NCDs caused 4.7 million deaths in Africa in 2023, new GBD analysis finds

Non-communicable diseases — cardiovascular disease, cancers, diabetes, chronic kidney and respiratory conditions, and mental disorders among them — now define the health burden across Africa, according to a systematic analysis published in The Lancet Global Health on 21 September 2026 as part of the Global Burden of Disease (GBD) Study 2023 [s1]. In 2023, non-communicable diseases (NCDs) accounted for an estimated 2.33 billion incident cases, 4.70 million deaths, and 263 million disability-adjusted life-years (DALYs) across the continent [s1].

Those totals are the product of two forces pulling in opposite directions: a growing, ageing population that pushes absolute numbers up, and slowly improving underlying rates that pull them down. Between 1990 and 2023, the age-standardised NCD incidence rate fell 2.7%, the mortality rate fell 9.0%, and the DALY rate fell 6.4% [s1]. The modest scale of those declines is the story. Rates are moving in the right direction, but not nearly fast enough to offset population growth, so the number of Africans falling ill and dying from NCDs keeps climbing.

Where the deaths concentrate

The analysis, drawn from vital registration, verbal autopsy, surveillance systems, censuses, surveys and other sources, ranks the leading causes of NCD death on the continent [s1]. In 2023 the five largest were ischaemic heart disease (801,000 deaths), stroke (700,000), chronic kidney disease (293,000), hypertensive heart disease (246,000), and diabetes (245,000) [s1]. Four of those five are cardiovascular or cardiometabolic conditions — a pattern that points less to any single disease than to a shared cluster of underlying risks.

Disability tells a different story than death. When the authors ranked causes by years lived with disability (YLDs) — a measure of illness that does not kill but degrades daily life — mental disorders came first, at 30.9 million YLDs, followed by musculoskeletal disorders at 17.1 million [s1]. These are conditions that health systems built around acute infectious disease are poorly configured to detect or manage over decades, and they rarely feature in mortality statistics that drive funding decisions.

The risk factors behind the burden

The GBD framework attributes a share of disease to modifiable risk factors, and here the analysis is blunt about how much of the toll is preventable. Of the total NCD burden in Africa, 35.1% of DALYs and 57.4% of deaths were attributable to the 88 risk factors GBD 2023 quantifies [s1]. In other words, more than half of NCD deaths on the continent trace to exposures that policy can, in principle, change.

One risk factor dominates. High systolic blood pressure alone contributed 26.2% of all NCD deaths in Africa, ahead of dietary risks (14.7%) and air pollution (14.2%) [s1]. Hypertension is cheap to detect and, with generic medicines, cheap to treat — yet across much of the continent it goes undiagnosed until it presents as the stroke or heart failure that the mortality table records. The prominence of air pollution as the third-ranked driver folds household and ambient air quality into what is usually framed as a lifestyle problem, and points toward interventions well outside the clinic.

Why the framing matters

For two generations, global health investment in Africa has been organised around infectious disease and maternal and child survival — the areas where the fastest gains were available and where donor money concentrated. This analysis documents a continent where the arithmetic has shifted underneath that model. The authors describe a "complex and evolving" burden in which age-standardised rates are improving modestly even as absolute cases, deaths and DALYs rise, a combination that will keep demand on health systems growing for decades regardless of further progress on rates [s1].

The methods carry the usual caveats of GBD modelling. Africa has some of the world's thinnest death registration, so many estimates lean on verbal autopsy, surveys and statistical models rather than direct counts, and the wide uncertainty intervals around the cause-specific figures — ischaemic heart disease, for instance, ranges from 653,000 to 965,000 deaths — reflect that [s1]. The direction and rough magnitude are firmer than any single point estimate.

What the analysis establishes is a shift in what "global health in Africa" now has to mean. A burden once dominated by communicable disease is increasingly a burden of blood pressure, diet, air quality and untreated mental illness — conditions that unfold over years, demand continuous rather than episodic care, and are, on these numbers, more than half preventable [s1]. The policy implication the authors draw is that surveillance and primary-care systems built for acute infection will have to be rebuilt for chronic disease if the modest gains in underlying rates are to translate into fewer deaths.

This article is informational and is not medical advice.

Sources

• Burden of non-communicable diseases and their attributable risk factors in Africa from 1990 to 2023: a systematic analysis for the Global Burden of Disease Study 2023 — The Lancet Global Health, 21 September 2026.