Every Beat Counts: Africa’s Struggle with Hypertension and Heart Disease

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Every Beat Counts: Africa's Struggle with Hypertension and Heart Disease

September 29, 2025

Today September 29, the world marks World Heart Day. Cardiovascular diseases are now the second leading cause of death in sub-Saharan Africa, claiming nearly one million lives every year. Globally, the World Health Organization (WHO) estimates that more than three quarters[1] of cardiovascular deaths occur in low- and middle-income countries. The reasons are stark: limited access to primary health care, late diagnosis, and scarce treatment options. For many, the disease is discovered only at an advanced stage, cutting lives short in their most productive years.

Hypertension is at the center of this crisis. Across Africa, about one in three adults lives with high blood pressure, with prevalence rates of 27-30% according to WHO[2]. Yet awareness and control remain dangerously low. In sub-Saharan Africa, only 40-50% of people with hypertension know they have it, around 30-35% receive treatment, and fewer than 20% manage to keep their blood pressure under control. As a result, countless heart attacks and strokes are linked to undiagnosed or poorly treated hypertension[3].

This persistent reality pushed the Cameroon Baptist Convention (CBC) Health Services, a Cameroonian faith-based hospital system, to launch the Know Your Numbers campaign in 2017. The initiative encouraged Cameroonians to track their "essential health numbers", that are blood pressure, weight and blood sugar, in order to detect risk factors for hypertension, diabetes, or obesity early on.

Backed by partners such as Novartis through their program Novartis Access, the program also tackled the issue of affordability. Novartis Access[4] provides a portfolio of 15 essential medicines for the treatment of hypertension, diabetes, chronic respiratory diseases, and breast cancer. Back in 2018, thanks to a memorandum[5] signed in 2017 between Novartis and the Ministry of Health of Cameroon, these Novartis Access medicines were available in some local health facilities, such as CBC, at a price of about USD 1 per treatment per month. This significantly reduced the cost of care and allowed low-income patients to access treatment that would otherwise have been out of reach.

The first results of Know Your Numbers were remarkable: around 13,000 beneficiaries[6] in 2018. Evelyne is one of them. Now aged 52, she has a smile that never leaves her face and a contagious good mood. Diagnosed with hypertension in 2017, she faced the same obstacles as thousands of others: a specialist consultation cost 10,000 CFA francs (≈ USD 18), and monthly treatment could reach 15,000 CFA (≈ USD 27), almost a third of her monthly income of 45,000 CFA (≈ USD 81). Evelyne says she therefore gave up on seeking treatment and, at the same time, lost all joy of living.

"I thought I was just waiting for death," she recalls. That changed in 2018, when Know Your Numbers enrolled her into the CBC program. Since then, she has been receiving treatment at less than USD 2 a month. Her blood pressure is now under control, and her joy of living restored. Evelyne now goes to the hospital once every two months, mostly for routine check-ups.

Don't Miss a Beat

Beyond Cameroon, other initiatives have been making progress at the continental level. One example is Healthy Heart Africa (HHA), launched by AstraZeneca in 2014 to prevent and control hypertension through a partnership-driven approach. The program focuses on early detection, management, and access to care in more than 1,300[7] health facilities across Africa. By May 2025, nearly 67.4 million[8] people have been screened for elevated blood pressure and over 11,700 health workers trained.

Building on this focus on health workers, evidence also shows that community-driven models can deliver outstanding results. A recent study[9] in rural South Africa, published in the New England Journal of Medicine, demonstrated that community health workers, supported by nurses and digital tools, achieved blood pressure control rates of over 80%, far higher than those seen in many high-income countries. As my colleague Mark Chataway recently noted in an article[10] on Medium, this illustrates how African health systems, by empowering community health workers and nurses, can achieve remarkable outcomes in hypertension care and demonstrate models of innovation that others could learn from.

At the global level, other initiatives are making similar progress. The Global Hearts Initiative[11], launched in 2016 by WHO and the United States Centers for Disease Control and Prevention (U.S CDC), helps low- and middle-income countries strengthen cardiovascular care at the primary health level. It is based on six complementary components: promoting healthier behaviors such as balanced diets, physical activity, and reducing salt and tobacco use; using simple and standardized treatment protocols for hypertension and other risk factors; ensuring the availability of essential medicines and basic technologies; managing patients based on their overall cardiovascular risk rather than a single blood pressure number; organizing team-based care involving doctors, nurses, and community health workers; and finally, providing regular patient follow-up supported by data collection and evaluation systems.

According to a recent study[12], programs using this package have already enabled the treatment of more than 12 million hypertensive patients in over 165,000 primary health centers across 32 low- and middle-income countries.

These examples prove one thing: controlling hypertension and cardiovascular disease is possible and affordable, even in resource-limited settings, when private organizations support meets public will.

Prevention, however, remains the first line of defense: eating more fruits and vegetables, limiting salt and saturated fats, exercising regularly, avoiding tobacco, and reducing alcohol consumption. Early detection is just as essential: a simple blood pressure measurement can save lives. Several pan-African organizations, such as the Pan-African Society of Cardiology (PASCAR), are calling for the integration of hypertension control into primary care and for essential treatments to be made accessible to all.

On this World Heart Day 2025, the message is clear: don't miss a beat. Take the pulse of your health, act early, and remember, every beat counts: for you, for your family, for all.

[1] https://www.who.int/fr/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

[2] https://www.who.int/news-room/fact-sheets/detail/hypertension

[3] https://www.jns-journal.com/article/S0022-510X%2824%2900103-5/abstract

[4] https://www.novartis.com/stories/living-hypertension-cameroon-few-dollars-day

[5] https://www.novartis.com/stories/living-hypertension-cameroon-few-dollars-day

[6] https://ncdalliance.org/stories/news-blogs/2018/joining-fight-against-ncds-cameroon

[7] https://globalhealthprogress.org/collaboration/healthy-heart-africa-2/

[8] https://www.astrazeneca.com/sustainability/health-equity/healthy-heart-africa.html

[9] https://www.nejm.org/doi/full/10.1056/NEJMoa2509958

[10] https://medium.com/beingwell/restrictive-practices-in-medicine-are-holding-high-income-countries-back-f2f34e218ff6

[11] https://www.who.int/news/item/15-09-2016-global-hearts-initiative

[12] https://www.jacc.org/doi/10.1016/j.jacc.2023.08.043

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POSTED BY: Anne Mireille Nzouankeu