Building resilient healthcare systems for Africa’s rising burden of NCDs By Jorge Levinson, Cluster Divisional Head of Pharmaceuticals

African countries are confronting a dual health challenge. Infectious diseases remain a major priority, while non-communicable diseases (NCDs) such as cardiovascular disease, diabetes and cancer are rising rapidly. The question is no longer whether health systems must change, but how quickly they can become more preventive, connected and resilient while navigating geopolitical volatility, constrained public finances and fragile supply chains.

For decades, the region rightly concentrated on HIV/AIDS, tuberculosis, malaria, Ebola and other infectious diseases. That work must continue. Yet demographic change, rapid urbanization and shifts in diet and physical activity are accelerating a parallel NCD burden. Many people still reach the health system only after chronic conditions have advanced, making treatment more complex and costly for patients, families and governments.

Climate change adds another layer of risk. Extreme heat can worsen chronic conditions, disrupt health services and supply routes, and place additional strain on vulnerable communities. Resilience therefore cannot mean preparing for one disease or one crisis at a time. It must mean building systems able to detect risk earlier, maintain essential services during shocks and deliver continuous care closer to where people live.

This is as much an economic imperative as a health priority. Poorly controlled chronic disease reduces productivity, increases household expenditure and places avoidable pressure on hospitals. Conversely, earlier diagnosis and reliable treatment help people remain healthy, economically active and able to support their families. Health expenditure should therefore be evaluated not only as a cost, but as an investment in human capital and sustainable growth.

The financing environment makes this agenda more urgent. Declining official development assistance and mounting fiscal pressure are exposing the risks of excessive dependence on external funding. The answer is not abrupt withdrawal from international partnership. It is a deliberate transition towards stronger domestic ownership, complemented by development finance, private investment and targeted external support where it creates lasting capability.

Governments can broaden the available toolkit through better public financial management, pooled procurement, blended finance, appropriate risk-sharing arrangements and evidence-based partnerships. But additional funding must be accompanied by clearer priorities and measurable outcomes. Every rand, shilling or naira invested should be connected to visible improvements: more people screened, shorter diagnostic journeys, fewer treatment interruptions and lower avoidable hospital admissions.

A practical resilience agenda should focus on four priorities. First, integrate NCD prevention, screening and follow-up into primary healthcare and community services. Second, establish sustainable financing models that protect essential care and reduce the burden paid directly by families. Third, accelerate regulatory cooperation so that quality medicines and technologies reach patients sooner. Fourth, use interoperable data and digital tools to identify gaps, support continuity of care and measure impact.

Primary healthcare is the critical starting point. A blood-pressure check, diabetes risk assessment or cancer-screening referral delivered early and close to the community can prevent complications that would otherwise demand specialist or hospital care. Reliable referral pathways, trained health workers and uninterrupted access to essential medicines then turn a single screening encounter into sustained health improvement.

Regulatory reform is equally important. Differing national requirements, repeated assessments and unpredictable timelines delay access and consume scarce technical capacity. The operationalisation of the African Medicines Agency creates an opportunity to deepen joint regulatory work, reliance and common standards while national authorities retain their legal responsibilities. The objective is not weaker oversight; it is trusted, rigorous oversight with less duplication and greater predictability.

More coherent regulation can also support the implementation of the African Continental Free Trade Area, regional supply chains and sustainable local capability. Local manufacturing should be pursued where it is viable and quality assured, supported by predictable demand, efficient procurement and access to regional markets—not as an isolated ambition detached from economic realities.

Patient protection must remain non-negotiable. Substandard and falsified medical products undermine treatment outcomes, erode trust and place lives at risk. Stronger pharmacovigilance, secure supply chains, coordinated enforcement and clear accountability across borders are therefore essential components of access. Faster access only has value when the products reaching patients are safe, effective and quality assured.

Partnerships must likewise move beyond isolated projects. Governments should set public-health priorities and accountability frameworks. Industry can contribute scientific expertise, technology, supply-chain capability and investment. Multilateral organisations and development finance institutions can help de-risk scalable models. Civil society and patient groups must ensure that programmes respond to lived realities. Success should be judged by durable system capacity, not by the number of partnerships announced.

As Vice-President of the Innovative Pharmaceutical Association South Africa, I believe the innovative pharmaceutical industry must engage as a constructive, solutions-oriented partner. Through strategic partnerships, Bayer is also working to extend care beyond traditional facilities. Collaborations with mobile health clinics and Rhiza Babuyile help bring education, prevention and treatment closer to underserved communities. These initiatives matter most when they connect to local referral pathways, public-health priorities and mechanisms that can endure beyond a pilot phase.

African Countries do not need to choose between responding to today’s health pressures and preparing for tomorrow’s. With stronger primary care, smarter financing, regulatory convergence, trusted data and purposeful partnerships, it can do both. The measure of resilience will be simple: whether more people can receive the right care earlier, closer to home and without being pushed into financial hardship.

The future of healthcare in the region will be shaped by the choices made now. Bold leadership is required, but so is disciplined execution. If prevention, access, quality and sustainability become shared measures of progress, Africa can transform the NCD challenge into an opportunity to build healthier populations, stronger economies and more resilient health systems for generations to come.