Economic Burden and Health System Implications of Chronic Disease in Sub-Saharan Africa

Non-communicable diseases (NCDs) are now among the leading causes of illness and death in sub-Saharan Africa, exerting pressure on health systems traditionally oriented toward infectious diseases. Recent years have seen alarming rises in conditions such as cancer and chronic kidney disease, which require costly, long-term care yet remain inequitably accessible across populations. For example, kidney replacement therapy in South Africa highlights stark public–private sector divides, while cancer-related premature mortality in Kenya and South Africa underscores the immense productivity losses borne by households and economies. Despite these trends, evidence on the combined health system and economic burden of NCDs remains fragmented. Addressing this gap is essential to inform policies that balance direct treatment costs with the broader societal implications of lost productivity, and to guide sustainable financing strategies under the Universal Health Coverage (UHC) agenda.

This Research Topic seeks to bring together scholars, practitioners, and policymakers to generate fresh evidence and critical perspectives on the economic and health system implications of NCDs in sub-Saharan Africa. We are particularly interested in contributions that quantify direct health system costs (e.g., treatment, resource allocation, service delivery gaps) alongside indirect costs (e.g., productivity losses, years of potential life lost, household-level financial risk), and that explore the consequences for equity, efficiency, and sustainability of care. Ultimately, this Research Topic seeks to inform the design of health financing and service delivery reforms that can better protect households, reduce inequities, and support economic development in sub-Saharan Africa in the face of the growing NCD crisis.

Two case studies exemplify the urgency of this agenda. In South Africa, kidney replacement therapy (dialysis and transplantation) illustrates the stark divide between public and private sectors: while insured patients access costly but life-saving modalities, the majority dependent on the public system face rationing and limited options. The distribution of modality use also has profound cost implications, raising questions about efficiency and equity in resource allocation. In Kenya and South Africa, rising cancer mortality highlights the often-overlooked productivity dimension of NCDs: premature deaths translate into large economic losses at household, community, and national levels, undermining economic growth and exacerbating poverty.

Suitable themes for manuscripts include, but are not limited to:

• Cost analyses of high-burden NCD interventions and treatment modalities.

• Public–private sector disparities in access to NCD care.

• Productivity losses and macroeconomic impacts of premature NCD mortality.

• Health financing strategies and policy options for sustainable NCD control.

• Comparative analyses across diseases, countries, or regions.

• Methodological innovations in measuring direct and indirect NCD costs.

Topic Editor Mickael Hiligsmann received research grants from Angelini Pharma and Radius, paid to his institution. He received financial support from IBSA, Echolight, Pfizer, and Teva Pharmaceuticals, paid to his institution. The other Topic Editors declare no competing interests with regard to the Research Topic subject.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: NCDs, non-communicable diseases, Sub-Saharan Africa, economic burden, health systems

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.