Advances in prevention, treatment, and public health have reduced deaths from major diseases in Africa, allowing people to live longer. However, a recent study, the Global Burden of Disease 2023, reveals that while mortality rates are falling, the number of people living with disabilities and chronic health conditions is rising. This trend is attributed to various factors, including an increase in noncommunicable diseases such as heart disease, stroke, and diabetes. As a result, many people are spending more years living with the consequences of disease and injury.
The study shows that globally, healthy life expectancy at birth increased from 61.1 years in 2010 to 63.1 years in 2023. However, the gap between living longer and living healthier is widening. Globally, years lived with disability rose from 786 million to 990 million between 2010 and 2023. In many African countries, this is occurring alongside a growing burden of noncommunicable diseases. Health systems have become increasingly effective at reducing mortality but have not expanded rehabilitation services at the same pace.
Rehabilitation can help people recover after illness or injury, maintain independence, and participate fully in society. Yet, it remains overlooked in many health systems. To address this growing challenge, governments, health systems, and development partners need to make rehabilitation a core part of healthcare rather than an afterthought. This means integrating rehabilitation into primary care, expanding the rehabilitation workforce, and ensuring that services are available in communities.
The Global Burden of Disease 2023 study examined trends in life expectancy, causes of death, and disability across the world. The study provides one of the clearest pictures yet of how health is changing in Africa. The findings related to disability are particularly significant, as public health discussions often focus on reducing mortality. However, surviving a health condition does not necessarily mean returning to full health.
Several forces are driving the trend of increasing disability in Africa. More people are surviving conditions such as HIV, tuberculosis, and neonatal complications. At the same time, population growth, ageing, and the rising prevalence of noncommunicable diseases mean that more people are living with conditions that affect their functioning. From a rehabilitation perspective, this is a critical finding, as Africa's health systems are increasingly caring for people who need support not only to survive but also to maintain independence and mobility.
The study's findings suggest that Africa's health systems are increasingly effective at saving lives but are not equipped to help people live well after illness or injury. Governments and development partners can change the lack of rehabilitation capabilities by integrating rehabilitation into primary healthcare, investing in workforce development, and expanding access to community-based services. This will require a shift in focus from solely reducing mortality to also improving the quality of life for people living with disabilities.
Ultimately, success in healthcare should not be measured only by lives saved but also by whether people can live well after survival. By prioritizing rehabilitation and making it a core part of healthcare, Africa's health systems can better support people living with disabilities and chronic conditions. This will enable people to move, work, learn, care for their families, and participate fully in their communities.
Key points
- Rehabilitation is crucial for people living with disabilities and chronic conditions in Africa.
- Health systems in Africa need to prioritize rehabilitation to support people living with disabilities.
- Governments and development partners must invest in rehabilitation workforce development and community-based services.
