast Foods outlets that litter our streets, illustrate the transformative influence of liberalisation, and its impacts on our cultures and health. Dietary transition, for instance, is a matter of public health, as an indicator of rapid cultural shift among young and middle class people from organic traditional foods to ultra-processed industry foods.
I have until recently, believed in the singular discourse of behavioural explanation of the rise of high morbidity and mortality from non-communicable diseases in the so-called emerging markets of the developing countries. However, after deeply investigating, I now believe that the loss of environmental control is a powerful predictor of such behaviors. Underneath this, are powerful driving forces of multinational corporations.
These manufacture, transport, and distribute carcinogenic and harmful products.

These corporations are vicious in taking control of our everyday social environment and transforming them into markets, through targeted advertisements, targeted product packaging such as the alcohol sachets, and investing in trade policies that galvanizes their operations. Sachets are designed to attract the poor; sweetened drinks and highly salted foods are targeted at children. Moreover, certain products such as tobacco, whether over the counter, or counterfeit, most are laced with addictive chemicals.
The claim of sedentary lifestyle as a “causality” in an African setting is questionable as it capitulates upon scrutiny against sound evidence.

What is the percentage of Ugandans indulging in sedentary lifestyle, and why? What population are most afflicted by cancer and diabetes, and why?

When we analyse these questions and others, with the help of National Health Survey data and from HMIS reports alone, we may discover interesting trends and intersecting patterns between cancer, diabetes, chronic respiratory diseases and heart diseases with poverty, age and gender, and HIV/Aids status.
The sedentary lifestyle claim in Uganda in that sense is far-fetched given our modest of social interactions, poor transportation system, irregular and expensive electricity and television. The increasing use of social media may augment the risk of inactivity given that nearly 19.5 million Ugandans are now on social media. Most of these behaviours are associated with the emerging digital neoliberal economy.
Ugandans are becoming more obese with a bulging belly morphological dilemma.

Government must make screening services universal and mandatory.

In Uganda, men tend to resist screening because of reputational masculinity – fear of diagnoses which may alter their social status. This is problematic because most of these conditions, when diagnosed early, are reversible and treatable.
Many Ugandans live with hypertension and various conditions unknowingly. The culture of gauging illness by pain or immobility compromises treatment efficacy, and fans mysticism of poisoning, bewitching, etc.
In sum, the liberal market emphasises labour market attachment, production, and productivity. There is little room for being indisposed from the production line. You are responsible for getting sick and expected to get well on your own, perish!

Mr Komakech specialises in chronic disease and injury prevention.