Disease Control in Sub-Saharan Africa: Are We Doing Enough?

Geographically comprising of 48 countries, Sub–Saharan Africa (SSA) represents the most genetically diverse region in the world, offering an imploring opportunity to tap into medical research and development.1 Without question, SSA is capable of becoming the breadbasket of the world; however this will require unification across fundamental regulatory requirements, health education, socioeconomic standards and healthcare in order to manage the plethora of communicable and non-communicable diseases currently pandemic here.


SSA accounts for 64% of the global disease burden from human immunodeficiency virus (HIV/AIDS), tuberculosis (TB) and malaria, but only 4% of the world’s health workforce. Its pharmaceuticals sector faces challenges with high drug prices and regulations, which open up opportunities for illicit imports and production. Drugs that should only be prescribed by qualified doctors are sold on the streets, resulting in improper usage and the possibility of bacterial resistance, a dangerous challenge for a region with the highest incidence of TB.


Regulatory authorities recommend that the SSA region adopt the International Consensus of Harmonization (ICH) laws and strictly adhere to the Helsinki Agreement when conducting clinical trials. Greater harmonization will ensure that safe, effective, and high quality medicines are developed and registered in the most resource-efficient manner.2


Nevertheless, the region has a bright future. The newly elected World Health Organization (WHO) director general, Tedros Adhanom Ghebreyesus, the first African to hold this post, is the former minister of health in Ethiopia. In addition to his awareness of health education and mobility logistics, he is conscious of the importance of integrating community members into health programs in order to prevent large scale disease outbreaks. Pharmaceutical companies are investing in the development of drugs to combat diseases in Africa and marketing and community educational programs are being used to weaken the illicit drug trade. Intense research efforts are being directed to combat the predominant infectious diseases in specific countries, be it AIDS in South Africa, schistosomiasis in Senegal and Ethiopia, or malaria and TB in Cameroon and Burkina Faso.


Such efforts have seen a diminishing prevalence of malaria in infants and children younger than 5 years. Collaborative efforts of scholarship and health education incentives between SSA and the rest of the world have provided new generations of highly educated and aware scientists and investigators, and the hope is that these specialists can help ensure SSA continues to grow in sufficient disease control.

The Ebola outbreak in Guinea (2014-2016) stressed the importance of trained local responders, adequately staffed personnel at village health facilities and a well-informed and engaged community responding to the outbreak. Guinea’s fight against Ebola is a story of innovation, humility and dedication, where the country gave the world a wake-up call about the disease and then offered solutions to take into the future.


Between 2005 and 2015, six of the world’s 10 fastest-growing countries were in SSA – Angola, Nigeria, Ethiopia, Chad, Mozambique and Rwanda. In eight of the past 10 years, SSA has grown faster than Asia. In 2020, the International Monetary Fund expects Africa to grow at a rate of 6% — about the same as Asia. Continuing such trends, it is estimated that by 2035, Africa’s workforce, which is larger than any other continent, will be making significant strides in the fields of agriculture, healthcare, manufacturing, hospitality and technology.

Nigeria and South Africa constitute the largest economies in SSA, and South Africa is considered to have the best standard of healthcare in this region, guaranteeing universal access to subsidized healthcare for all citizens based on a sliding scale according to income. A National Health Insurance (NHI) initiative is in a pilot phase prior to being introduced across the country in a phased approach completing in about 2025.


With this in mind, Clarivate Analytics has developed a comprehensive report that focuses on present-day disease control in SSA. While it would be an exhaustive exercise to tabulate all the diseases, the report touches on the most prolific conditions, what control measures have been taken, and by whom, how effective they have been, what therapeutics are available to the general public today, and what is missing. While several other fundamental challenges exist (such as nutrition, education, job creation, agriculture and safe water supply), pharmaceutical companies can fill one gap by increasingly investing in this region and curbing the disease burden. The automobile industry is successfully trading in SSA, so what needs to be done to ensure that drug companies do the same?


These and other questions are addressed in the full report, also titled “Disease control in Sub-Saharan Africa,” and available via download here.


Also, the author, Shyama Ghosh, recently completed an in-depth look at unique disease challenges in Africa. See this recent post here on Life Sciences Connect.


For epidemiological data on diseases mentioned in the paper, learn more about the Incidence and Prevalence Database.



1.“Genetic diversity of Sub-Saharan Africa revealed,” BBC News, Dec. 4, 2014.

  1. Medicines Control Council. http://www.mccza.com/