Experts warn donor reliance threatens NCD response in Africa
The World Health Organisation estimates that NCDs account for 74 percent of global deaths and 84 percent of premature deaths in low- and middle-income countries. In Africa, cases have been steadily increasing since 2017.
African countries have been urged to scale up domestic financing for Noncommunicable Diseases (NCDs) as the rising burden threatens already overstretched health systems.
Experts say relying on external aid is unsustainable, warning that without deliberate investment, the continent faces deeper health and economic setbacks.
The World Health Organisation (WHO) estimates that NCDs account for 74 percent of global deaths and 84 percent of premature deaths in low- and middle-income countries.
In Africa, cases have been steadily increasing since 2017.
At a two-day stakeholders’ meeting in Nairobi that brought together researchers, policy experts, and health financing specialists from seven African countries, participants emphasized that countries must prioritize homegrown solutions to reduce dependency on donors.
“Domestic resource mobilization is more than just raising funds—it is about aligning those funds with national priorities and ensuring they are spent efficiently,” said Dr. Jackson Otieno, senior research and policy analyst at the African Institute for Development Policy (AFIDEP). “
By putting domestic resource mobilization at the center of health financing, African countries can secure long-term, predictable funding for NCDs and reduce dependence on external aid.”
In Kenya, a report by the Ministry of Health shows that in the 2018/2019 financial year, only 11.6 percent of the national health budget went to NCDs. Nearly 80 percent was directed to curative services, with just 3.7 percent set aside for preventive care.
By the 2024/2025 fiscal year, treasury allocation for NCDs was USD 78,000 against a planned budget of USD 555,900.
Dr. Gladwell Gathecha, Deputy Head of the Ministry’s NCD Division, said the problem is made worse by gaps in evidence and weak budget structures.
“NCD financing in Kenya faces numerous bottlenecks, including limited data and evidence, lack of dedicated budget capacity, and technical constraints in budget tracking,” she said.
Participants at the Financing Accelerator Network for NCDs (FAN) forum also raised concern over inequities created by heavy out-of-pocket spending, noting that many families are being pushed into poverty while trying to meet health costs.
“We must invest in prevention and early treatment of NCDs rather than wait until people are terminally ill, that is like supervising death,” said Dr. Rose Oronje, AFIDEP’s Deputy Executive Director.
Kenya’s health system is currently funded by both levels of government, social health insurance, and development partners. However, households still pay close to a quarter of the costs directly.
The workshop brought together representatives from Kenya, Somalia, Uganda, Rwanda, Malawi, and Ghana, who shared country experiences and strategies to boost domestic health financing and reduce reliance on donor support in tackling NCDs.
