The Demographics and Health Scenario

The Demographics and Health Scenario explores the impact of targeted interventions in family planning, disease mortality reduction, water and sanitation (WaSH), and child nutrition across Africa. By 2050, the scenario aims to increase modern contraceptive use to 75% in sub-Saharan Africa and 85% in North Africa, while reducing mortality for the top five disease types in each country by 20 percentage points. It also projects an increase in sub-Saharan African average access to safely managed water and sanitation from 29% in 2025 to 61% by 2050. These health improvements are supported by a projected 5% increase in health spending, totaling an additional US$18.9 billion continentwide.

• The scenario targets a significant increase in the use of modern contraceptives by 2050: average usage is projected to reach 75% in sub-Saharan Africa (a 24 percentage point increase over the Current Path) and 85% in North Africa.
• To reduce the disease burden, the scenario models a 20 percentage point reduction below the Current Path for mortality rates of the top five disease types in every African country. Additionally, in nine countries where HIV infection rates exceed 1% of the population, the rate is reduced by 20% below the Current Path.
• The scenario projects a substantial increase in access to safely managed water and sanitation in sub-Saharan Africa, with the average access rate rising from 29% in 2025 to 61% by 2050. In North Africa, total access rates are projected to increase from 78% in 2025 to 92% by 2050.
• The scenario aims to reduce under-five stunting rates by 20% below the 2050 Current Path in 39 African countries where the 2021 rate was above 20%. This would result in the number of stunted children in Africa declining from 30 million in 2025 to 12.8 million in 2050.
• Implementing these health and infrastructure improvements requires a 5% increase in health spending, amounting to an additional US$18.9 billion continentwide, with infrastructure spending peaking at US$4.7 billion per year in 2037.

APA

Cilliers, J. (2026). The Demographics and Health Scenario. Institute for Security Studies. https://futures.issafrica.org/thematic/guide.pdf?thematic=03-demographic-dividend&topic=06-demographics-and-health

Chicago

Cilliers, Jakkie. The Demographics and Health Scenario. Institute for Security Studies, 2026. https://futures.issafrica.org/thematic/guide.pdf?thematic=03-demographic-dividend&topic=06-demographics-and-health.

Wikipedia

{{cite report |last1=Cilliers |first1=Jakkie |title=The Demographics and Health Scenario |publisher=Institute for Security Studies |date=28 May 2026 |url=https://futures.issafrica.org/thematic/guide.pdf?thematic=03-demographic-dividend&topic=06-demographics-and-health |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{cilliers2026demographics, author = {Cilliers, Jakkie}, title = {{The Demographics and Health Scenario}}, institution = {Institute for Security Studies}, year = {2026}, month = may, url = {https://futures.issafrica.org/thematic/guide.pdf?thematic=03-demographic-dividend&topic=06-demographics-and-health}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }