Envisioning a healthy future: Africa’s shifting burden of disease

The document analyzes Africa's epidemiological transition, noting that while communicable diseases currently cause a disproportionate share of deaths, non-communicable diseases (NCDs) are rising. Using scenario modeling, it argues that achieving SDG 3.3 (eradicating communicable diseases) would significantly boost GDP and life expectancy but accelerate the shift toward NCDs, potentially stressing health systems. Conversely, achieving SDG 3.4 (reducing premature NCD deaths) improves productivity through reduced disability but offers smaller overall economic gains than the eradication of infectious diseases.

• Africa has the highest prevalence of communicable diseases globally; in 2015, 57% of all deaths in Africa were caused by communicable diseases, compared to 18% in other developing regions.
• Non-communicable diseases (NCDs) are increasing in Africa due to rising incomes and unplanned urbanisation, which lead to unhealthy diets, reduced physical activity, and increased tobacco use.
• There is a critical link between early-life communicable diseases and later NCDs: children suffering from respiratory infections and diarrhoeal diseases are more susceptible to stunting, which increases the risk of early-onset heart disease.
• Under the 'Current Path' forecast, most African countries are not expected to meet SDG 3.3 or 3.4 by 2030, although significant mortality reductions are still predicted.
• The 'Africa Uninfected' scenario, which simulates achieving SDG 3.3, would add 233 million healthy years to the population by 2030 and increase cumulative GDP by nearly US$8.6 trillion by 2050 compared to the Current Path.
• Achieving SDG 3.3 would accelerate the epidemiological transition, shifting the primary disease burden from communicable to non-communicable diseases by 2021 instead of 2031.
• The 'Africa Enduring' scenario, focusing on SDG 3.4, would add 84 million healthy years by 2030, with a significant portion (42 million years) coming from reduced disability rather than reduced mortality.
• The authors recommend investing in 'horizontal health systems'—broad general services—rather than relying solely on 'vertical programmes' that target specific diseases, to better manage the dual burden of communicable and non-communicable diseases.

APA

Narayan, K., & Donnenfeld, Z. (2016). Envisioning a healthy future: Africa’s shifting burden of disease. Institute for Security Studies. https://issafrica.s3.amazonaws.com/site/uploads/af18.pdf

Chicago

Narayan, Kanishka, and Zachary Donnenfeld. Envisioning a healthy future: Africa’s shifting burden of disease. Institute for Security Studies, 2016. https://issafrica.s3.amazonaws.com/site/uploads/af18.pdf.

Wikipedia

{{cite report |last1=Narayan |first1=Kanishka |last2=Donnenfeld |first2=Zachary |title=Envisioning a healthy future: Africa’s shifting burden of disease |publisher=Institute for Security Studies |date=October 2016 |url=https://issafrica.s3.amazonaws.com/site/uploads/af18.pdf |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{narayan2016envisioning, author = {Narayan, Kanishka and Donnenfeld, Zachary}, title = {{Envisioning a healthy future: Africa’s shifting burden of disease}}, institution = {Institute for Security Studies}, year = {2016}, month = oct, url = {https://issafrica.s3.amazonaws.com/site/uploads/af18.pdf}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }