The Demographics and Health Scenario

The Demographics and Health Scenario is a research paper that models the potential impact of accelerated fertility decline and health infrastructure improvements across Africa. It outlines a series of ambitious but empirically grounded interventions starting in 2027 to enhance human development and economic growth relative to a 'Current Path' forecast.

• The scenario aims to significantly increase the use of modern contraceptives by 2050 to accelerate demographic transition. In sub-Saharan Africa, average usage is projected to rise from 33% in 2025 to 75%, while North Africa's average usage is expected to reach 85%.
• To address the 'double burden of disease', the scenario implements interventions to reduce mortality rates by 20 percentage points below the Current Path for 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 model forecasts a rapid expansion of safely managed water and sanitation (WaSH) infrastructure. In sub-Saharan Africa, average access is projected to increase from 29% in 2025 to 61% by 2050, with urban access rising to 74% and rural access to 45%. North Africa's total access rates are projected to grow from 78% in 2025 to 92% by 2050.
• The scenario targets a reduction in under-five stunting rates by 20% below the 2050 Current Path in 39 African countries that had rates above 20% in 2021. This would reduce the number of stunted children in Africa from 30 million in 2025 to 12.8 million in 2050.
• Implementing these health improvements requires a 5% increase in health spending, totaling an additional US$18.9 billion continentwide, with infrastructure spending peaking at US$4.7 billion per annum 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} }