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Fighting non-communicable diseases in East Africa: assessing progress and identifying the next steps
  1. Christian Kraef1,2,3,4,
  2. Pamela A Juma5,6,
  3. Joseph Mucumbitsi4,7,8,
  4. Kaushik Ramaiya4,9,10,
  5. Francois Ndikumwenayo4,11,12,
  6. Per Kallestrup1,3,4,
  7. Gerald Yonga4,6,13
  1. 1Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
  2. 2Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Germany
  3. 3Danish NCD Alliance, Copenhagen, Denmark
  4. 4East Africa NCD Alliance, Kampala, Uganda
  5. 5African Population and Health Research Center, Nairobi, Kenya
  6. 6NCD Alliance Kenya, Nairobi, Kenya
  7. 7College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
  8. 8Rwanda NCD Alliance, Kigali, Rwanda
  9. 9Shree Hindu Mandal Hospital, Dar es Salaam, United Republic of Tanzania
  10. 10Tanzania NCD Alliance, Dar es Salaam, United Republic of Tanzania
  11. 11University of Burundi, Bujumbura, Bujumbura Mairie Province, Burundi
  12. 12Burundi NCD Alliance, Bujumbura, Burundi
  13. 13University of Nairobi, Nairobi, Kenya
  1. Correspondence to Dr Christian Kraef; christiankraef{at}


Sub-Saharan Africa has seen a rapid increase in non-communicable disease (NCD) burden over the last decades. The East African Community (EAC) comprises Burundi, Rwanda, Kenya, Tanzania, South Sudan and Uganda, with a population of 177 million. In those countries, 40% of deaths in 2015 were attributable to NCDs. We review the status of the NCD response in the countries of the EAC based on the available monitoring tools, the WHO NCD progress monitors in 2017 and 2020 and the East African NCD Alliance benchmark survey in 2017. In the EAC, modest progress in governance, prevention of risk factors, monitoring, surveillance and evaluation of health systems can be observed. Many policies exist on paper, implementation and healthcare are weak and there are large regional and subnational differences. Enhanced efforts by regional and national policy-makers, non-governmental organisations and other stakeholders are needed to ensure future NCD policies and implementation improvements.

  • control strategies
  • health policy
  • public Health
  • other study design

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  • Handling editor Seye Abimbola

  • Contributors All authors contributed to conception and design of the article. JP and CK collected the data. CK, PAJ, JM, and PK drafted the manuscript. All authors critically revised the manuscript and gave final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.