---
title: "Stroke is not just a health crisis but an economic challenge Africa cannot ignore"
description: "When policymakers discuss economic growth, productivity and development, they rarely begin with stroke. Here’s why it would be valuable if they did."
type: "NewsArticle"
publisher: "Daily Maverick"
site: "https://www.dailymaverick.co.za"
section: "Sponsored Content"
author: "South African Medical Research Council (SAMRC)"
author_url: "https://www.dailymaverick.co.za/author/south-african-medical-research-council/"
canonical_url: "https://www.dailymaverick.co.za/article/2026-10-28-stroke-is-not-just-a-health-crisis-but-an-economic-challenge-africa-cannot-ignore/"
published: "2026-10-28T10:29:36"
lang: "en-ZA"
word_count: 1005
---

# Stroke is not just a health crisis but an economic challenge Africa cannot ignore

> When policymakers discuss economic growth, productivity and development, they rarely begin with stroke. Here’s why it would be valuable if they did.

By South African Medical Research Council (SAMRC) · Published 28 October 2026, 12:29 SAST

## Content

Stroke is often perceived as a medical issue that belongs only in hospitals and neurology clinics. In reality, it is increasingly becoming an economic and development challenge that affects labour markets, social protection systems, health budgets and national productivity. The growing burden of stroke threatens progress toward sustainable development goals and poses a particular challenge for low- and middle-income countries, where health systems are already under strain.

Globally, stroke is now the [third leading cause of death](https://www.thelancet.com/journals/laneur/article/PIIS1474-4422\(24\)00369-7/fulltext) and one of the leading causes of long-term disability. In 2021 alone, there were nearly [12 million new strokes, approximately 7.3 million deaths and almost 94 million people](https://www.who.int/news-room/fact-sheets/detail/stroke) living with the consequences of stroke. The disease accounted for more than [160 million disability-adjusted life years (DALYs) lost worldwide](https://pmc.ncbi.nlm.nih.gov/articles/PMC11786524/). The economic consequences are equally striking. Recent estimates suggest that stroke costs the global economy approximately [$891 billion annually](https://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2823%2900277-6/fulltext), equivalent to more than 1% of global GDP through healthcare expenditure, lost productivity, informal caregiving and premature mortality. Without urgent action, these costs could rise to US$2.3 trillion annually by 2050.

A [South African study](https://pmc.ncbi.nlm.nih.gov/articles/PMC4762059/) conducted in a rural setting found that the direct costs of stroke were about R2.5-R4.2 million in 2012 and consumed between 1.6% and 3.0% of the sub-district health budget. This highlighted the substantial economic burden that stroke places on already constrained health systems, with approximately 80% of the costs attributable to inpatient care.

Behind these numbers are profound economic consequences. Stroke removes people from the workforce, reduces household income, increases dependency and places large demands on health and social care systems. Families often become informal caregivers, sacrificing employment and educational opportunities in the process. For governments, the costs extend far beyond acute care, encompassing rehabilitation, long-term support and lost economic output.

Stroke is not gender neutral. [Globally, women experience a higher prevalence of stroke](https://www.thelancet.com/journals/laneur/article/PIIS1474-4422\(08\)70193-5/abstract), in part because they live longer and therefore face greater lifetime exposure to stroke risk. The result is not only a health burden but a social and economic one, with many women living longer with stroke-related disability and requiring ongoing care and support.

### **Nowhere is this challenge more apparent than in Africa**

The continent is undergoing a profound epidemiological transition. While infectious diseases remain a priority, non-communicable diseases such as hypertension, diabetes, obesity and cardiovascular disease are rising rapidly. Stroke sits at the intersection of these trends. Recent analyses suggest that [Africa now carries the highest age-standardised disability burden from stroke globally](https://www.thelancet.com/journals/langlo/article/PIIS2214-109X\(25\)00109-3/fulltext), with a disproportionate impact on younger populations. Alarmingly, strokes in Africa occur before the age of 70, affecting people during their most economically productive years.

This matters because Africa's future prosperity depends on the health and productivity of its people. A continent with the world's youngest population cannot afford to overlook a disease that increasingly affects working-age adults, undermines household resilience and places growing pressure on public finances. Fortunately, stroke offers something that many major health challenges do not: *A clear pathway to prevention.*

### **The ROI of prevention**

The evidence is unequivocal. [Many strokes can be prevented](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2932620-4/fulltext) by controlling blood pressure, reducing tobacco use, promoting physical activity, improving diets and strengthening management of diabetes and cardiovascular disease. High blood pressure remains the single most important modifiable risk factor, yet millions of people remain undiagnosed, untreated or inadequately controlled.

From an economic perspective, prevention represents one of the highest-return investments available to governments. Screening programmes, access to affordable medicines and community-based prevention initiatives cost far less than managing lifelong disability. Every stroke avoided helps preserve productivity, maintain household income and reduce healthcare expenditure. Yet prevention alone is not enough.

Many [African countries continue to face significant gaps in stroke care](https://www.nature.com/articles/s41582-021-00542-4). Access to clot lysis or mechanical removal, imaging, rehabilitation services, specialised stroke units and trained health professionals remains uneven. Delays in diagnosis and treatment often mean that potentially preventable disability becomes permanent disability. The result is a cycle in which individuals, families and health systems absorb costs that could have been avoided through earlier intervention.

Governments therefore face a dual challenge: investing in prevention while simultaneously strengthening health systems to ensure timely diagnosis, treatment and rehabilitation. Put simply, governments can either pay for prevention today or pay far more for disability, lost productivity and long-term care tomorrow.

### **Evidence for equitable healthcare**

Research must also become part of the solution. For too long, much of the world's evidence base has been generated outside the settings that bear the greatest burden. Africa requires stronger surveillance systems, locally relevant data and context-specific interventions. Policymakers need reliable evidence to guide decision-making, prioritise investments and evaluate impact. Without data, it is difficult to target resources effectively or measure progress.

This is why institutions such as the South African Medical Research Council have invested in research on cardiovascular disease, hypertension, cardiometabolic health, health systems strengthening and non-communicable disease prevention. Generating evidence is not an academic exercise; it is a prerequisite for effective policy.

The opportunity before us extends beyond reducing mortality. A comprehensive response to stroke advances multiple policy objectives simultaneously. It supports healthy ageing strategies. It contributes to universal health coverage. It enhances workforce productivity. It reduces healthcare expenditure over the long term. Perhaps most importantly, it promotes equity, because stroke disproportionately affects those least able to absorb its economic consequences.

The challenge, then, is not whether we know what to do. The challenge is whether we have the political will to act at the scale required.85

The global community has demonstrated its capacity to mobilise around urgent health threats. Stroke deserves a similar level of ambition. Governments, funders, researchers, civil society and the private sector all have a role to play in building healthier populations and more resilient health systems. **DM**

*Authors: Pro.f Liesl Zühlke and D.r Ebrahim Samodien*

*Prof. Liesl Zühlke is the SAMRC Vice-President of Extramural Research and Internal Portfolio and Director of the Children’s Heart Disease Research Unit at the University of Cape Town.*

*Dr Ebrahim Samodien is a Research Manager within the Office of the SAMRC Vice-President and Research Translation Portfolio Lead at Cochrane South Africa.*

![Image](https://cdn.dailymaverick.co.za/i/34He3QrYsDo6fdZrU_aIjmIJVDo=/200x100/smart/filters:strip_exif\(\)/file/attachments/2999/NavyandGoldSimpleElegantPageBorderDocument1_491760.png)