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|b The environment is the primary determinant of individual and community health. The Global Burden of Disease is defined as a comprehensive assessment of deaths and disabilities resulting from the disease, using the Disability-Adjusted Life Years (DALYs) index. The total number of deaths from various diseases in the world (2012) was about 55.6 million, with environmental factors accounting for 23.0%. The total burden of disease was 2736 million years, with environmental impacts accounting for approximately 22.0%. The total disability-adjusted life years from environmental diseases in Africa was nearly 175.0 million years, representing 29.3% of the total world number. The losses were clearly evident in nine African countries: Nigeria, Democratic Republic of the Congo, Ethiopia, Tanzania, Angola, Uganda, Kenya, South Africa and Mozambique, These countries accounted for 59.4% of the total loss of healthy life years due to environmental diseases in Africa. The main priority risks to the environment and health in Africa were indoor and outdoor air pollution, chemicals and hazardous wastes, poor access to safe drinking water, inadequate sanitation and the impact of vectors, as well as environmental and climatic changes. The main actions to reduce the environmental burden of disease in Africa are: raising environmental awareness, enacting and enforcing environmental legislation, improving health services and facilities, using clean technologies, as well as investing in preventive health programs.
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