Combating Gender-Based Violence for Sustainable Development: Empowering African Women and Girls

Despite international frameworks and regional commitments to combating Gender-based violence (GBV), millions of women across the world, particularly in Africa continue to face high prevalence of violence. This violation of  fundamental human rights not only harms individuals but also impedes progress towards sustainable development, prosperity, and equality. In commemoration of the International Day for the Elimination of Violence against Women, this article emphasises the urgent need to address gender-based violence in Africa. 

Background

Gender-based violence (GBV) is one of the most pervasive human rights violations worldwide, affecting individuals in every country and across all segments of society. It entails any harm or threat of harm inflicted on a person due to male-female power imbalances entrenched within a society (UNICEF, 2024). GBV can be physical, sexual, mental, or economic in nature. Sexual violence, intimate partner violence, female genital mutilation, child marriage, sex trafficking and femicide are all forms of gender-based violence. While men and boys can also be victims of GBV,  women and girls experience this violence at a disproportionately higher rate. Globally, an estimated 736 million women (nearly one in three) have faced  physical and/or sexual violence at least once in their lifetime. The prevalence of GBV  has intensified in different settings, such as the workplace and online spaces, and has been further exacerbated by post-pandemic effects, climate change, and conflicts. Survivors of GBV often suffer from related consequences including severe physical injuries, unwanted pregnancies, exposure to HIV or other sexually transmitted infections, post-traumatic stress disorder, anxiety, and depression. 

Although the international community has made strides in creating awareness and addressing violence against women, as outlined in the Maputo Protocol, Beijing Declaration, and the Sustainable Development Goals (SDG 5.2), progress remains uneven, especially in regions grappling with poverty, political instability, and limited institutional capacity.

Key Statistics on Violence against Women and Girls in Africa

*Gender-based violence in Africa remains pervasive and multifaceted, manifesting as physical, sexual, psychological, and economic violence. 

*Approximately 42% of women in Eastern and Southern Africa, and 37% of women in Sub-Saharan Africa experience physical and/or sexual violence in their lifetime. These figures are well above the global average of 30%.

*Africa has some of the highest child marriage rates, with 4 out of 10 girls married before the age of 18, especially in countries like Niger (76%) and the Central African Republic (68%).

*Africa accounts for more than 50% of all cases of Female Genital Mutilation and Cutting (FGM/C), which affects over 230 million women and girls worldwide

*In 2022, Africa recorded the largest number of Femicide with approximately 20,000 women and girls killed by their intimate partners or other family members. This is nearly half of the global total of approximately 48,800. 

*Gender-based violence costs African countries an estimated 2% to 4% of GDP annually primarily due to  lost productivity and health-related expenses. For instance, South Africa loses $2 billion annually as a  result of  GBV-related costs.

Challenges in Addressing Gender-based Violence (GBV)

Significant barriers still persist, despite various national and regional policies aimed at reducing GBV in Africa. Some of these barriers include: 

Cultural Norms and Traditional Beliefs: In many African communities, particularly in rural areas, deeply ingrained  gender roles often justify or normalise violence against women, especially within marriage or intimate relationships. For instance, studies show that about 51% of African women believe that a husband is justified in beating his wife under certain circumstances, such as infidelity or neglect of household duties. These beliefs perpetuate  abuse and make it difficult for women to seek help.

Shame and Stigmatization: Victims of gender-based violence, particularly sexual violence, frequently face shame and ostracization when they report abuse. This stigma is intensified in  communities where victims are seen as complicit in the violence, discouraging women from speaking out or seeking justice. As a result, many cases of GBV are often underreported, complicating efforts to measure and address the problem effectively.

Conflict and Displacement: Armed conflicts in Africa, especially in regions like the Sahel, Central African Republic, eastern Democratic Republic of the Congo, and northern Nigeria have led to alarming rates of sexual violence and exploitation against women and girls. In these  conflict zones, women are increasingly vulnerable to abuse and face high risks of violence. Displacement driven by conflict or environmental crises, place women and girls in precarious situations where they may lack basic protections. For instance, internally displaced persons (IDP) camps and refugee settlements often lack adequate security, making women targets of sexual violence and exploitation.

Limited Support Services and Inadequate Funding: Many African countries struggle with  budget constraints that limit access to essential support services for GBV survivors, such as safe shelters, legal aid, and psychological counselling. In addition, many GBV initiatives in Africa are funded by international donors rather than national governments, leading to inconsistent and sometimes unsustainable interventions. Without stable domestic funding, these programs risk discontinuation, and efforts to establish a permanent, accessible support system for survivors remain limited. As a result, the reach and effectiveness  of GBV interventions are undermined, particularly in fragile and conflict-prone regions.

Weak Legal and Policy Framework: While many African nations have laws that prohibit GBV, significant gaps still exist. For instance, marital rape is still not universally criminalized in several countries, limiting legal recourse for many women. Even in countries with comprehensive legal frameworks, enforcement is often weak, allowing perpetrators to remain unaccountable. In addition, limited resources and inadequate training for law enforcement officials and judicial staff often prevent the effective implementation of existing laws. Some law enforcement representatives  lack the sensitivity to handle GBV cases properly, and survivors often face judgement, victim-blaming, or even retaliation when they  come forward. For instance, law enforcement officers in some regions may pressure survivors to reconcile with their abusers rather than pursue legal action, which further perpetuates cycles of abuse.

Policy Recommendations

To significantly mitigate violence against African women and girls, a multisectoral approach that brings together governments, civil society, and international organisations is essential. Prioritising women’s rights across the continent can help accelerate progress toward sustainable development and create a safe and more inclusive society that upholds human dignity. Some recommended strategies to achieve this include:

Strengthen Legal Frameworks and Enforcement: African Governments should align national laws with international and regional protocols on GBV. Traditional norms and beliefs that do not support basic human rights should not be upheld. Efforts should focus on closing legal gaps, particularly regarding marital rape and domestic violence. Additionally, governments should invest in more training and capacity-building programs for law enforcement and judicial officials to ensure the effective, fair and prompt enforcement of GBV laws.

Invest in Prevention and Support Services: African Governments should prioritise increased funding allocation for essential support services such as safe shelters, psychological counselling, and medical services for GBV survivors. Prevention programs to create awareness about GBV and reform harmful societal norms are crucial  to fostering positive social change. These programs should focus on promoting respect for women and girls, and enhancing gender equality. To be most effective, prevention and awareness initiatives  should be integrated within schools, workplaces, and community groups. 

Promote Education and Economic Empowerment for Women: Expanding access to education for girls, along with vocational training, can help reduce vulnerabilities to early marriage and economic dependency – two common precursors to violence. Having women and girls access their right to quality education can increase their independence, freedom, and employability. Furthermore, economic support programs such as  micro-loans and vocational training, should be developed for survivors to help them rebuild their lives and achieve financial independence. 

Enhance Data Collection and Monitoring: Reliable, disaggregated data on gender-based violence is crucial for understanding the full scope of the problem and tailoring responses. Enhanced data systems will enable African nations to measure progress, identify high-risk groups, and assess intervention effectiveness. Thus, governments should strengthen data collection systems to capture accurate data on GBV prevalence, types, and outcomes. This can be achieved by establishing clear protocols for reporting GBV incidents to ensure that data is collected uniformly by trained personnel. Also, a centralised and secured national database to track GBV incidents should be developed, allowing for systematic collection and analysis. This could include cases reported to law enforcement authorities, healthcare facilities, and support services, enabling a comprehensive view of GBV trends across sectors.

Expand Partnerships with Civil Society Organizations and NGOs: Governments should collaborate with NGOs, especially those with expertise in GBV, to design and implement community-based interventions. Also, funding should be allocated to local NGOs working on GBV prevention and support, recognizing their role in bridging service gaps. Stable long-term funding will empower these organisations to plan and execute interventions effectively. 

 

Image:Sandro Bozzolo

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Reforming public procurement in Nigeria: What needs to change

Nigeria faces significant challenges with corruption, as illustrated by the 2023 Corruption Perceptions Index. Public procurement is particularly vulnerable, and is one of the main areas through which corruption manifests in the public sector. Addressing corruption in public procurement is therefore important for a number of reasons. First, procurement is a lever for development that helps to ensure projects deliver development benefits to beneficiaries. It is vital to promoting sustainability and is also crucial for the effective utilization of public funds. Furthermore, procurement accounts for up to 50% of government expenditures in sub-Saharan Africa, making it essential from a policy implementation and financial management perspective.

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Authors- Sope Williams and Adedeji Adeniran

 

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The Hidden Costs of Tobacco: An Environmental Perspective

Climate change is arguably one of the greatest challenges of the 21st century with severe impacts on humanity. While the health implications of tobacco use are well-documented, the environmental damage caused by the tobacco industry is equally concerning. Tobacco is responsible for over 8 million deaths globally- 7 million of these deaths are caused by direct use of tobacco while 1.2 million are a result of second-hand smoke. 

Given the ongoing climate crisis, the tobacco industry poses a significant threat to the planet, ranking among the world’s largest polluters and contributors to global warming. The acute environmental damage caused by the tobacco industry begins long before its products are consumed and continues long after they are discarded.

Each year, the tobacco industry claims more than 8 million human lives, destroys 600 million trees through deforestation, consumes 200,000 hectares of land, depletes 22 billion tonnes of water, and generates 84 million tonnes of CO2 emissions. The entire lifecycle of tobacco products, from cultivation, manufacturing, distribution, sales and final disposal of end products (cigarettes), has a profound impact on both the environment and public health.

Tobacco farming is primarily concentrated in low-income countries, largely due to the industry’s efforts to cut costs and bypass stringent regulations. To maximise profits, tobacco is typically grown in a monoculture setting, where large quantities of a single crop are cultivated on the same piece of land. To manage the challenges of monoculture, the industry utilises large amounts of toxic chemicals and pesticides, which pose huge risks to farmers and the environment. Annually, between one to five million pesticide poisonings occur, resulting in the deaths of an estimated 11,000 farmers globally. Tobacco farming also contributes to food insecurity as lands that could otherwise have been used to grow food crops essential for human well-being are diverted for tobacco cultivation. Over time, tobacco farming degrades the quality of the soil, reducing its ability to support the growth of nutritious food crops.

Furthermore, tobacco cultivation contributes to water pollution and land degradation.  The heavy use of pesticides and chemicals during tobacco farming contributes to soil degradation while chemical residues from these farms have been detected in nearby waterways. Even after consumption, cigarette butts discarded in water bodies pose a significant threat to aquatic ecosystems. Research has shown that the chemicals leaching from a single cigarette soaked in a litre of water for 24 hours can kill 50% of both saltwater and freshwater fish within 96 hours.

The World Health Organisation (WHO) estimates that 22 billion tonnes of water are used during tobacco production globally. This is equivalent to the volume of water that flows into the Amazon River (the largest river in the world). Tobacco farming is extremely water-intensive, requiring up to eight times more water than tobacco farming. The lifecycle of a single cigarette, from cultivation to disposal, requires approximately 3.7 litres of water. This is particularly concerning, given that between 2000 and 2017, an estimated 2.2 billion people worldwide lack access to safe drinking water. As the demand for tobacco products continues to rise, so does the pressure on scarce water resources, exacerbating water scarcity and compromising the health of millions of people. 

The tobacco industry is also a major contributor to carbon emissions. It generates carbon dioxide in several ways, starting with the production of cigarettes. A single stick of cigarette produces up to 14 grams of CO2 throughout its lifecycle from production to disposal. On one hand, the tobacco industry is a major contributor to climate change and deforestation. Annually, it emits up to 80 million tonnes of carbon dioxide during production. Moreover, over 600 million trees are cut down each year to produce cigarettes. This process releases stored carbon dioxide into the atmosphere. On average, It takes about  one tree to produce 15 packs of cigarettes.”

Ways Forward

Reducing tobacco consumption and production is crucial for achieving Sustainable Development Goals (SDGs). The tobacco industry significantly contributes to climate change, exerting negative environmental impacts throughout its lifecycle; from deforestation to greenhouse gas emissions. 

To address this pressing concern, governments and policymakers must act fast. A multi-faceted approach is necessary to curb the environmental harm the industry poses as well as promote sustainable alternatives. 

Some policy recommendations include:

1. Support Farmer Transition: Implement policies to incentivise tobacco farmers to transition to sustainable crops. This includes providing training, technical assistance, and financial support.
2. Impose Strong Tobacco Taxes: Enact robust tobacco taxation policies to reduce consumption and generate revenue for public health programs.
3. Strengthen Advocacy and Awareness Campaigns: Collaborate with civil society organisations to raise public awareness about the harmful effects of tobacco production, consumption, and waste disposal.
4. Investment in Research and Development: Funding research into sustainable agriculture and innovative tobacco alternatives can develop more environmentally friendly practices and products.

By adopting these strategies, governments and policymakers can effectively address the climate impact of the tobacco industry, promote public health, and promote the United Nations Sustainable Development Goals.

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Tackling Africa's Food Crisis: Strategies for a Sustainable 2030

Food insecurity is a global challenge, and achieving the United Nations Sustainable Development Goal 2 “zero hunger” by 2030 is a top priority. This is a particularly  pressing issue in Africa, which has been disproportionately affected  for many years and is home to many countries facing soaring food inflation (WHO, 2023). The ongoing war in Ukraine, coupled with the aftermath of the COVID-19 pandemic, has further exposed the continent’s deep-rooted structural vulnerabilities (UNDP, 2022). Africa has been grappling with millions of starving populations, including severely malnourished and emaciated children. This crisis is driven by a combination of rising conflict, climate change, and inefficient agricultural practices. Reports from the African Union (AU) and Food and Agriculture Organisation (FAO) reveal that approximately 346 million people in Africa are currently experiencing food crises. Furthermore, the Famine Early Warning Network Systems projects that many African countries would require food assistance by early 2024 due to the ongoing El Niño event.

Global and Regional Disparities in Food Insecurity

From 2014 to 2023 as revealed in Figure 1A,  all regions experienced fluctuations, but Africa consistently had  the highest prevalence of severe food insecurity, averaging around 19.41% . In contrast, Asia, South America and Latin America and the Caribbean reported lower average rates of 8.26%, 7.58%, and 8.96%, respectively. More worrisome, the severity of food insecurity in Africa has consistently surpassed the combined rates of Asia and either Latin America or South America, except in 2021, which may have been influenced by the Covid-19 pandemic.

Additionally, the global average of 9.23% is significantly lower than Africa’s rate. This clear divergence  highlights the unique and enduring food security challenges facing Africa, necessitating distinct policy responses and urgent interventions.

Within the African regions, disparity still exists. As shown in Figure 1B, from 2014 to 2023, food insecurity rates in Africa fluctuated, starting at 16.3% in 2014 and rising to 21.6% in 2023. Eastern Africa consistently reported the highest prevalence, with rates increasing from 20.6% in 2014 to 24.2% in 2023, peaking at 26.7% in 2021. This was followed by West Africa, experiencing  fluctuations ranging from 10.1% to 18.8% during the same period. Data for Middle Africa was not available until 2020, but it recorded the highest values in 2023, reaching 36% and 38% . North Africa generally reported lower levels of food insecurity, ranging from 8.7% and 12%. In contrast, Southern Africa witnessed relatively stable figures, hovering around 9% to 11%.

By June 2023, food insecurity and malnutrition in West and Middle Africa were projected to peak to 10-year high. According to the UN World Food Programme, 45,000 individuals in the Sahel were  projected to face the risk of  enduring catastrophic hunger in the Sahel for the first time. Middle Africa was anticipated to record the highest level in Africa, while West Africa was projected to experience a 40 % increase in the number of  people struggling with food insecurity, rising from 23.6 million in 2021. This crisis was compounded by soaring grain prices, driven by inflation, sanctions, and restrictions on agricultural trade, along with a 12-million-ton cereal deficit for the 2023-2024 season, further straining the region’s reliance on food imports (WFP, 2024).

Figure 1A: Prevalence of Food Insecurity in the Total Population                        

Source: Author’s analysis of FAO data, 2024

Figure 1B: Prevalence of Food Insecurity in Africa

Source: Author’s analysis of FAO data, 2024

Average Regional Prevalence of Severe Food Insecurity in Africa

The average values displayed in figure 2 highlight the persistent challenge of severe food insecurity in Eastern Africa, which exhibits  a consistently high prevalence. Northern Africa maintained a comparatively lower yet stable rate, while Southern Africa showed moderate and stable levels. However, the lack of data for Middle Africa underscores significant gaps in understanding the situation, emphasizing the need for comprehensive reporting and targeted interventions across these regions.

Figure 2: Average Regional Prevalence of Severe Food Insecurity in African Regions

Source: Author’s analysis of FAO data, 2024

 

Efforts to Tackle Food Insecurity in Africa

Efforts to combat food insecurity in Africa involve both global and regional initiatives. A significant example is a World Bank report in 2021, highlighting  a substantial $570 million multi-phase program designed for regional capacity development for agricultural risk management,  and promoting intra regional value chains in West Africa, while encouraging climate smart practices. This program, aims to benefit approximately four million people across the region, initially focusing on Mali, Burkina Faso, Togo, Niger, and three key regional organizations, including the Economic Community of West African States (ECOWAS), the West and Central Africa Council for Agriculture Research and Development (CORAF), and the Committee for Drought Control in the Sahel (CILSS).

Addressing food insecurity on the African continent requires  a unified approach involving local, national, regional, and global stakeholders, including humanitarian, developmental, and peacebuilding entities, governments, and donors (Delgado, Tschunkert & Smith, 2023; FAO, 2021). Effective strategies include integrating policies across these sectors  in conflict-prone areas, bolstering climate resilience in food systems, reinforcing the economic resilience of vulnerable populations, and optimizing food supply chains to improve affordability and access.

Regionally, the Comprehensive Africa Agriculture Development Programme (CAADP), a long-term initiative, was launched in 2003, as part of  the Agenda 2063 continental initiatives. It encourages African governments to allocate at least 10% of their national budgets to agriculture and rural development. The New Partnership for Africa's Development (NEPAD) launched in 2002, continues to implement various programs aimed at addressing food security and agricultural development across the continent.  Additionally, the African Development Bank's "Feed Africa" Strategy, launched in 2015, is a comprehensive initiative designed to transform agriculture and food security.  This strategic framework focuses on  promoting agricultural growth and rural development to tackle the critical challenge of food insecurity.  The Common Market for Eastern and Southern Africa (COMESA) also has an agricultural strategy that aims to enhance food security, promote agricultural trade, and foster regional integration in eastern and southern Africa. Meanwhile, the Alliance for a Green Revolution in Africa (AGRA) is a partnership that supports smallholder farmers by promoting sustainable agricultural practices, improving seed varieties, and facilitating market access. In addition to these major initiatives, several other programs have been implemented to further support agricultural development across the continent.

African nations have also implemented country-specific programmes to enhance their food systems. Notable initiatives include the  FADAMA project in Nigeria; E-voucher Program in Zambia; National Agricultural Advisory Services in Uganda (NAADS); Kilimo Kwanza (Agriculture First) in Tanzania, the National Agriculture and Livestock Extension Program (NAC) in Kenya, PRODEC (Programme de Développement de l'Économie Ruralel) in Senegal, Malawi's agricultural development initiatives and Ethiopia's productive safety net policy, among others. Despite these efforts, food insecurity remains a critical issue across the region. 

Why Efforts Seem Futile

Source: Author’s analysis of FAO data, 2023.

 

Amidst climate-related disasters and ongoing conflicts in Africa, which inhibit progress and strain livelihoods on the continent, government expenditure in agriculture has remained low over time. A report by OXFAM reveals that between 2019 and 2022, about two-thirds of African countries spent less than 5% of their budget on agriculture, which is far below the 10% target set by the Maputo Declaration, which over 40 African countries endorsed.

The allocation of government expenditure to agriculture varies significantly across African regions. From 2001 to 2021, the continent allocated an average of 2.68% of its government expenditure to agriculture. Notably, Eastern Africa stands out with the highest average of 4.66%, indicating  a pronounced commitment to agricultural investments compared to other regions. Western Africa follows with  an average of 3.48%, while Northern Africa allocated an average of 2.93%. In contrast, Southern Africa shows a lower average of 1.75%, reflecting a comparatively reduced allocation to agriculture in government spending. Middle Africa falls even lower, with an average of 1.49%. 

During the same period, the global Agriculture Orientation Index (AOI) averages 0.47, implying that, on average, about 47% of government expenditures allocated to agriculture align with the sector's contribution to the global economy. However, in Africa, the average AOI is markedly lower at 0.18, indicating a relatively reduced commitment to agriculture in government spending compared to GDP and a slow progress  towards achieving SDG 2 by 2030. Within the African context, Southern Africa stands out with an AOI of 0.64, reflecting a stronger emphasis  on agriculture in terms of both government expenditures and GDP. In comparison,  other regions have recorded lower values: West Africa at 0.14, Middle Africa at 0.15, East Africa at 0.20, and North Africa at 0.26.

Traditionally, one might expect  that higher government expenditure on agriculture would correlate with a greater  economic impact from the sector and an increased level of food security. However, the paradox in the Southern African region suggests that factors beyond direct government spending, such as private sector contributions, efficiency, climate-induced practices, insecurity trends, technology adoption, and value-added activities, play a significant role in shaping the economic impact of the agricultural sector. A report by the Economic Research Southern Africa (ERSA) in 2023 shows that the region is the most climate-resilient region in Sub-Saharan Africa. In contrast, the Horn of Africa, Eastern Region, despite being  the most climate vulnerable region and a leading area of conflict and fragility globally, records the highest average share  of government expenditure on agriculture in Africa.

What can we do differently?

To effectively address this issue, interventions must be tailored to the specific circumstances of each region in Africa, where  sustained and targeted efforts to combat food insecurity are most  urgently needed. 

Addressing Climate and Armed Conflict Challenges: Climate-induced conflict is one of the pronounced forms of disaster in Africa. For instance, due to increasing parched land, herders seek to prevent their livestock from getting puny, while farmers strive to protect their crops from stunted growth. This  leads to migration and unhealthy competition for resources  among these groups. The complex interplay between climate-related stressors and societal tensions underscores the need for holistic approaches to address both environmental and security challenges in Africa. 

Increased Investment in Agriculture: Globally, 30–34% of food supply is produced by smallholder farmers who work on less than 2 hectares of land (FAO, 2021).  African nations should prioritize substantial investments in agriculture, specifically targeting smallholder farmers and sustainable farming practices, with effective monitoring in place. This investment should include funding for infrastructure development, access to modern farming technologies, and agricultural training. Additionally, initiatives aimed at increasing the resilience of agricultural systems to climate change should be prioritised.

Cross-Border Collaboration: To address the unique and persistent food security challenges in Africa, countries should engage in regional collaborations. This includes sharing best practices, pooling resources, and coordinating efforts to address issues that transcend national boundaries. Collaborative approaches can enhance the efficiency and effectiveness of interventions and policies and leveraging the African Continental Free Trade Area (AfCFTA) can further foster collaboration.

Data and Reporting Improvement: Comprehensive data collection and reporting systems are crucial for understanding the dynamics of food security in Africa. Governments and organisations should prioritise the collection of accurate and up-to-date data on food production, consumption, and distribution. These data will enable informed decision making, early warning systems, and targeted interventions in areas facing acute food insecurity. Furthermore, it will help track progress toward food security goals and hold stakeholders accountable for their commitments.

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The Health and Economic Burden of Tobacco-Induced Heart Diseases: A Cross-Country Analysis in Sub-saharan Africa

Smoking causes more than 1 in 10 cardiovascular deaths globally. Smoking is the leading preventable risk factor for cardiovascular diseases such as ischemic heart disease (IHD), which narrows heart arteries, and cerebrovascular diseases. However, awareness of links between smoking and cardiovascular disease remains low in many parts of the world, including Africa. Supporting better tobacco control policy design and execution, the Tobacco Control Data Initiative (TCDI) seeks to increase access to country-specific tobacco control data for governments, civil society, and academia. The six country-specific TCDI websites provide stakeholders with data that will inform better tobacco control policy design and implementation through comprehensive primary and secondary research.  
In this blog post, we discuss the heart-related implications of tobacco usage with emphasis on their health and economic impacts in South Africa, Zambia, Ethiopia, Kenya, the Democratic Republic of the Congo (DRC), and Nigeria.

South Africa
Health Impact: According to the Global Burden of Disease Study (2021), over 32,000 people in South Africa died from tobacco-related illnesses (TRIs), including cardiovascular disease (see Figure 1 below). Cardiovascular diseases, such as ischemic heart diseases, hypertensive diseases, and other forms of heart disease, account for 22% of the country's total TRI deaths. Additionally, tobacco use contributed to 13% of non-communicable disease (NCD) deaths in the country.

Figure 1

 

Economic Impact: In 2016, the cost of tobacco-related diseases in South Africa was estimated at 42 billion Rand (USD 2.88 billion). Of this, 28 billion Rand (USD 1.58 billion) was attributed to lost productivity, while 14 billion Rand (USD 790.07 million) went to direct healthcare expenses.

 

Zambia

Health Impact: According to a 2019 UNDP report, tobacco consumption in Zambia caused approximately 7,100 deaths annually . The top three causes of tobacco-related deaths were lower respiratory infections (1,839 deaths), ischemic heart disease (1,629 deaths), and tuberculosis (1,032 deaths). Other cardiovascular diseases contributed to 373 deaths.

 

Figure 2

Source: UNDP/Ministry of Health (Zambia). 

 

Source: UNDP/Ministry of Health (Zambia)

Economic Impact: In 2016, Zambia's health expenditure on tobacco-related illnesses amounted to ZMW 154.3 million (US$ 9 million). Out-of-pocket expenses stood at ZMW 42.5 million (US$ 2.5 million), while private insurance covered ZMW 37.6 million (US$ 2.2 million). Additionally, indirect costs, including productivity losses and premature death, were estimated at ZMW 1.4 billion (US$ 82 million).

Kenya

Health Impact: According to a TCDI study in Kenya, cardiovascular disease accounted for 9% of all deaths associated with tobacco use, while 33% of those who had myocardial infarction (heart attack) had a history of tobacco use.

Economic Impact: In 2021, tobacco-related illnesses, including myocardial infarction, led to economic losses between US$544.4 million and US$756.2 million. Myocardial infarction alone accounted for $171.43 to US$233.06 million, primarily due to healthcare costs and lost productivity.

 

Nigeria

Health Impact: The Global Burden of Disease report for 2021 attributed 29,605.1 deaths in Nigeria to tobacco-related illnesses. In the same year, smoking was associated with cardiovascular disease and ischemic heart disease deaths, resulting in approximately 4,806.55 and 2,794.32 deaths, respectively.

Economic Impact:  In Nigeria, tobacco-related CVDs cost approximately N273 million (US$ 890.1 thousand), and the National Tobacco Control Act has been implemented to reduce tobacco's impact on IHD, especially in light of rising shisha use among younger demographics.

Democratic Republic of Congo (DRC)

Health Impact: Noncommunicable diseases (NCDs) like cardiovascular disease, cancer, and diabetes are major health challenges in the DRC.  The GBD 2021 report estimated that there were 4725 deaths from tobacco-related cardiovascular diseases and 2579 deaths from ischemic heart diseases. In the DRC, the mortality rate due to smoking in 2019 was estimated at 4.05%

Economic Impact: Tobacco-related illnesses, such as cardiovascular diseases, have imposed significant economic burdens on the DRC. Between 2019 and 2021, budget allocations for the health sector reached 165.54% in 2020, yet households continue to bear a substantial portion of health costs. While tobacco taxes are collected, none are allocated to public health, violating the "polluter pays" principle and exacerbating economic strain on health systems.

 

Ethiopia

Health Impact: Tobacco use contributes to 5% of all non-communicable disease (NCD) deaths in Ethiopia, with 29% of these deaths attributed to cardiovascular diseases, as reported by the Global Burden of Disease (2021). Additionally, the estimate reveals that in 2021, tobacco was responsible for 1.14% of all deaths and accounted for 0.8% of years of life lost. According to Tobacco Atlas (2023), tobacco use is responsible for over 9,884 deaths annually in Ethiopia. 

Economic Impact: Tobacco places a heavy economic burden on Ethiopia, costing around 1.391 billion Ethiopian Birr (US$43.6 million) each year due to healthcare expenses and lost productivity (WHO, 2020). Additionally, smokers spend about 11.7% of their income on cigarettes, depriving them of resources that could otherwise help reduce poverty. 

 

 

The significant burden of non-communicable diseases, especially cardiovascular diseases, is evident across these nations, with tobacco-related deaths disproportionately affecting men. The economic costs, both direct and indirect, from healthcare expenses to lost productivity strain already fragile healthcare systems. Furthermore, environmental degradation linked to tobacco production exacerbates the long-term impacts on these emerging economies. Addressing the tobacco epidemic through stronger regulatory frameworks, public health campaigns, and sustainable alternatives is crucial to mitigating these multifaceted consequences and promoting healthier, more resilient societies.

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