Demographic and Epidemiological Transitions Across Africa: A Regional Policy Perspective

Abstract Background Africa is undergoing demographic and epidemiological transitions marked by population growth and a shift from communicable to non-communicable diseases (NCDs). These transitions vary by region and impact public health priorities. This study compares demographic and disease trends across five African regions to inform policy. Methods We conducted a descriptive study using secondary data. Demographic indicators (birth/death rates, population size) from the World Bank (1960-2020) and disease burden data (deaths and DALYs from CDs, NCDs, and injuries) from the Global Burden of Disease Study (1990-2019) were aggregated by African Union regions. Results All regions experienced population growth, notably Eastern Africa, which rose from 70M in 1960 to over 330M in 2020. Northern Africa's population grew from 50M to 300M, while Southern Africa saw the lowest growth, from 30M to 190M. Birth rates declined across all regions, most notably in Northern and Southern Africa. CD mortality declined in all regions post-2000, especially in Northern Africa (from 32% to 9%). NCD mortality rose sharply in Northern Africa (to 83% of total deaths). Central and Western Africa showed slower transitions, maintaining high CD burdens. Eastern and Southern Africa showed signs of dual burden, with declining CDs and rising NCDs. Conclusions Africa's demographic and epidemiological transitions are uneven. Public health policies must be region-specific. NCD response must be strengthened, while CD control remains essential in less advanced regions. Key messages • Africa's transitions are region-specific; policies must reflect this diversity. • NCD funding must increase to match the rising burden.