Africa’s Diabetes Time Bomb Ticks for Us All
By Darius Spearman (africanelements)
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On November 14, 2025, a day set aside to raise global awareness, the World Health Organization (WHO) delivered a chilling message. Africa is sitting on a diabetes “time bomb” (gazettengr.com). While this news may seem distant, its roots and repercussions echo deeply within the African Diaspora. The soaring rates of this chronic disease on the continent are not an isolated crisis. They are a mirror reflecting the shared struggles against systemic inequities, historical legacies, and social conditions that have long plagued Black communities worldwide. For African Americans, who face disproportionately high rates of diabetes, this is more than a headline; it is a familiar story of a health crisis fueled by a lack of access and opportunity (hhs.gov).
The challenges in Africa—from the high cost of insulin to the lack of testing facilities—are stark reminders of the healthcare battles fought in our own neighborhoods. Both on the continent and in the diaspora, communities grapple with similar social determinants of health. These include limited access to healthy foods, safe spaces for exercise, and quality medical care (frontiersin.org). The historical threads of colonialism and slavery have woven a tapestry of socio-economic disparity that contributes to poor health outcomes on both sides of the Atlantic. Therefore, understanding the crisis in Africa is essential. It helps us see the bigger picture of our collective fight for health equity and social justice.
A Ghost Illness Becomes a Public Enemy
For much of the 20th century, diabetes was barely a footnote in African medical records. A medical missionary in Uganda in 1901 described the disease as “rather uncommon and very fatal,” a view that persisted for decades (researchgate.net). This reality has shifted dramatically. By 1980, an estimated 4 million people in the African region had diabetes. That number was projected to surge significantly by 2010. This explosion of a once-rare ailment signals a profound change in the health landscape of the continent.
This change is what experts call an “epidemiological transition.” In simple terms, it is a shift in the main health threats a population faces. Historically, African nations battled infectious diseases like malaria and tuberculosis. Now, they face a rising tide of non-communicable diseases (NCDs) like diabetes and heart disease (who.int). This transition is driven by longer life expectancies and societal changes. However, it means health systems built to fight infections are now struggling to manage chronic conditions.
Fighting on Two Fronts: The Double Burden
Africa is now grappling with a “double burden of disease.” This means countries must fight high rates of infectious diseases and a growing epidemic of NCDs at the same time (datelinehealthafrica.org). Imagine a hospital with limited resources trying to treat patients with HIV/AIDS and tuberculosis, while also seeing a flood of new patients with diabetes complications. This is the daily reality for many healthcare systems across the continent.
This double burden puts an immense strain on already fragile health infrastructures. Resources must be split between two very different kinds of health challenges, often with devastating consequences. The situation creates a cycle where poor health deepens poverty through high healthcare costs (businessday.ng). This reality is not unlike the challenges in underserved Black communities in America. There, residents often face higher rates of both infectious diseases and chronic conditions like hypertension and diabetes, straining local clinics and community health resources.
How Modern Life Fuels an Old Disease
The rise of diabetes in Africa is closely tied to major societal shifts. Rapid urbanization is a key driver. As millions of people move from rural villages to sprawling cities, traditional lifestyles disappear (healthcoachafrica.com). Active, farm-based work is replaced by sedentary jobs. Diets once rich in unprocessed foods are swapped for the convenience of fast food and sugary drinks. This lifestyle transformation is a primary cause of rising obesity and insulin resistance, a condition where the body’s cells stop responding properly to insulin.
Insulin resistance is a critical precursor to type 2 diabetes. When cells resist insulin, the pancreas must work overtime to produce more of the hormone to manage blood sugar (nih.gov). Eventually, the pancreas cannot keep up, causing blood sugar levels to rise. Furthermore, socioeconomic factors like urban poverty and economic inequality worsen the problem. At the same time, low public awareness about diabetes prevention and management, sometimes influenced by cultural beliefs that attribute illness to supernatural causes, prevents early diagnosis and effective care (frontiersin.org).
Diabetes Prevalence Surge in WHO African Region
This chart illustrates the dramatic increase in diabetes prevalence among adults in the WHO African Region from 1990 to 2022 (who.int).
The Unseen Numbers of Africa’s Diabetes Crisis
The statistics paint a grim picture of the diabetes crisis in Africa. In 2021, an estimated 24 million adults were living with the disease on the continent (who.int). By 2022, that number had surged to 54 million adults in the WHO African Region, with prevalence jumping from 6.4% in 1990 to 10.5% in 2022. Projections are even more alarming, suggesting the number of people with diabetes could reach 55 million by 2045, a stunning 129% increase (gazettengr.com). This outpaces the expected global average increase, signaling a uniquely urgent problem.
Perhaps the most shocking statistic is the rate of undiagnosed cases. A staggering 54% of people with diabetes in the African Region do not know they have it, which is the highest proportion in the world (who.int). This means over 34 million people are living without essential care, leaving them vulnerable to severe complications and premature death. Consequently, Africa has the highest diabetes mortality rates globally. The age-standardized death rate is 48 per 100,000 people, more than double the global rate of 23 per 100,000. Additionally, the crisis affects the young, with a five-fold increase in type 1 diabetes among children and teens between 2011 and 2021.
Undiagnosed Diabetes in the African Region
Over half of all adults living with diabetes in the African Region are undiagnosed, the highest proportion in the world (who.int).
A Crisis of Access and Justice
At its core, the diabetes crisis is a story of systemic failure and a profound social justice issue. The high rates of death and disability are not inevitable; they are the direct result of inadequate healthcare infrastructure and restricted access to care. Many communities lack basic testing facilities, equipment, and trained health personnel (gazettengr.com). A 2019 WHO survey revealed that only 36% of countries in the region had essential medicines for chronic diseases available in public hospitals. This problem is not new. As early as 2003, no African country had 100% accessibility to insulin, a life-saving drug for many with diabetes.
This lack of access is compounded by alarmingly low healthcare spending. In 2021, diabetes-related expenditure in Africa was just $13 billion, a mere 1% of the global total (who.int). This chronic underfunding ensures the crisis will worsen. Furthermore, other health challenges complicate the situation. The widespread use of certain life-saving anti-retroviral drugs for HIV/AIDS can contribute to glucose intolerance and central obesity, increasing the future burden of type 2 diabetes. Addressing this requires a commitment to social justice. It demands specific actions like implementing universal health coverage, strengthening primary care, and increasing funding for NCDs to ensure care is based on need, not the ability to pay (frontiersin.org).
Africa’s Diabetes Crisis: Key Figures
These statistics highlight the severity of the diabetes epidemic, from future projections to current mortality rates (gazettengr.com).
Our Shared Fight for Health Equity
The diabetes “time bomb” in Africa is a powerful call to action that resonates across the diaspora. The historical and social factors driving this crisis—poverty, urbanization, and systemic neglect—are the same forces that create health disparities in African American communities. African Americans are diagnosed with diabetes at higher rates than the total population and suffer more severe complications (hhs.gov). These shared vulnerabilities are not a coincidence; they are the product of a shared history.
Viewing this crisis through a social justice lens reveals the urgent need for equitable health policies and resource allocation on a global scale. The fight for access to affordable insulin in Mozambique is intrinsically linked to the fight against food deserts in Detroit. Moreover, strengthening healthcare systems in Africa and advocating for NCD funding mirrors the push for better community health services and culturally competent care in the United States. This is a collective struggle. By recognizing our connected histories, we can build a united front to demand health equity for all people of African descent, ensuring this time bomb is defused before it is too late.
About the Author
Darius Spearman is a professor of Black Studies at San Diego City College, where he has been teaching for over 20 years. He is the founder of African Elements, a media platform dedicated to providing educational resources on the history and culture of the African diaspora. Through his work, Spearman aims to empower and educate by bringing historical context to contemporary issues affecting the Black community.
