The hidden health toll on East Africa's key logistics artery

Trucks snarl up in Malaba border, Busia County. [File, Standard] The Northern Transport Corridor has for years been viewed as a key transport artery for the East African region, facilitating the movement of people and goods, but rarely looked at through the eyes of public health officials. And when the corridor's health issues are discussed, they have usually centred on HIV, with it being seen as facilitating transmission from one town to another and one country to the next. However, behind the hundreds of kilometres of tarmac and rail are truckers and communities along the corridor who grapple with numerous health risks every day. Other than HIV, they face risks of contracting other STIs as well as other communicable diseases like malaria and TB. Due to the nature of their work, the truckers have to contend with other diseases such as diabetes and hypertension. Then there are the grizzly accidents, many of which have been fatal. Other than death and life-altering injuries for some survivors, these accidents leave mental scars for motorists and other survivors, as well as area residents. Within Kenya, the corridor carries a significant share of the more than 40 million tonnes of cargo that pass through the Port of Mombasa each year. According to government data, the Mariakani Weighbridge documents over 3,500 trucks daily during peak months. North Star Alliance Chairman Bernard Kadasia said long-distance truckers and communities living along the corridor have, over time, fallen between the gaps of traditional health systems. Kadasia, who spoke during the second Transport Corridors and Health Conference in Nairobi, called on governments in the region to institutionalise health within the Northern Transport Corridor. "Our continent's transport corridors are the arteries of regional integration and trade. Every day, thousands of trucks, buses, traders and travellers move along these routes, connecting ports to hinterlands, farms to markets, and countries to one another. But we also know that where goods move, people move - and where people move, health risks move too," he said. "If we want safe, efficient and resilient transport corridors, we must treat health as core infrastructure, not as an afterthought." Other than diseases, motorists and communities living along the corridor have to grapple with road accidents, many of them being fatal or causing life-altering injuries. Last year, 690 accidents were recorded along the corridor, causing 802 deaths. The accidents were linked to fatigue, poor visibility and the pressures of long-distance travel. "These figures affirm that corridor health is not merely a health sector concern; it is a regional security, economic productivity, and development imperative," said Health Cabinet Secretary Aden Duale. "Healthy corridors are productive corridors, and productive corridors drive national and regional development." The CS added that the Eastern Africa region is increasingly facing complex and recurrent public health threats, calling for heightened vigilance not only among public health sector players but across other sectors as well. "The recent Marburg Virus Disease outbreak in Ethiopia, ongoing anthrax events in high-risk counties here in Kenya, and cholera resurging across East Africa all remind us that health security is not an abstract concept-it is a daily, proactive responsibility. And mobility, while vital for trade, rapidly intensifies these risks," he said. The Northern Transport Corridor covers 1,700 kilometres, stretching from the port of Mombasa through to Uganda, Burundi, Rwanda, the Democratic Republic of Congo and South Sudan. The Executive Secretary of the Northern Corridor Transit And Transport Coordination Authority (NCTTCA) John Deng said the corridor has, in recent years, registered major growth, which will be sustained in the coming years as more investments are put in infrastructure, but also systems. These are expected to bring out more health risks and put pressure on existing health facilities along the corridor. These developments include the continued enhancement of the port's capacity, the planned upgrade of roads, including the Rironi-Mau Summit road, the extension of the Standard Gauge Railway in Kenya, as well as other planned works by other countries within the corridor. "This progress also brings new responsibilities. The movement of people and goods introduces unique health vulnerabilities that transport and public health systems must address collaboratively," he said. "Health challenges along transport corridors remain diverse and complex. They include persistent communicable diseases, rising non-communicable diseases, mental health conditions among transport workers, and service access gaps for migrant and mobile populations." North Star Alliance, which has for two decades been trying to tackle diseases along different transport corridors in Africa, has been setting up clinics along major roads, including the Northern Transport Corridor. The Alliance operates a network of converted shipping containers referred to as "Blue Box" Roadside Wellness Centres, which offer last-mile health services at border posts, ports, transit towns and major truck stops in more than 10 African countries, including along the Northern Transport Corridor. The "blue boxes" provide primary healthcare for common illnesses as well as prevention, testing and management of HIV, TB screening and care, screening for hypertension, diabetes and other non-communicable diseases. In 2024, the clinics provided care to 200,904 people, a majority of them truck drivers at 100,000, while another 40,000 were female sex workers. The health centres also attended to local communities. "Behind these numbers are real stories - drivers who discover they have high blood pressure before it is too late, sex workers who access prevention and treatment in a safe, respectful environment and communities along the corridor who now have a reliable point of care," said North Star Alliance boss, Kadasia. He called on regional governments to institutionalise health in the governance of the Northern Transport Corridor through innovation and investment in scaling up roadside health networks.

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