In this article, we will be taking a look at the 15 unhealthiest countries in Africa. You can skip our detailed analysis on the topic and directly head to the 5 Unhealthiest Countries In Africa.
Global Healthcare Market Expansion and Africa’s Emerging Growth Opportunities
The global healthcare market is extensive and expanding rapidly. In 2023, it was valued at around $7.975 trillion, an increase from $7.5 trillion in 2022. The market is projected to grow at a compound annual growth rate (CAGR) of 6.3% through 2027, reaching $9.8 trillion. This market encompasses various segments, including hospitals, digital health, and healthcare services. Specifically, the hospital sector is expected to grow at an annual rate of 4.18% from 2024 to 2029, reaching $5.19 trillion by 2029.
The African healthcare market is valued at approximately $50 billion annually. However, a significant portion of healthcare products is imported, highlighting a dependency on foreign goods. The market is poised for growth, particularly in the digital health sector, which is projected to expand by 9.33% annually from 2024 to 2029, reaching a market volume of $7.59 billion by 2029. Approximately 60% of healthcare financing in Africa comes from private sources, with about 50% of total health expenditure directed towards private providers. The African Union aims to have 60% of vaccines manufactured on the continent by 2040 which is a significant increase from the current less than 1%.
African Union countries pledged to dedicate at least 15% of their budgets to health annually, according to the Abuja Declaration. By 2021, only a few nations, such as South Africa and Cabo Verde, had achieved this goal. In 2021, multilateral development banks contributed $12.2 billion in health financing, marking a 10.5% increase from 2020. This funding comprised concessional loans, non-concessional loans, and grants.
Biggest Healthcare Companies Dominating the Global Health Market
Companies like McKesson Corporation (NYSE:MCK), Walgreens Boot Alliance. Inc. (NASDAQ:WBA), and Humana Inc., among many others, rule the global healthcare market with their exceptional contributions. For example, McKesson Corporation (NYSE:MCK) launched a pilot initiative to advance health equity in underserved communities, with Avondale, Ohio, selected as the first site to improve access to essential pharmacy services. Financially, McKesson Corporation (NYSE:MCK) reported total revenues of $77.2 billion in Q2 2024, marking a 10% increase compared to the same quarter last year. The company’s earnings per diluted share from continuing operations for the same period were $4.92, down from $6.46 a year ago. This decrease includes a pre-tax provision for bad debts of $210 million related to uncollected trade accounts receivable from the bankruptcy of Rite Aid Corporation. McKesson returned $1.7 billion to shareholders in the first half of the fiscal year, which included $1.5 billion in common stock repurchases and $149 million in dividend payments. McKesson Corporation (NYSE:MCK) raised its fiscal 2024 adjusted earnings per diluted share guidance to a range of $26.80 to $27.40, reflecting solid operating business performance. The guidance also includes a forecasted growth of 14% to 17% compared to the prior year.
Similarly, Walgreens Boot Alliance, Inc. (NASDAQ:WBA) is the largest retail pharmacy and health destination across the U.S. and Europe with a presence in over 25 countries. The company offers a wide range of health services, including dispensing medicines and providing health and beauty products. Financially, Walgreens Boot Alliance, Inc. (NASDAQ:WBA) reported a loss per share of $6.85 in Q2 2024, compared to earnings per share of $0.81 in the same quarter of the previous year. This result includes a $5.8 billion after-tax non-cash impairment charge related to VillageMD goodwill. The company’s sales increased by 6.3% year-over-year to $37.1 billion in Q2, up 5.7% on a constant currency basis and the adjusted earnings per share increased by 3.4% to $1.20, reflecting a lower adjusted effective tax rate and improved profitability in U.S. Healthcare. Walgreens Boot Alliance, Inc. (NASDAQ:WBA) narrowed its fiscal 2024 adjusted EPS guidance to a range of $3.20 to $3.35. This reflects challenges in the U.S. retail environment, the early wind-down of a sale-leaseback program, and lower earnings due to Cencora share sales, partially offset by execution in pharmacy services and a lower adjusted effective tax rate.
READ ALSO: 20 States With the Healthiest Populations and 20 Countries With the Best Healthcare in 2024.
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Our Methodology
For our list, we looked at two indexes: the GHS index of 2021 and the health pillar of Legatum Prosperity index of 2023. The 2021 Global Health Security (GHS) Index assesses 195 countries’ preparedness for epidemics and pandemics across six categories. The global average score is 38.9, indicating weak international readiness despite COVID-19 efforts. Similarly, The Health pillar of the 2023 Legatum Prosperity Index assesses health outcomes, systems, risk factors, and mortality rates, highlighting the importance of physical and mental health and access to effective healthcare services for individual and national prosperity. Hence, we averaged the scores of GHS, and the health pillar’s from Legatum index and the final rankings in our list were adjusted according to the average we obtained of these scores.
The data we’ve discussed on malnutrition comes from GlobalNutritionReport.ORG
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Here is our list of the 15 unhealthiest countries in Africa.
15. Cameroon
Insider Monkey Score: 15
Cameroon tops the list for being the unhealthiest country in Africa. Malnutrition is a persistent issue in Cameroon, with 28.9% of children under five years of age affected by stunting, and 12.0% of infants having a low birth weight. The prevalence of anemia among women of reproductive age is also high at 40.6%. Non-communicable diseases (NCDs) are on the rise, with obesity affecting 19.2% of adult women and 7.5% of adult men. In 2023, Cameroon’s health expenditure per capita was $145.95, below the global average of $1,700.
14. Democratic Republic of Congo
Insider Monkey Score: 14
DR Congo has the second highest number of malaria cases and deaths globally, with children under five accounting for 67% of malaria-related deaths. Access to clean water is also severely limited, with less than 25% of the population having access to safe water sources. Life expectancy in the DRC is relatively low, with females expected to live up to 61 years and males up to 58 years. In 2021, the Democratic Republic of the Congo’s per capita health expenditure was $25.54, with 11.5% of the budget allocated to health. This is less than one-tenth of the average in sub-Saharan Africa. In 2017, the DRC spent 1.2% of its GDP on health, below the regional average of 2.4% and its income group’s 2.1%.
13. Equatorial Guinea
Insider Monkey Score: 12.5
The country has been ranked among the unhealthiest due to factors such as high blood pressure, diabetes risk, obesity, depression, and low levels of physical activity. Equatorial Guinea’s current health expenditure is 3.8% of its GDP, according to the CIA World Factbook.
12. Nigeria
Insider Monkey Score: 11.5
Nigeria is one of the poorest countries in the world. The country faces high mortality rates from communicable diseases such as malaria, viral hepatitis, and water-borne illnesses Nigeria’s 2023 health budget of N1.17 trillion ($2.911 billion) represents 5.75% of the total budget, a 1.05% increase from 2022 and the highest share since 2001. However, it remains below the 15% target set by the Abuja Declaration.
11. Guinea Bissau
Insider Monkey Score: 11.5
Guinea Bissau stands fifth among the unhealthiest countries in Africa. The country is burdened with high rates of infectious diseases such as malaria, tuberculosis, and HIV/AIDS. In 2020, the country’s health spending was $61 which is a 0.69% increase from 2019.
10. Angola
Insider Monkey Score: 10.5
Angola stands sixth among the unhealthiest countries in Africa. Angola has one of the highest child mortality rates in the world, with more than 10% of children dying before their fifth birthday. This rate is significantly higher compared to developed countries like Finland or Japan. Access to clean water is a significant issue in Angola, with 43% of the population lacking basic water services. Many Angolans rely on unsafe water sources, which increases the risk of waterborne diseases such as diarrhea and cholera. In 2023, Angola allocated 6.7% of its budget to health, a 48% increase from 2022, totaling 1.3 trillion kwanzas. The social sector received 23% of the overall budget, estimated at 20.1 trillion kwanzas.
9. Guinea
Insider Monkey Score: 9
Guinea struggles with both undernutrition and overnutrition, a phenomenon known as the “double burden” of malnutrition. In 2023, Guinea’s health budget rose by 48% to 1.3 trillion kwanzas. UNICEF also sought $16.1 million to assist women and children in humanitarian crises, focusing on health, nutrition, and child protection.
8. Liberia
Insider Monkey Score: 8
Liberia’s healthcare system has been severely affected by a 14-year civil war, which destroyed much of the country’s infrastructure and led to a significant loss of medical professionals. The 2014-2015 Ebola outbreak further exposed the weaknesses in Liberia’s healthcare system. Liberia’s 2023 health budget was $672.94 million, with World Bank support for various health projects, including RMNCAH-N initiatives, performance-based financing, nursing and midwifery training, and the construction of a 155-bed maternal and child health hospital. A complementary sub package includes 50 interventions, costing the government $5.35 per capita, with most delivered at district and county hospitals. The total per capita cost for the entire package is $12.28.
7. Eswatini
Insider Monkey Score: 7
Eswatini has one of the highest HIV prevalence rates in the world, affecting approximately 27% of the population. The prevalence of overweight individuals is 28%, and obesity stands at 23%, particularly affecting women. In 2022/2023, Eswatini allocated SZL 2.4 billion (10% of its budget) to health, primarily funding secondary and tertiary care, including patient referrals abroad.
6. Sierra Leone
Insider Monkey Score: 6
A significant issue in Sierra Leone is the lack of access to clean water and sanitation facilities. This deficiency contributes to the spread of waterborne diseases, which are a leading cause of morbidity and mortality in the country. In 2023, Sierra Leone allocated NLe 938.7 million ($41.3 million) to health, 6% of the national budget. This is a slight increase from 2022’s NLe 896.7 million ($39.5 million) but reflects a funding gap that leaves over half the population without essential healthcare, increasing preventable diseases and mortality.
5. Somalia
Insider Monkey Score: 5
Somalia ranks as the worst country for maternal health, with high maternal and infant mortality rates. In 2023, Somalia allocated 8.5% of its budget to health but spent only 7%, an improvement from 2022 when just 1.3% was spent despite a 10.6% allocation. The CIA estimates Somalia’s total health expenditure in 2023 at $26.351 billion.
4. Lesotho
Insider Monkey Score: 4
Lesotho is severely affected by the HIV/AIDS epidemic, with one of the highest prevalence rates in the world. In addition to HIV/AIDS, Lesotho faces a rising burden of non-communicable diseases such as heart disease, cancer, asthma, and diabetes. In 2022-23, the Government of Lesotho maintained its health and education budget allocations at 13% and 11%, the same as in 2021-22.
3. Chad
Insider Monkey Score: 3
Chad is off course to meet global nutrition targets, with high rates of malnutrition affecting both children and adults. Approximately 31.1% of children under five are stunted, and 10.2% suffer from wasting, both figures being higher than the regional averages. The prevalence of anemia among women of reproductive age is also concerning, affecting 45.4% of women aged 15 to 49 years. In 2023, Chad committed to increasing health sector spending to 15%, focusing on free emergency care, and HIV services, and reducing maternal mortality. UNICEF reported a 35% funding increase from 2022, with a 100% budget utilization by year-end. UNICEF’s 2023 health budget includes $2.5 million for health, $331,700 for HIV/AIDS, and $46.9 million for nutrition.
2. South Sudan
Insider Monkey Score: 2
South Sudan is one of the unhealthiest countries in the world. The country struggles with high rates of infectious diseases such as malaria, tuberculosis, and HIV/AIDS. South Sudan allocates less than 2% of its national budget to health. In 2017, public health spending was 0.8% of GDP, below the regional average of 2.4% and its income group’s 2.1%. By 2020, health expenditure rose to 5.3% of GDP. The RTGoNU covers about 2% of South Sudan’s healthcare needs, relying heavily on donors for training, medicine, and services. The World Bank contributed a $200 million grant in 2021 to support healthcare in remote and conflict areas.
1. Central African Republic
Insider Monkey Score: 1
The population faces high risks from diseases such as malaria, tuberculosis, HIV/AIDS, sexually transmitted infections (STIs), and leprosy. Water-borne diseases like typhoid and diarrhea are prevalent due to limited access to clean water, with only 37% of the population having access to safe water. Vaccination rates are also low, with only 41% of the population vaccinated against yellow fever, far below the 80% threshold needed for herd immunity. The Central African Republic has an extremely high mortality rate, with 5.6% of the population dying annually, which is more than double the rate of any other country in the world. The birth rate is 42.6 per 1,000 per year, but high infant mortality and pregnancy loss rates suggest severe health challenges for mothers and infants.
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Disclosure. None: The 15 Unhealthiest Countries in Africa is originally published on Insider Monkey.
