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Abstract

Introduction. Sub-Saharan Africa (SSA) faces a complex epidemiological transition characterized by the persistence of chronic communicable diseases and the rapid emergence of noncommunicable diseases (NCDs), exerting unprecedented pressure on fragile health systems. This narrative review aimed to analyze the dual health burden of chronic communicable diseases and NCDs within SSA health systems, identifying prevalence, interactions, socio-economic impacts, and gaps in care to propose reform perspectives. Methods. A narrative literature review was conducted for the period 2013–2023 using PubMed, Scopus, AJOL, and Google Scholar databases. Relevant articles and reports were selected and synthesized thematically. Results. SSA accounts for 71 % of the global HIV burden and 23 % of the tuberculosis burden. NCDs were responsible for 37 % of deaths in 2019, up from 26 % in 2000, and are projected to become the leading cause of mortality by 2030. Hypertension and diabetes prevalence is rising sharply, with a high proportion of undiagnosed cases. Health systems suffer from critical personnel shortages (estimated deficit of 6.1 million by 2030), inadequate infrastructure, fragmented funding and care programs, and limited treatment access. Out-of-pocket payments represent a major share of health expenditures, with catastrophic economic impact on households. Conclusion. Management requires a paradigm shift toward integrated approaches centered on strengthening primary health care, prevention, early screening, and continuity of care. Structural reforms, including increased domestic financing, improved program coordination, and investment in human resources, are essential.

Keywords

Double burden Chronic diseases communicable diseases noncommunicable diseases health systems Sub-saharan Africa HIV Tuberculosis diabetes hypertension health policy Double fardeau maladies chroniques maladies non transmissibles systèmes de santé Afrique subsaharienne VIH tuberculose diabète hypertension politique de santé

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Abdel Nacer Amoukou Issaka, Amadou Bouba Traoré Hassane, Nouhou Diori Adam, Roukayatou Karimou Issaka, Laminou Laouali, Abba Kaka, & Amza Abdou. (2026). The Burden of Chronic Communicable and Noncommunicable Diseases in Sub-Saharan African Health Systems: a Narrative Literature Review: Le Fardeau des Maladies Chroniques, Transmissibles et Non Transmissibles, sur les Systèmes de Santé en Afrique Subsaharienne : Une Revue Narrative de la Littérature. HEALTH SCIENCES AND DISEASE, 27(7), 40–46. https://doi.org/10.5281/zenodo.20727824
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References

  1. 1. World Health Organization Regional Office for Africa. State of health in the WHO African Region: analysis of the health situation, health services and health systems in the context of the Sustainable Development Goals. Brazzaville: WHO; 2018.
  2. 2. Kohnert D. On the socio-economic impact of pandemics in Africa: Lessons from COVID-19, trypanosomiasis, HIV, yellow fever, cholera. SSOAR; 2021.
  3. 3. Baluku JB, Olum R, Bagasha P, Okello E, Bongomin F. Prevalence of cardiovascular risk factors in active tuberculosis in Africa: a systematic review and meta-analysis. Sci Rep. 2022;12(1):16354.
  4. 4. World Health Organization Regional Office for Africa. Vision, strategies and special initiatives, 2023-2030: Ending diseases in Africa. Brazzaville: WHO; 2023.
  5. 5. Gouda H, Charlson F, Sorsdahl K, et al. Burden of non-communicable diseases in sub-Saharan Africa, 1990-2017: results from the Global Burden of Disease Study 2017. Lancet Glob Health. 2019;7(10):e1375-e1387.
  6. 6. Atakouma DY, D'Almeida S, Kpodzro K, et al. Burden of chronic diseases in sub-Saharan Africa. Med Sante Trop. 2017;27(3):249-254.
  7. 7. Atakouma DY, D'Almeida S, Kpodzro K, et al. Current policies to fight chronic diseases. Med Sante Trop. 2017;27(3):249-254.
  8. 8. Moyo E, Moyo P, Murewanhema G, et al. Key populations and Sub-Saharan Africa's HIV response. Front Public Health. 2023;11:1079990.
  9. 9. UNAIDS. 2023 Global AIDS Update: The Path That Ends AIDS. Geneva: UNAIDS; 2023.
  10. 10. Egede LE, Walker RJ, Monroe P, et al. HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries. BMC Public Health. 2021;21(1):1122.
  11. 11. NCD Alliance, RTI International. Spending Wisely: Exploring the economic and societal benefits of integrating HIV/AIDS and NCDs service delivery. Geneva: NCD Alliance; 2023.
  12. 12. African Union. African Union Roadmap on Shared Responsibility and Global Solidarity for the Response to AIDS, Tuberculosis and Malaria in Africa. Addis Ababa: AU; 2023.
  13. 13. World Health Organization Regional Office for Africa. HIV, Tuberculosis and Hepatitis. Available from: https://www.afro.who.int/health-topics/hiv-tuberculosis-hepatitis
  14. 14. World Health Organization Regional Office for Africa. Tuberculosis in the WHO African Region: 2023 progress update. Brazzaville: WHO; 2023.
  15. 15. Oms P, Deuffic-Burban S, et al. Challenges and difficulties in accessing treatment for hepatitis B management in sub-Saharan Africa. Med Mal Infect. 2023.
  16. 16. Lunel-Fabiani F, et al. Delta hepatitis in Africa: epidemiological and clinical particularities. Med Sante Trop. 2023;33(4):358-366.
  17. 17. Boyd A, et al. Prevalence of HIV and Hepatitis B Virus Co-Infection in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. J Acquir Immune Defic Syndr. 2015;68 Suppl 3:S261-71.
  18. 18. World Health Organization Regional Office for Africa. A decade of transformation: promoting health in Africa 2015-2024. Brazzaville: WHO; 2024.
  19. 19. World Health Organization. Deaths from non-communicable diseases are on the rise in Africa. Available from: https://www.afro.who.int/fr/news/les-deces-dus-aux-maladies-non-transmissibles-sont-en-hausse-en-afrique
  20. 20. Dzudie A, et al. Hypertension in sub-Saharan Africa: the current profile, recent trends and current and future challenges. J Hypertens. 2024.
  21. 21. Ataklte F, Erqou S, Kaptoge S, et al. Burden of Undiagnosed Hypertension in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Hypertension. 2015;65(2):291-8.
  22. 22. International Diabetes Federation. IDF Diabetes Atlas, 11th Edition. Brussels: IDF; 2024.
  23. 23. International Agency for Research on Cancer. SUB-SAHARAN AFRICA. Globocan 2022 Fact Sheet. Lyon: IARC; 2024.
  24. 24. Ngwa W, Addai BW, et al. Cancer in sub-Saharan Africa: a Lancet Oncology Commission. Lancet Oncol. 2022;23(6):e251–e312.
  25. 25. Kankeu HT, Saksena P, Xu K, Evans DB. The financial burden from non-communicable diseases in low- and middle-income countries: a literature review. Health Res Policy Syst. 2013;11:31.
  26. 26. UNDP. Health challenges in Africa: what role for digital? Available from: https://www.undp.org/fr/blog/les-defis-de-la-sante-en-afrique-quel-role-pour-le-numerique
  27. 27. World Health Organization Regional Office for Africa. Chronic staff shortages hamper health systems in Africa, according to WHO study. Available from: https://www.afro.who.int/fr/news/des-penuries-chroniques-de-personnel-entravent-les-systemes-de-sante-en-afrique-dapres-une
  28. 28. The Conversation. Healthcare financing crisis in Africa: three strategies to fight deadly diseases. Available from: https://theconversation.com/crise-du-financement-des-soins-de-sante-en-afrique-trois-strategies-pour-lutter-contre-les-maladies-mortelles-254836
  29. 29. World Bank. Health financing: trends in sub-Saharan Africa. Washington D.C.: World Bank; 2012.
  30. 30. Atakouma DY, et al. Advocacy for a change in policy of care based on improvement and palliative care. Med Sante Trop. 2017;27(3):249-254.
  31. 31. Gardete-Correia L, et al. Inaccessibility or even non-existence of adequate health structures... Rev Mal Respir. 2004;21(4 Pt 1):751-6.
  32. 32. Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. J Chiropr Med. 2006;5(3):101-17.
  33. 33. World Health Organization Regional Office for Africa. Towards universal health coverage in 2030? Brazzaville: WHO; 2022.
  34. 34. Salim Abdool Karim, Quarraisha Abdool Karim. HIV Infection and AIDS in Sub-Saharan Africa. In: Holmes KK, et al. Major Infectious Diseases. 3rd edition. World Bank; 2017.
  35. 35. Adoun Bignon AP. Thesis: HIV/AIDS-associated cancers at CNHU-HKM Cotonou 2015-2019. Abomey-Calavi University; 2020.
  36. 36. Lemoine M, et al. Prevalence of viral hepatitis in sub-Saharan Africa among the general population: an umbrella review. BMJ Open. 2024;14(5):e082025.
  37. 37. Mensah GA, Roth GA, Sampson UK, et al. Cardiovascular diseases in Africa in the twenty-first century. Cardiovasc J Afr. 2022;33(6):350-360.
  38. 38. Hinneh T, Akyirem S, Bossman IF, et al. Regional prevalence of hypertension among people diagnosed with diabetes in Africa. PLOS Glob Public Health. 2023;3(12):e0001931.
  39. 39. Egede LE, et al. Prevalence and correlates of pre-diabetes in Sub-Saharan Africa. BMJ Open. 2023;13(10):e073578.
  40. 40. Joko-Fru WY, et al. Cancer in Africa: The Untold Story. JCO Global Oncol. 2021;(7):537-540.
  41. 41. World Bank. The Global Burden of Disease: findings for sub-Saharan Africa. Available from: https://www.banquemondiale.org/fr/news/feature/2013/09/09/global-burden-of-disease-findings-for-sub-saharan-africa
  42. 42. Gaye I, Diouf I, et al. Shortage of diabetes specialists requires training general practitioners. Med Mal Metab. 2013;7(6):513-518.
  43. 43. Gautier L, et al. Burden of chronic diseases in sub-Saharan Africa. Med Sante Trop. 2017;27(3):249-254.
  44. 44. Act on NCDs. A new healthcare paradigm: Integrating NCDs into the HIV response. Available from: https://actonncds.org/fr/actualites/20230906-communique-de-presse-un-nouveau-paradigme-de-soins-de-sante-integrer-les
  45. 45. Republic of Côte d'Ivoire. Integrated Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2015-2019. Abidjan; 2015.
  46. 46. Cabri-sbo.org. Health financing: trends in sub-Saharan Africa. Available from: https://www.cabri-sbo.org/uploads/files/Documents/report_2012_oxford_policy_management_value_for_money_health_1st_dialogue_french_financement_de_la_sante_tendances_en_afrique_subsaharienne.pdf
  47. 47. Government of Senegal. Study on catastrophic health expenditures and their impact. 2017.
  48. 48. United Nations. Household and community response to the HIV/AIDS epidemic in sub-Saharan Africa. New York: UN; 1999.
  49. 49. Le Monde. In Africa, diseases weigh down household budgets and national economies. Available from: https://www.lemonde.fr/afrique/article/2019/10/02/en-afrique-les-maladies-plombent-le-budget-des-menages-et-l-economie-des-pays_6013972_3212.html
  50. 50. Baluku JB, et al. People with active TB have a 51% higher risk for major adverse cardiovascular events than controls. Sci Rep. 2022;12:16354.
  51. 51. Institute for Health Metrics and Evaluation. Global Burden of Disease 2023. Seattle: IHME; 2025.
  52. 52. Atakouma DY, et al. Advocacy for a change in policy for based on improvement and palliative care. Med Sante Trop. 2017;27(3):249-254.
  53. 53. Bationo N, et al. Implementing integrated patient-centered care for chronic diseases in sub-Saharan Africa: a scoping review. Pan Afr Med J. 2021;39:213.
  54. 54. The Conversation. Prevention rather than cure: to alleviate health spending, African countries must rethink strategic approaches. Available from: https://theconversation.com/crise-du-financement-des-soins-de-sante-en-afrique-trois-strategies-pour-lutter-contre-les-maladies-mortelles-254836
  55. 55. Republic of Mali. Integrated Strategic Plan to Fight Non-Communicable Diseases 2019-2023. Bamako; 2019

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