NCDs to overtake infectious diseases in Sub-Saharan Africa by 2030
A panel discussion during the 4th Global NCD Alliance Forum in Kigali, Rwanda on February 13, 2025. Experts at the forum warned that by 20230, non-communicable diseases will overtake infectious illnesses as the leading cause of death in sub-Saharan Africa.
What you need to know:
- In 2021, Kenya had one of the highest rates of diabetes in Africa, with millions of individuals battling the disease amid limited access to affordable healthcare.
IN KIGALI, RWANDA
In just five years, non-communicable diseases (NCDs) will overtake infectious illnesses as the leading cause of death in sub-Saharan Africa, experts have warned.
The prediction comes at a time the region is grappling with both a growing chronic disease burden and sharp foreign aid cuts for the health sector.
The stark forecast emerged during the 4th Global NCD Alliance Forum in Kigali, Rwanda, where more than 700 delegates from 89 countries gathered on February 13. This is the first time the forum has been held in sub-Saharan Africa, reflecting the region's mounting health challenges.
At the same time, global statistics paint a troubling picture. The World Health Organization reports that NCDs – including cancer, heart disease, diabetes, and mental health conditions – now account for 74 per cent of deaths worldwide. More than a billion people live with obesity, 1.3 billion with hypertension, and half a billion with diabetes or chronic respiratory diseases.
In Kenya, the scale of the NCD burden is staggering, and the figures are only expected to rise. According to WHO, NCDs already account for a significant portion of deaths in the country, with cardiovascular diseases and cancer leading.
In 2021, Kenya had one of the highest rates of diabetes in Africa, with millions of individuals battling the disease amid limited access to affordable healthcare.
Speaking during the forum, Katie Dain, CEO of the NCD Alliance, stressed the urgency of addressing the non-communicable diseases burden amid what she described as a global "polycrisis," where the challenges faced by people living with NCDs are exacerbated by other factors such as pandemics, climate change, conflicts and humanitarian crises.
This year's forum themed ‘Leadership on NCDs Towards 2025 and Beyond’, is being held against a backdrop of global health challenges as development aid freezes. The US administration's freeze on foreign aid and withdrawal from the World Health Organisation have left the global health community in shock, stalling key initiatives aimed at tackling both communicable and non-communicable diseases worldwide.
"The consequences of the Donald Trump administration's actions are far-reaching," Dain said.
"Health programmes that offer life-saving medication and treatment to those living with chronic diseases are in jeopardy, and global health financing, as we knew it, has been turned upside down."
According to Dain, freezing of USAID, which, whilst not directly focusing on NCDs particularly, is going to have a huge ripple effect across all health issues.
But all hope is not lost.
Against this challenging backdrop, Rwanda has emerged as a potential model for addressing the NCD crisis. The country's innovative approach, which emphasises prevention alongside treatment, is showing remarkable results.
"For too long, the global response to NCDs focused primarily on treatment," said Dr Yvan Butera, Rwanda's minister of Health. "We have taken a different path. Tobacco use has dropped from 13 per cent in 2012 to 7.1 per cent in 2022, thanks to aggressive taxation policies and community engagement."
Rwanda's strategy includes creative public health initiatives like car-free days and comprehensive school health programmes such as physical activities. Most significantly, over 90 per cent of the population enjoys access to NCD treatment through the Community-Based Health Insurance system, with payments scaled to income levels.
"The system operates on a sliding payment scale based on income, making NCD coverage widely accessible across the country. Rwanda's health insurance also covers certain medications, ensuring both prevention and access to treatment," Dr Butera said.
However, Rwanda's progress stands in stark contrast to wider regional struggles. In Kenya, which reports one of Africa's highest diabetes rates, resource constraints and decentralised healthcare delivery create significant barriers to NCD prevention and treatment.
"The deficits in resource allocation affect early screening, leading to late diagnoses," explained Dr Mary Nyamongo, NCD Alliance Kenya Board chairperson. "While our national policies address NCDs comprehensively, implementation remains our greatest challenge. Furthermore, the decentralisation of health functions to counties has created uneven delivery at community and county levels, making it more challenging to address these growing health risks effectively," she added.
Cancer care particularly illustrates the healthcare divide between global north and south. Prisca Githuka, who chairs Kenya's Cancer Survivors Association, reports that patients often wait too long to access basic pain medications like morphine.
"Currently, patients in Kenya are struggling to access morphine, and some are forced to wait for months to receive radiotherapy treatment," she said.
Despite these challenges, the forum highlighted significant progress in civil society engagement. "We now collaborate with 72 national and regional NCD alliances," noted Alison Cox, policy and advocacy director at the NCD Alliance.
"The East African NCD Alliance has become a model for other regions, particularly in involving people living with NCDs in policy development."
To reduce the prevalence and impact of non-communicable diseases, Dr Nyamongo says there is a need to implement resourced policies and interventions that can reach the most vulnerable groups.
"While the current Kenya Health Policy (2014-2030) adequately addresses NCDs, and the National NCD Strategy has operationalised the commitments outlined in the policy, effective implementation is still the major challenge. Limited resources continue to be a significant barrier to putting these plans into action, added Dr Nyamongo.
The Global NCD Alliance Forum is a pivotal gathering in the lead-up to a high-level meeting in New York this September.
According to Cox, this event will provide a key opportunity for governments to discuss noncommunicable diseases in a more significant, broader context than ever before, bringing health discussions from the World Health Assembly in Geneva to the UN headquarters in New York.
"At this high level, heads of state and government will convene, making it a critical point to elevate NCDs on the global agenda," added Cox.
