November is World Diabetes Awareness Month, and World Diabetes Day is marked on 14 November. Non-communicable diseases (NCDs) like diabetes and certain cardiovascular conditions can, in many cases, be attributed to forces including rapid, unplanned urbanisation and the globalisation of unhealthy lifestyles.
In this regard, African countries are among those most affected, as each year, 17 million people die from an NCD before age 70; 86 percent of these premature deaths occur in low- and middle-income countries. Of all NCD deaths, 77 percent are in low- and middle-income countries. It’s clearer now more than ever: We, as a people, must make a choice to take control of our health—starting right now.
Type 1 and 2 diabetes—Type 2 alarmingly growing in prevalence—are rapidly becoming two of Africa’s most pressing health challenges, mirroring the global rise in non-communicable diseases (NCDs).
While Type 1 diabetes is no less severe a health problem, Type 2 is the one we can choose to take control of. Like Type 1 diabetes, Type 2 is caused by insufficient insulin production or the inability of the body to use insulin effectively. Being overweight, making uninformed dietary choices, consuming alcohol or tobacco products, and being physically inactive are contributing factors. This has been observed in 95 percent of people diagnosed.
Why is diabetes a concern?
Diabetes can present in stealthy ways, often presenting symptoms only in the late stages, which is one of the primary reasons it usually goes undetected. In fact, more than half (54%) of people living with diabetes in the African Region are undiagnosed.
It is a multidimensional condition, as uncontrolled blood sugar in people living with diabetes can lead to severe damage across various organs. Heart and blood vessel damage raises the risk of heart attacks and strokes by two to three times. In the lower limbs, poor blood flow, slow healing, and nerve damage (neuropathy) can result in diabetic foot ulcers, potentially leading to amputation.
Chronic damage to the retinal blood vessels, known as diabetic retinopathy, can impair vision and lead to blindness. Diabetes is also a leading cause of kidney failure and can worsen outcomes in infectious diseases like tuberculosis and HIV. 3
BUT—Type 2 diabetes can be controlled, or even stopped in its tracks, in some instances. And it all starts with a simple series of choices.
Stop saying, “I don’t have the time.”
There is a rule of halves in diabetes care on our continent:
Half of those living with diabetes remain undiagnosed; half of those diagnosed do not receive the care they need, and only half of those in treatment are reaching their targets. These are not just numbers but people—mothers, fathers, brothers, and sisters—whose lives are marked by unnecessary hardship and, in many cases, premature death.
The digital age has turned our lives around—for the better in many ways and the worse in others. We spend more time on our screens and less time outside. We should be taking more time to look up and take in the real world—even just once a day.
Sedentary lifestyles, spent indoors with minimal exercise, contribute to the risks of obesity and diabetes. Of course, not everyone is the next CrossFit champion or marathon runner. But taking the time to step away from your desk or couch for a walk can make a significant difference.
Convenience or fast food is often high in calories, unhealthy fats, sugar, and salt while low in essential nutrients like fibre, vitamins, and minerals. Rapid urbanisation, population growth, and expanding economies, which have seen a rising middle class, are leading to more Africans indulging in fast foods more often because they are convenient, tasty, affordable, and generally very well-marketed.
We have seen it in developed economies, and now, we see it in Africa. Overweight and obesity levels across Africa are rising, and health systems that aren’t equipped to deal with the challenge are already under strain.
African children are being increasingly exposed to high-sugar, energy-dense, cheap processed foods. Linked to this, obesity among 7- to 11-year-olds increased from 4 percent in 1990 to 7 percent in 2011 and is expected to reach 11 percent in 2025.
Yes, we all deserve to treat ourselves and our families to our favourite takeaway meal now and then. But it should be the exception rather than the rule. As hardworking people in high-stress environments, we often say, “We don’t have time.” We must make time to enjoy the company of the people we love in person rather than via text. We owe it to ourselves and our families to make healthier choices.
One test for a lifetime of freedom
The World Health Organization set global targets for diabetes care by 2030, advocating for universal access to these life-saving resources. For Africa, this means increased access to diagnostics and integrating self-monitoring into routine care, enabling people to take control of their health and live full, productive lives.
When diabetes is detected early, people can begin managing it effectively, avoiding severe complications. Early detection allows individuals to take charge of their health and make informed choices to lead longer, healthier lives. Yet, many African healthcare systems face significant challenges, and regular screenings remain limited, particularly in rural areas.
However, we can learn from successful examples. Rwanda, for instance, has expanded healthcare access through its National Diabetes Prevention and Control Programme – a success story driven by public-private partnerships that have seen primary health systems significantly strengthened, education prioritised and over 200,000 people screened.
The Roche Changing Diabetes® in Children initiative—a public-private partnership—actively supports patient education and advocacy, training of healthcare professionals, and the establishment of national clinics and equipment in several African countries.
In the big picture, these partnerships are promoting an end-to-end approach to diabetes care that brings diagnostics closer to patients through decentralised point-of-care testing, connects them to ongoing support, and provides chronic care to improve outcomes.
Public-private partnerships and innovative funding models are making progress, taking testing and care to more people in remote areas. But as individuals, we can help the process along and significantly impact the statistics.
Take a moment; it all comes back to making time. We can make healthier choices for ourselves and our loved ones. We can sit down together for more home-cooked family meals and step away from our screens to take more walks.
Diabetes may be a significant health challenge in Africa, but it is also a manageable one. Through early diagnosis, lifestyle awareness, and strengthened healthcare systems—and just a bit of time—we can empower ourselves to take control of our destinies.
As the English writer William Penn said, “Time is what we want most but what we use worst.”
Let’s use ours more wisely.
Dr Allan Pamba is the executive vice-president, Diagnostics, Africa at Roche Diagnostics.
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