The Global NCD Crisis is a Ticking Clock for Africa’s Health Systems

By Vania Kibui (Senior Advisor, Policy Advocacy & Strategic Engagement, Amref Health Africa) and William Kidega (Health Research Development & Innovation Advocacy & Communications Advisor, Amref Health Africa) with Ralph Achenbach (Executive Director, Amref Health Africa Deutschland)

At the 80th United Nations General Assembly (UNGA80), world leaders adopted a Declaration on Non-communicable Diseases (NCDs) and Mental Health. For Africa, where fragile health systems already shoulder the weight of infectious diseases, this declaration is a welcome signal. But it is not enough. The Declaration presented an opportunity for timely, strategic and centered repositioning of mental health—not as a separate concern—but as a central pillar of the NCD response. This can be a missed opportunity largely dependent on the actions taken going forward.

As Amref Health Africa, we recognise the urgency. Unless governments move beyond political pledges to bold financing reforms and system redesigns, NCDs will push African health systems to collapse within this decade. The question is no longer about awareness, but about political will, financial re-engineering, and solidarity.

This reality came into sharp focus at Amref’s side event in New York, “Unlocking Africa’s Youth Potential through Integrated NCD and Mental Health & Wellbeing.” This critical discussion was held in the face of a silent and mounting mental health crisis for youth in Africa. Mental health conditions, long neglected and heavily stigmatized, are rising sharply among youth across the world, including in Africa. This crisis compounds Africa’s growing disease burden of non-communicable diseases (NCDs), thus forming a dangerous synergy that threatens to undermine decades of health and development gains.

The message was clear: Africa’s youth, our greatest asset, are standing on the fault line of an unfolding health crisis. The integration imperative is therefore the only imperative.

The African NCD Crisis and Systemic Failure

The data are sobering. NCDs now account for more than 71% of global deaths and are projected to become the leading cause of death in sub-Saharan Africa by 2030. In many African hospitals, conditions such as hypertension, diabetes, and cancer already account for half of all admissions, and almost 35% of deaths.

This crisis is fueled by rapid urbanisation, unhealthy diets, and weak preventive systems. Yet the funding model for NCDs has failed:

• Unsustainable financing: While infectious diseases once benefited from heavily subsidized programmes, chronic NCD care is left largely uncovered.
• Catastrophic costs: Families now shoulder nearly 80% of NCD care out-of-pocket, pushing millions into poverty and delaying treatment until it is too late.

According to Dr Githinji Gitahi, Amref’s Group CEO, health systems built on the infectious disease model are “ill-equipped for the chronic care continuum.” Without new resources and attention, they will buckle under the weight of long-term NCD care.

Revolutionising Care: A Two-Pronged Paradigm Shift

Addressing Africa’s NCD crisis requires a radical paradigm shift, one that reshapes how and where care is delivered.

Downstaging Diagnosis and Care: Today, most NCD diagnoses come late, when treatment is costly and complex. The future lies beyond hospital gates, but in communities where prevention and early diagnosis begin. Governments must invest in Community Health Workers (CHWs), equipping them with low-cost tools such as mobile phones, glucometers, and blood pressure machines. With these, CHWs can detect conditions early and bring care closer to households.

Digital tools should also be part of this shift, but only simple, offline-first systems that work in rural clinics and communities, not expensive high-tech pilots that fail at scale.

Integrating Mental Health and NCDs: Chronic disease often carries an invisible burden: depression, anxiety, and hopelessness. NCDs and mental health are linked, particularly among young people facing unemployment and poverty.

Integrated care models that address both physical and mental wellbeing are the only way to ensure youth can thrive.

A Call to Action: Pillars for Global and National Commitment

The Declaration at UNGA80 is a starting point. To protect Africa’s health and economic future, governments and partners must act decisively on the following pillars:

1. Financial Re-engineering and Progressive Universalism

• Impose health taxes on tobacco, alcohol, sugary drinks, and ultra-processed foods.
• Ring-fence revenues to fund NCD and mental health programmes.
• Incorporate NCD care into national insurance schemes to reduce the crushing out-of-pocket burden on families.

2. Systemic Rebuild: Empowering the Frontlines

• Invest in and integrate CHWs as the backbone of NCD prevention and early care.
• Ensure they are trained, paid, and fully embedded into health systems.

3. Policy and Regulation: Protecting the Next Generation

• Enforce strong food policies to eliminate industrial trans fats, restrict marketing of high-sugar and high-salt products to children, and regulate unhealthy food environments.
• Prevention is the most cost-effective cure. Every dollar spent on reducing risk factors saves health systems multiple times in treatment costs.

A Global Imperative

Less than 3% of development assistance for health currently goes to NCDs, despite their growing toll. This imbalance is unsustainable. Global solidarity is not charity; it is a strategic investment in stability and security.

The HIV/AIDS response showed what is possible. Breakthrough treatments like lenacapavir became accessible in both high- and low-income countries through political will and innovative financing. The same urgency and equity must now guide NCD and mental health responses.

The Clock is Ticking

The time for framing NCDs as a “future problem” is over. They are here, today, eroding Africa’s health systems and threatening the continent’s development.

The legacy of UNGA80 must not be another declaration. It must be a decade of tangible, funded action, with NCDs and mental health fully integrated into primary health care, backed by domestic financing and global solidarity.

Africa cannot afford to treat NCDs as a silent killer, only to discover too late that they have become the catalyst for systemic collapse.

Picture: Amref Health Africa.