By Michael Gwarisa
Zimbabwe’s estimated annual deaths from non-communicable diseases (NCDs) more than doubled over three decades, rising from about 21,000 in 1990 to 42,000 in 2023, according to a new Lancet Global Health study.
The study, which analysed Global Burden of Disease (GBD) 2023 data across all 54 African countries, estimated that Zimbabwe recorded about 42,000 NCD deaths in 2023, up 100.7 percent from 1990.
The increase in deaths was accompanied by a substantial rise in the overall burden of illness. The researchers estimated 2.45 million disability-adjusted life-years (DALYs) attributable to NCDs in Zimbabwe in 2023, representing a 91 percent increase since 1990.
NCD incidence was also estimated at 2.48 million cases in 2023, a 54.1 percent increase from 1990. However, the study presents an important distinction that is critical when interpreting the Zimbabwe figures.
While the number of deaths increased sharply, Zimbabwe’s age-standardised NCD mortality rate was estimated at 451.2 deaths per 100,000 people in 2023, representing a change of just 0.6 percent from 1990. The uncertainty interval around that estimate ranged from a decline of 11.8 percent to an increase of 13.4 percent.
In other words, the study does not establish a statistically clear increase in Zimbabwe’s population-adjusted NCD death rate over the period. Instead, the absolute number of deaths has risen substantially as the population and its demographic structure have changed.
Across Africa, the researchers found a similar pattern.
“Absolute burden has more than doubled,” the study says, despite modest declines in age-standardised death and disability rates between 1990 and 2023.
The continental analysis estimated 4.70 million NCD deaths in Africa in 2023, accounting for about 45 percent of all deaths. NCD deaths increased by 122.2 percent between 1990 and 2023, while the age-standardised mortality rate declined by 9 percent.
The researchers describe this as a paradoxical trajectory driven predominantly by population growth and demographic change.
For Zimbabwe, the findings point to the growing importance of diseases that often develop over long periods and require sustained prevention, diagnosis and treatment.
Across Africa, the five leading individual causes of NCD death in 2023 were ischaemic heart disease, stroke, chronic kidney disease, hypertensive heart disease and diabetes.
The study found that more than half of NCD deaths across the continent were attributable to the 88 risk factors assessed by the GBD analysis. High systolic blood pressure was the largest contributor, accounting for 26.2 percent of NCD deaths, followed by dietary risks at 14.7 percent and air pollution at 14.2 percent.
The findings are particularly significant for hypertension, which the researchers identify as the leading risk factor for NCD mortality and DALYs in Africa.
The study notes that hypertension on the continent is characterised by early onset, high prevalence, poor awareness and persistently low control rates. It cites evidence showing that fewer than half of adults in some multicentre African studies were aware of their condition, while control rates were often below 50 percent.
Diet has also emerged as a major concern. The researchers found that deaths attributable to dietary risks in Africa increased by 130 percent between 1990 and 2023, compared with a 46 percent increase globally.
The study links the growing dietary burden to nutritional transition, including increased consumption of processed foods, poor diet quality and limited access to healthier alternatives.
Air pollution was identified as another major contributor, with the researchers noting that ambient particulate matter and ozone pollution are rising in parts of Africa amid urbanisation and industrialisation.
The study’s authors argue that the continent cannot rely solely on treatment of established disease. They call for stronger prevention, earlier diagnosis, community-based screening and better access to treatment.
For Zimbabwe, the figures provide a clear measure of the scale of the challenge. An estimated 42,000 NCD deaths in one year, alongside 2.45 million DALYs, represents a substantial health burden even though the age-standardised mortality rate has remained broadly stable.
The findings therefore point to two realities that need to be considered together: Zimbabwe is not necessarily experiencing a dramatic increase in its population-adjusted NCD mortality rate, but the country is carrying a much larger absolute NCD burden than it did three decades ago.
The researchers conclude that a substantial proportion of Africa’s NCD burden remains linked to modifiable risk factors and say this creates opportunities for prevention through available.
