Economic Impact of Diabetes in Sub-Saharan Africa
By Chinonso Cynthia Ukah. BNSc, RN, RM, RPHN. Freelance Health Writer. Medically reviewed by A. Odutola, MBBS, PhD, FRCSEd.
1. There is credible evidence that the economic impact of diabetes care in African countries is very high.
2. For example, in South Africa, emergency diabetes care alone cost the country 2.7 billion ZAR (approx. USD $205 million) in 2018, and in Uganda, a dialysis session costs the equivalent of USD $2000 in local currency.
3. According to reports by a prominent Nigerian newspaper, between November 2024 and April 2025, the price of a single vial of insulin in Nigeria rose nearly seven-fold and a full monthly supply cost 58,000 Naira (nearly USD $39 at current official exchange rate).
4. As families often serve as unpaid caregivers for diabetic patients with complications, the economic loss to many African countries are compounded as the potential contribution of many productive people are lost to the economy.
5. But all is not economic gloom and doom for African diabetics as according to the World Health Organization, the equivalent of one dollar per person in annual investment in diabetes prevention in the local currency of many African countries, could save seven million lives by 2030 while significantly lowering long-term treatment costs.
Diabetes is a major contributor to global health expenditure. In Africa, the burden of the disease and its complications is steadily increasing, even though the region has a disproportionately low share of global healthcare spending. This imbalance is reflected in the estimated total diabetes-related expenditure of $3.3 billion spent in 2017 (1).
Despite an increase in the incidence of the disease, especially in sub-Saharan Africa, current diabetes-related spending accounts for only 1% of global diabetes expenditure [2], highlighting critical gaps in funding, access, and policy prioritization.
As a chronic disease with no known cure, diabetes mellitus requires lifelong management including medication, routine monitoring, and lifestyle changes. These ongoing needs place a heavy financial burden on individuals, families, and already strained healthcare systems across the continent. To further complicate this, only 26.1% of adults aged 30 and above who are diagnosed with diabetes receive treatment, and 58% of diabetes-related deaths in Africa occur before the age of 70. [3]
This article explores the various factors driving the economic impact of diabetes care in Africa and highlights policy actions that can help reduce the economic burden and improve outcomes at both public and individual levels.
Diabetes is a chronic disease that affects both the rich and poor across the world. It is widespread and more common in low- and middle-income countries like Nigeria, Kenya, South Africa, Uganda, Ghana, and Tanzania, where more than 8 in 10 (80%) of the world’s diagnosed diabetics are found.
Diabetes mellitus is a condition where the body either cannot produce enough insulin (Type 1 diabetes) or cannot properly use the insulin it produces (Type 2 diabetes). Insulin is a hormone that helps regulate blood sugar levels, and when it doesn't function properly, blood sugar levels rise to high levels and cause a variety of complications. Many people associate diabetes with sugar consumption. But scientifically, the causes are a combination of genetic factors, lifestyle choices and other health conditions like hypertension.
As the disease continues to spread across the continent, it is important to understand both its prevalence, medical implications and the economic challenges that make diabetes care difficult to access for many Africans.
The rate of occurrence (prevalence) of diabetes simply means the number of people who have diabetes in a specific location. According to an authoritative source, [4] this prevalence has been steadily increasing over the past few decades in Africa and is expected to continue, as seen from the projections below (fig. 1).
Source: Fig. 1: Projection of diabetes prevalence over the next two decades. Source: Atlas
Several factors contributing to this rising rate of occurrence include, poor awareness of the condition among the general population and diverse healthcare system inadequacies for diagnosis, care and prevention. It has been estimated that only 46% of people with diabetes in Africa are aware of their condition, making the region one of the highest proportion of undiagnosed cases in the world. [5]
To fully understand the economic impact of this rising epidemic, let us now consider the direct and indirect costs of diabetes care in Africa.
A black female self-injecting insulin into the skin of her right lower abdomen
These are the actual expenses used to manage and treat diabetes and its complications. In many African countries, these costs drain the already limited healthcare resources of people living with diabetes as most patients have to pay out-of-pocket.
Medications and supplementary items used for the treatment of diabetes and its complications range from insulin, oral anti-diabetic drugs, glucometers, and glucose test strips, many of which are not produced locally but imported. The Guardian Nigeria recently highlighted how expensive it has become for diabetics in Nigeria to maintain their care process. As of November 2024, one vial of insulin, which previously cost N3,500 (USD $2.3), now goes for N22,000 ($14.7). A pack of a popular brand of insulin in the Nigerian market costs approximately N58,000, an amount that is out of reach for most minimum wage earners in Nigeria.
Beyond insulin, oral anti-diabetic drugs and glucose monitoring supplies have also experienced price hikes in recent years:
Insulin alone can take up a significant part of a family's monthly income in Africa and this signals the need for subsidized diabetes care. But the relief provided by hospitals in Africa is little to insignificant. For example, the National Health Insurance Scheme (NHIS) in Nigeria provides only partial coverage for diabetes care like consultations and basic tests but not the full cost of essential medications like insulin or glucose monitoring supplies.
Poorly managed diabetes often leads to emergency situations like diabetic ketoacidosis, foot ulcers, hypoglycemia and stroke. Managing these complications is costly and often requires intensive care resources, which many African healthcare centres especially in rural areas hospitals do not have.
In South Africa, for example, the direct public sector medical cost of diagnosed Type 2 Diabetes Mellitus (T2DM) alone amounted to ZAR 2.7 billion (approximately USD 198 million) in 2018. Projections suggest that the country’s public health sector will spend ZAR 35.1 billion on diabetes care by 2035, with nearly half of that expenditure allocated to managing diabetes-related complications.
Globally, most diabetics end up with a kidney disease during their lifetime as a result of damage caused by diabetes. And at some point in time, dialysis will be used to support the function of the kidney when it eventually fails.
In most African communities, dialysis is rare and extremely expensive. According to reports from the International Journal for Equity in Health, many public facilities in sub-Saharan Africa simply do not have the capacity to provide dialysis service, meaning patients either die or pay out of pocket in the few private dialysis centers available.
For example, in the whole of Uganda, only two districts out of over 130 had functional public sector haemodialysis centers (three only) as of the year 2022. Each district served a population of 400,000 to 1.5 million people. At home peritoneal dialysis remains unavailable as this was discontinued for various logistics reasons. Patients needing dialysis could only receive service from the three public dialysis centres or access service from private sector dialysis centres if they can afford it. As would be expected, pressure on and rationing of service occur.
Also in Uganda, a haemodialysis session could cost a very large sum of USD $2000 in local currency per session. Same situation goes for the Limpopo Province of South Africa where a 2019 retrospective study showed that an average annual dialysis costs between ZAR 212 286 (USD 25,888) to ZAR 255,076 (USD 31,106) per patient.
Let’s examine the indirect costs of diabetes on the economy.
These are the hidden costs that diabetes imposes on Africans and the economy. They may seem less visible but are no less impactful.
Data from the International Diabetes Federation shows that most people with diabetes in Africa are between 20–59 years old. These are the most productive years of people and Africa may be losing most of its productive workforce to diabetes.
A recent survey found that every retired South African with type 2 diabetes lost an average of three years of their productive life to the disease and this resulted in a loss of approximately USD 70,000 for the country. Diabetes is forcing many into early retirement, robbing them and the economy of valuable working years.
Premature death from diabetes is defined as death before 70 years of age. According to WHO, 58 out of 100 people with diabetes in Africa die prematurely. And diabetes is expected to become the seventh leading cause of death by 2030.
What this means is that children will be stripped of their breadwinners, families will fall into poverty, and this could easily become generational.
When complications of diabetes set in (foot ulcers, amputations, blindness, kidney failure, gluteal ulcers), the person affected will need someone to care for them. But because most of their income goes into medications and hospital visits, there’s usually nothing left to hire a professional caregiver. So, family members must take up the role. They give up their jobs, drop out of school and sacrifice their mental health, all to care for a loved one, often without any payment. The toll of diabetes is heavy both emotionally and financially.
And this is just at the household level.
Now, let’s look at the economic impact of diabetes care on Africa’s challenged public health infrastructure.
The complications of diabetes and their management require long hospital stay. This puts pressure on few hospital beds available as they serve more as hospice at considerable public cost rather than for short stay acute care.
Managing diabetes eats up large portions of the national health budgets, funds that could be used for prevention, infrastructure, or other diseases.
These commonly increase the risk of complications and the cost of care.
With limited access to basic tools like glucose meters and test strips, early detection and monitoring remain out of reach for many Africans. This translates to more treatment of complications of diabetes at high cost in public hospitals.
Most diabetes cases go undiagnosed, making it difficult to plan, fund, or implement proper interventions. This affects decision making at policy level with attendant economic cost.
Family members, often young or elderly, are forced into unpaid caregiving roles, causing productivity loss to the national economy as these informal caregivers are either taken off the national workforce or contribute part-time.
Prevention of diabetes is far cheaper than its treatment. Here are some data to consider:
The diabetes crisis in Africa is a present and escalating emergency. The disease is silently taking lives, draining the African economy, and burdening families beyond comprehension while attention is diverted to HIV, tuberculosis (TB) and malaria. What makes the situation more ironic is that much of the suffering, cost, and loss caused by diabetes is preventable. Millions of lives could be saved, and billions of money could be saved and redirected to address early detection, affordable medications, trained personnel, and stronger health systems.
Africa no longer has the liberty to ask whether they can afford to invest in diabetes prevention and care but whether they can afford not to. A continent with a rising youth population, untapped potential, and a resilient spirit should not continue to lose its workforce and future to a disease that is manageable with low cost preventive methods.
Now is the time for bold political will, strategic partnerships, and sustainable funding. It is time for health systems to evolve from reactive crisis management to proactive prevention.
1. Mapa-Tassou C, Katte JC, Mba Maadjhou C, Mbanya JC. Economic impact of diabetes in Africa. Curr Diab Rep. 2019;19(5):5. Available from here.
2. Mba CM, Mbanya JC. Challenges and economic burden of diabetes in Africa. InObesity and Diabetes: Scientific Advances and Best Practice 2020 Dec 15 (pp. 21-34). Cham: Springer International Publishing. Available from here.
3. World Health Organization. Diabetes – African Region [Internet]. Brazzaville: WHO Regional Office for Africa; [cited 2025 May 21]. Available from here.
4. International Diabetes Federation. IDF Africa [Internet, n.d.]. International Diabetes Federation; [Cited 2025 Apr 18]. Available from here.
5. World Health Organization African Region. African region tops world in undiagnosed diabetes: WHO analysis [Internet]. 14 November 2022. WHO Africa; [Cited 2025 Apr 18]. Available from here.
Related:
Type 1 Diabetes Mellitus: An Explainer for Africans
Type 2 Diabetes: What Africans Need to Know
Diabetes in Pregnancy in Sub-Saharan Africa: An Overview
You May Have Prediabetes and Not Know. How to Find Out (Tips)
Herbal Treatment of Diabetes in Sub-Saharan Africa: Is it real?
Management of Type 2 Diabetes in Nigeria
Childhood Diabetes in Sub-Saharan Africa: Type 1
Type 2 Diabetes Mellitus in African Children
Published: May 28, 2025
© 202. Datelinehealth Africa Inc. All rights reserved.
Permission is given to copy, use and share content freely for non-commercial purposes without alteration or modification and subject to source attribution.
:
DATELINEHEALTH AFRICA INC., is a digital publisher for informational and educational purposes and does not offer personal medical care and advice. If you have a medical problem needing routine or emergency attention, call your doctor or local emergency services immediately, or visit the nearest emergency room or the nearest hospital. You should consult your professional healthcare provider before starting any nutrition, diet, exercise, fitness, medical or wellness program mentioned or referenced in the DatelinehealthAfrica website. Click here for more disclaimer notice.
