Impact of the Demographics and Health Scenario

This research paper by the Institute for Security Studies analyzes the projected impacts of a 'Demographics and Health scenario' on Africa by 2043. It compares this scenario against a 'Current Path' baseline, forecasting improvements in water, sanitation, and hygiene (WaSH), disease burden, infant mortality, life expectancy, and overall economic prosperity.

• The Demographics and Health scenario projects significant improvements in WaSH infrastructure by 2043. Approximately 1,034 million Africans (47% of the population) would have access to safely managed sanitation services, compared to 904 million (39%) on the Current Path. Additionally, 57% of the population would be connected to safely managed water services, up from 48% on the Current Path. The number of countries achieving 50% access to safely managed sanitation is expected to rise from nine in 2030 to 22 by 2043.
• The scenario forecasts a reduction in the disease burden and infant mortality. By 2043, years of life lost due to communicable diseases are projected to decline to 145 million (from 294 million in 2023) and non-communicable diseases to 157 million (from 122 million in 2023). Infant mortality rates are projected to drop to 20 deaths per 1,000 live births by 2043, compared to 25 on the Current Path. The Central African Republic, South Sudan, and Lesotho are expected to see the most gains in infant mortality reduction.
• Life expectancy and fertility rates are expected to improve under this scenario. By 2043, life expectancy in sub-Saharan Africa is projected to reach 73.3 years, compared to 71.3 years in the baseline scenario. The total fertility rate in sub-Saharan Africa is projected to be approximately 2.6 children per fertile woman by 2043, down from 3.3 in the Current Path.
• The scenario predicts positive economic outcomes, including a higher GDP per capita and reduced poverty. Africa's average GDP per capita in 2043 would be US$252 higher than the Current Path, with the largest percentage gains in Mozambique, Liberia, and the DR Congo. The African economy is projected to be US$79 billion larger in 2043, despite a population that is 84 million smaller. Furthermore, 41 million fewer Africans would be considered extremely poor by 2043, with the most significant reductions occurring in Mozambique, Nigeria, and the DR Congo.

APA

Cilliers, J. (2026). Impact of the Demographics and Health Scenario. Institute for Security Studies. https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=04-impact-demographics-health-scenario

Chicago

Cilliers, Jakkie. Impact of the Demographics and Health Scenario. Institute for Security Studies, 2026. https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=04-impact-demographics-health-scenario.

Wikipedia

{{cite report |last1=Cilliers |first1=Jakkie |title=Impact of the Demographics and Health Scenario |publisher=Institute for Security Studies |date=29 March 2026 |url=https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=04-impact-demographics-health-scenario |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{cilliers2026impact, author = {Cilliers, Jakkie}, title = {{Impact of the Demographics and Health Scenario}}, institution = {Institute for Security Studies}, year = {2026}, month = mar, url = {https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=04-impact-demographics-health-scenario}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }