Elusive essential NCD drugs compound suffering in Africa

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KIGALI

Prisca Githuka's journey with cancer began in 2013 when she discovered a lump in her breast. After a series of tests, she was diagnosed with triple-positive breast cancer.

Her treatment journey was filled with challenges, including surgery, chemotherapy and radiotherapy. However, the biggest hurdle she faced was accessing essential medicines.

"The targeted treatment sessions I needed, called Herceptin, were very expensive," she recalls. "It cost around Ksh350,000 ($35,000) per session, and I needed 16 sessions and 30 radiotherapies at Ksh10,000 (about sh300,000)."

Githuka’s struggles are similar to how many people living with non-communicable diseases (NCDs) in Kenya and other African countries face similar challenges in accessing essential medicines.

"The essential drugs are supposed to be available in all public facilities," Githuka says. "But they are not. Patients are forced to buy them from private pharmacies, which is expensive."

The lack of access to essential medicines remains a significant concern for people living with NCDs. 

"Disease does not wait, it progresses," Githuka emphasizes. "If patients cannot access the medicines they need, they will suffer the consequences."

"For the last 10 years of my treatment, I have had to swallow some medicine that costs $5 (about sh18,500) per pill, taken every day, which is a lot of money," she says. "I did fundraising, got a loan, and drained all my savings to pay for my treatment and buy drugs that were not accessible in public health facilities."

According to her, access to quality and timely treatment for every NCD patient should be a priority, especially in Africa. She also calls for tax exemptions on essential drugs and treatment equipment, as well as a greater focus on prevention and advocacy from people with lived experiences of NCDs.

"Ten years ago, I was given a two-year appointment to receive mandatory treatment, but now patients wait for three months," she says.

A global burden

According to the World Health Organisation (WHO), one out of every two people needing insulin for type 2 diabetes does not receive it. Diabetes is on the rise in low and middle-income countries, yet the consumption of insulin has not kept pace with the growing disease burden.

Speaking to journalists at the opening press conference of the NCD Global Forum at the Kigali Convention Center on February 13, 2025, Katie Dain, CEO of the NCD Alliance, emphasised the urgent need for action.

Kigali Convention Center at night. (Credit: John Musenze)

"When we take a step back and look at progress on NCDs, it's clear that we are significantly off track," Dain said. "Governments agreed to a set of global targets back in 2012 to reduce premature mortality from NCDs by 2025. And we know that progress against all of these targets is essentially falling short. NCDs are the number one killer worldwide."

She highlighted that NCDs remain a burning issue in sub-Saharan Africa, accounting for a third of deaths in the region. "In just five years, by 2030, they will have overtaken HIV/AIDS, tuberculosis, and maternal mortality as the region's leading cause of death," she warned.

"We live in an era of polycrisis, with pandemics, climate change, conflicts, and humanitarian crises colliding globally," Dain continued. "At the centre of this storm are people living with NCDs."

She also pointed to the challenges caused by global health funding cuts: "The Trump administration’s recent freeze on development aid and the potential dismantling of USAID have sent shockwaves through the global health community. It is paralyzing health programs that provide lifesaving medication and treatment to people, disrupting the health financing landscape as we know it. Any hit to global health financing is a hit for all health issues, including NCDs."

Many African countries face a dual burden of infectious and NCDs, particularly in regions with high HIV prevalence. While HIV treatment programmes have extended the lives of many, the risk of developing NCDs and neurocognitive conditions associated with aging has increased significantly. Additionally, exposure to risk factors such as tobacco, alcohol, unhealthy food, air pollution, physical inactivity, stress and mental health issues is contributing to the growing NCD crisis.

Speaking to journalists at the opening press conference of the NCD Global Forum at the Kigali Convention Center on February 13, 2025, Katie Dain on left , CEO of the NCD Alliance, emphasized the urgent need for action. (Credit: John Musenze)

Today, NCDs—including cancer, heart diseases, chronic respiratory diseases, and diabetes—along with mental health conditions such as depression and anxiety, account for 74% of deaths globally. The number of people living with NCDs is staggering according to WHO:

• One billion people are living with obesity.
• 1.3 billion have hypertension.
• One billion are affected by a mental health disorder.
• Half a billion suffer from diabetes and chronic respiratory diseases.

"In the five short years since we last held the Forum in Sharjah, UAE, we have lost 215 million people to NCDs. To put that in context, that is the population of Nigeria," Dain SAID.

A call for action

Dain stressed that prevention is key to controlling the NCD burden. "Real progress has been made in creating healthier environments and reducing risk factors, thanks to the hard work of many people here at this year’s Forum.

More countries are implementing legislation to tax unhealthy products, restrict marketing, and improve front-of-pack labeling. But the prevalence of tobacco, unhealthy food, alcohol, and air pollution remains stubbornly high. The world is set to miss all 2025 risk factor targets."

She urged global leaders to use the upcoming UN High-Level Meeting on NCDs as an opportunity to course-correct.

"We know how to reduce the NCD burden. We have the toolkit of solutions at our fingertips. What is needed is political leadership and financing that matches the scale of the problem to rapidly scale up implementation."

Like many sub-Saharan African countries, Rwanda has experienced significant increases in NCD cases over the past two decades.

The Rwanda health ministry has responded by implementing NCD strategies focused on strengthening the health system which has brought their life expectancy 20% higher than any other countries globally. However, much work remains to ensure that essential medicines and treatments are accessible to all.