Africa-Press – Uganda. Abstract
Africa stands at a decisive moment in which urgent action is essential to safeguard its brain health and economic stability. While Africa’s population remains predominantly young, it is expanding and aging rapidly. This demographic shift is projected to drive a sharp rise in neurodegenerative diseases, including Alzheimer’s, with profound health and economic costs—but brain health research, policy, funding and care across the continent remain critically underdeveloped. In this Perspective, we examine key trends in aging and brain health across Africa and introduce the 6 × 5 Plan—a 5-year strategic framework developed through collective multi-stakeholder insights—to address this pressing challenge. The plan targets six high-impact priorities: strengthening advocacy and health literacy, positioning brain health as a socioeconomic driver, breaking down silos of people and data, repurposing local resources, investing in artificial intelligence and digital health, and boosting research funding. To ensure effective implementation and long-term sustainability, the plan will be executed through a pan-African, multisectoral task force. This initiative seeks to accelerate Africa’s response to the needs of a changing population and position the continent as a global leader in brain health innovation.
Main
Africa, the world’s second-largest continent, is home to 1.5 billion people—nearly 20% of the global population1,2. Spanning 54 countries across five geopolitical zones, the region is a rich mosaic of biological, social and environmental diversity. With over 2,000 distinct linguistic groups, Africa stands as the most genetically and culturally diverse region in the world3,4,5.
Although Africa remains relatively youthful compared to other regions, rapid industrialization and improvements in living standards over the past 50 years have accelerated its demographic transition. By 2050, the number of Africans aged 60 and above is projected to soar from approximately 69 million in 2017 to over 226 million—an astonishing increase of more than 200%6. This shift is expected to drive a substantial rise in age-related health conditions, with Alzheimer’s disease and related disorders (ADRD) emerging as a pressing concern. Beyond the social and human toll, the economic burden of ADRD will be immense, encompassing direct healthcare costs, productivity losses and caregiving expenses—further straining already fragile health and economic systems7,8. Yet, Africa’s preparedness remains limited, with research, policy and funding efforts still woefully underdeveloped.
In this Perspective, we examine Africa’s aging trends, related policies and economic implications. We present a multi-stakeholder, 5-year action plan that prioritizes high-impact, practical interventions in brain health across six key areas. The plan aims to fast-track Africa’s preparedness and enhance the continent’s response to its expected aging demographic and the associated economic challenges.
The health and economic burden of dementia in Africa
In the late 20th century, ADRD was primarily considered a global health issue in high-income countries (HICs). However, this perception is rapidly changing, with recent projections indicating that by 2050, 70% of dementia cases will be in low- and middle-income countries (LMICs) and Africa will contribute a considerable proportion of these. The number of ADRD cases in Africa is expected to surge to an estimated 14 million by 2050, accounting for approximately 12% of global dementia cases—a sharp increase from around 3 million in 2019 (refs. 8,9). In sub-Saharan Africa, dementia cases are projected to rise from 2.13 million in 2015 to 7.62 million by 2050, while North Africa is anticipated to experience an even more dramatic increase, reaching 10 million cases, reflecting a 367% rise in prevalence8,10,11. Beyond demographic shifts, factors such as healthcare access, diagnostic methods, genetics and environmental risks may contribute to these regional variations10,11.
Despite limited data on dementia-related mortality and morbidity in Africa, the disease already represents a considerable health burden. The Global Burden of Disease Study 2019 indicates that dementia accounts for a substantial portion of neurological disability-adjusted life years in Africa, with age-standardized rates ranging from 232 to 387 per 100,000 population, depending on the region12. Countries such as Tunisia, Algeria and Egypt have some of the highest dementia-related disease burdens globally13.
The economic impact is also substantial. In 2019, the global economic burden of dementia exceeded US$1.3 trillion, with sub-Saharan Africa possibly contributing over US$6.2 billion8. This includes direct and indirect medical costs, informal care and productivity losses14,15,16.
It is crucial to emphasize that these burdens are likely underestimated, as the true health and economic impact of ADRD in Africa remains difficult to assess due to unreliable data, resource constraints and substantial diagnostic gaps.
Brain health policies and dementia research in Africa
Between 1988 and 2024, brain health and aging-related policies, including those targeting ADRD, have undergone considerable advancements across Africa. A critical appraisal of these policy shifts and trends is included in Box 1; key policies from the past 35 years are listed and briefly described in Table 1. Despite this progress, regional implementation remains slow, with many African countries struggling to transition from frameworks to actionable programs. According to the Global Dementia Observatory (https://www.who.int/data/gho/data/themes/global-dementia-observatory-gdo)17,18, Africa ranks among the lowest in reporting and engagement, with only 12 countries submitting Global Dementia Observatory data. Among these countries, only one has a dementia-specific policy in development, 4 have integrated dementia into broader policies, 5 have conducted public awareness campaigns, 3 have initiated risk-reduction efforts, 4 have incorporated dementia into noncommunicable diseases (NCDs) or healthy aging initiatives and 4 provide training and support for caregivers. No African country has yet met the WHO (World Health Organization) recommendation to establish comprehensive national dementia strategies by 2025 (refs. 18,19,20,21,22).On a positive note, a promising trend is emerging across the continent to strengthen implementation strategies, driven by a growing commitment to pan-African collaboration and global partnerships. This momentum is primarily fueled by the African Union’s Agenda 2063, which envisions a future where Africa’s citizens are healthy and well nourished, supported by substantial investments in quality healthcare23. Notable developments include the 2023 launch of the African Union Task Force on Non-Communicable Diseases, Injuries, and Mental Health24. Furthermore, interesting and innovative multisectoral declarations have been proposed, including the 2023 Nairobi Declaration on Reducing the Burden of Dementia in LMICs25, which emphasizes the critical need for cross-sector collaboration to strengthen continent-wide efforts, and the 2024 Yaoundé Declaration on Brain Economy26, which advocates for policies that position brain health as a fundamental driver of economic development and societal well-being.
On the research front, several researcher-led initiatives are actively working to bridge the knowledge gaps on ADRD in Africa. Notable examples include the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI Dementia)27,28, the Brain Resilience Kenya Study (https://www.aku.edu/bmi/research/Pages/brk.aspx/), the African Dementia Consortium29, the Africa-FINGERS study30, the AD-DETECT Kenya Study (https://www.aku.edu/bmi/research/Pages/ad-detect-kenya.aspx/), the Strengthening Responses to Dementia in Developing Countries (STRiDE) project31 and the African Initiative for Bioinformatics Online Training in Neurodegenerative Diseases (AI-BOND)32.
However, most of these research efforts remain fragmented and relatively small in scale, with time-limited funding and/or narrow scope, and perhaps most crucially, they lack substantial multisectoral support—particularly from governments. As a result, their implementation, scalability, generalizability and overall impacts may be limited.
Accelerating Africa’s preparedness for its aging transition
Many African nations are currently undergoing a critical phase in their demographic transition, entering (or on the cusp of entering) a ‘golden window’ of economic opportunity, driven by favorable demographic shifts. Fertility rates are declining, and the ratio of working-age individuals to dependents is projected to increase from approximately 1.0–1.3 to around 1.7 over the next two decades33,34,35. This transition presents a unique opportunity for accelerated economic growth through expanded labor force participation and increased productivity.
However, this demographic dividend—that is, the potential for accelerated economic growth when the working-age population becomes proportionally larger than the non-working-age population—is neither guaranteed nor permanent. Without timely and strategic investments in policies that support healthy aging, longevity and cognitive resilience, Africa risks transitioning rapidly from a scenario where the majority of dependents are children, to a burdensome scenario where the majority of dependents are older adults. Such a shift could undermine the economic gains realized during this period of increased productivity36.To fully capitalize on this ‘golden window’, African countries must draw on lessons from nations further along the aging curve and take coordinated, proactive measures to ensure that their future aging populations remain healthy, engaged and economically productive for as long as possible.
Several valuable lessons have emerged from countries at more advanced stages of population aging, which highlight the importance of adopting preventative brain health policies across the entire life course, rather than focusing solely on later life. Key strategies identified as particularly effective include addressing social determinants of health and modifiable risk factors—such as improving maternal health, promoting early childhood education, supporting mental well-being, reducing chronic stress, fostering social connectedness, encouraging physical activity, minimizing exposure to air pollution and ensuring early detection and management of chronic diseases in midlife37,38. Additionally, investing in primary care and community-based health systems39,40,41, along with the early adoption of digital health technologies such as telemedicine42,43,44,45, could provide more affordable and sustainable alternatives to traditional, resource-intensive diagnostic methods and specialized referral services.
Nonetheless, it is important to acknowledge that Africa faces a distinct set of complex challenges that may constrain its ability to adopt strategies proven effective in other regions. These include limited infrastructure, restricted funding, shortages in the health workforce and notable cultural and linguistic diversity8. Developing effective brain health strategies for Africa requires not only adapting global lessons to local contexts, but also fostering innovative, locally driven approaches. This requires a shift in the continent’s mindset toward inclusive, life-course health policies, alongside the development of strong multisectoral partnerships that actively engage governments, academia, communities, civil society and the private sector. While much of the existing work in this area has been spearheaded by the WHO and nonprofit organizations, stronger leadership and active involvement from national governments across the continent are essential. A coordinated, continent-wide effort—supported by global partnerships —will be critical for codeveloping scalable, affordable and evidence-based solutions tailored to Africa’s unique needs.
The 6 × 5 Plan
Here, we present the 6 × 5 Plan—a collaborative, expert-informed strategic framework designed to accelerate Africa’s response to its shifting demographics. This plan reflects the collective insights of a diverse group of stakeholders who convened at the Nature conference titled ‘The Future of Dementia in Africa: Advancing Global Partnerships’ (https://natureconferences.streamgo.live/). Held in collaboration with the Davos Alzheimer’s Collaborative (DAC; https://www.davosalzheimerscollaborative.org/) and the Brain and Mind Institute at Aga Khan University, the event took place in September 2024 in Nairobi, Kenya. The conference gathered over 250 participants, including researchers, clinicians, government officials, WHO representatives and patient advocacy groups from across Africa and around the world. Over the course of 2 days, evidence was collected through various channels, including conference sessions, roundtable discussions, surveys and expert consultations to identify the priorities list of the 6 × 5 Plan.
This plan identifies six key priorities to be pursued over the next 5 years, with an emphasis on continuous progress and adaptation to evolving needs. The priorities have been carefully selected as actionable ‘low-hanging fruits’; that is, actions with the greatest potential to strengthen the continent’s preparedness for its growing aging population and address brain health needs in the short and intermediate term. Figure 1 illustrates the six priority areas and the five core principles that underpin their implementation. To ensure the plan’s sustainability and scalability, we also established a multisectoral pan-African task force to oversee its implementation across diverse contexts.The following section outlines the six priority areas, the rationale for their selection and their expected impact. A summary of the associated gaps and actionable opportunities for each priority is provided in Table 2.
Priority 1: enhancing brain health advocacy and health literacy
There is a pervasive lack of urgency in recognizing ADRD as a key public health priority across Africa. While the importance of brain health is acknowledged to some extent, conditions affecting older adults, such as Alzheimer’s disease, often become deprioritized in public health efforts.
A major barrier to addressing Alzheimer’s disease in Africa is the absence of culturally relevant terms in many African languages. This void leads to the use of stigmatizing or descriptive (and often derogatory) language, further perpetuating misconceptions about the condition46,47. In many African cultural settings, dementia is often linked to madness, witchcraft and demonic possession, or it is dismissed as a natural part of aging48,49,50. These misunderstandings fuel stigma, which negatively impacts not only patients but also their families and caregivers, potentially leading to psychosocial challenges such as isolation, social withdrawal, unemployment and marginalization.
To address these challenges, there is an urgent need for continent-wide, harmonized advocacy and health literacy campaigns aimed at reshaping public perceptions of dementias as a biological issue that requires immediate attention. We recommend the development of a shared vocabulary, incorporating culturally appropriate and non-stigmatizing terms for dementia and related conditions in various African languages, to foster open discussions and greater public understanding. In addition, innovative advocacy strategies, for example, leveraging storytelling techniques through social media, narrative-driven short films and digital tools, could help to make brain health education more accessible and relatable across linguistic and geographic boundaries. Fostering community collaboration—by partnering with local grassroots organizations, community and religious leaders, and local media outlets—should be prioritized to ensure campaigns are culturally relevant and effectively reach diverse audiences.
To maximize impact, these brain health literacy and advocacy efforts should be integrated into existing campaigns for NCDs such as HIV, mental health, cardiovascular diseases, diabetes and stroke. This integrated approach can enhance community engagement, optimize resource use and amplify outreach while addressing overlapping risk factors for ADRD.
Priority 2: positioning brain health as a driver of socioeconomic transformation
Africa’s brain health agenda must move beyond a traditional, disease-centric model and adopt a holistic, systems-based approach that integrates the sustainable development goals (SDGs) into a broader framework. This approach must address both individual and societal determinants of brain health, recognizing the complex interplay between personal risk factors and broader social, economic and environmental influences. Positioning brain health as a cornerstone of Africa’s societal well-being, economic growth and sustainable development is imperative. Achieving this transformation requires equitable, inclusive and long-term socio-ecological public health strategies that highlight the socioeconomic benefits of investing in brain health for future generations.
Two emerging, interconnected concepts—brain resilience and brain capital—embody this vision, advocating for a strategic shift that links brain health to systemic challenges such as poverty, health inequities and workforce productivity. Brain resilience refers to the brain’s ability to adapt, recover and maintain function despite aging, injury or stress51,52. At a systemic level, it extends to strengthening health, education and economic infrastructures, ensuring they can absorb, adapt and evolve in response to external pressures53,54. Brain capital55 positions brain health as a critical economic and societal asset, emphasizing the importance of investing in cognitive function, creativity and mental resilience to drive innovation, workforce productivity and long-term economic stability.
Africa is naturally positioned to benefit from these concepts due to its rich cultural and communal traditions. The continent has a deeply rooted heritage of social connectedness, collective identity and intergenerational support—factors shown to promote cognitive well-being and mitigate cognitive decline. For example, the Zulu concept of ukuphumelela (‘becoming victorious’) underscores mutual support, social cohesion and shared responsibility56, while the Ubuntu philosophy—‘I am because we are’—emphasizes relational connectedness and communal well-being57. These cultural principles have been associated with lower rates of social isolation, enhanced cognitive resilience and even instances of ‘super-aging’ in some African communities58,59,60,61. By integrating these values into brain health strategies, Africa has the opportunity to pioneer holistic, community-centered solutions that could serve as global models—particularly for regions facing social and economic challenges.
To effectively adapt a brain resilience model, Africa requires stronger support for lifespan-based brain health interventions that address the intersectional factors shaping cognitive well-being. These include an emphasis on the first 1,000 days of life (a critical phase for brain development), childhood education to build foundational cognitive skills, lifelong learning opportunities to enhance creativity and adaptability, and women’s health initiatives to address gender disparities in brain health. In addition, strengthening mental healthcare systems is essential to support emotional resilience, while healthy aging strategies should incorporate physical activity, nutrition and social engagement to promote cognitive well-being and healthy longevity.
This vision is increasingly embraced by cutting-edge pioneering initiatives such as the Wellcome Leap program (https://wellcomeleap.org/), which provides a strong model for a lifespan approach to health and development in research, emphasizing the significance of key life stages exemplified by programs such as the 1kD program (https://wellcomeleap.org/1kd/; which focuses on early childhood development), the Dynamic Resilience program (https://wellcomeleap.org/dr/; which advances causal measures and models of health resilience) and the CARE program (https://wellcomeleap.org/care/; which aims to innovate in women’s health by reducing Alzheimer’s risk through neuroendocrine risk reduction and interventions).
Additionally, the current understanding of dementia risk factors must be updated and adapted to reflect Africa’s unique context. Besides the 14 modifiable risk factors identified by the Lancet Commission on Dementia38, Africa must evaluate and address additional region-specific risks, such as poverty and economic insecurity, infectious diseases and their neurological impacts, climate change and environmental stressors, and forced migration and displacement.
Most importantly, integrating brain health into economic and employment policies is essential. Brain health is not just a healthcare issue—it is a fundamental economic driver. Poor brain health leads to reduced workforce output, increased healthcare costs and heightened social and economic burdens. Strategic investments in brain health can transform these challenges into opportunities for innovation and economic growth62. African governments and policymakers must recognize brain health as a critical economic priority, embedding it into economic policies, workforce development strategies and social protection frameworks.
Priority 3: repurposing existing resources across the continent
Repurposing offers a cost-effective, high-impact approach to expanding health systems and strengthening public health programs without requiring substantial new financial investments. By optimizing existing resources, Africa can develop self-sustaining, pan-continental brain health strategies. The effectiveness of this approach was demonstrated during the COVID-19 pandemic, highlighting its potential to drive innovation and resilience63. To achieve this, the continent needs a comprehensive Pan-African Resource Repurposing Strategy for Brain Health—one that identifies underutilized resources and fosters sustainable, affordable and locally driven solutions.
A major opportunity lies in leveraging Africa’s expertise in infectious disease management. The continent’s extensive experience in handling large-scale health challenges such as HIV/AIDS, COVID-19 and childhood immunization programs provides valuable insights. The infrastructure, surveillance systems and community engagement strategies developed for these initiatives can be adapted to brain health efforts, particularly for early detection, intervention and dementia prevention.
Strengthening the healthcare workforce is another critical priority that can benefit from repurposing. Africa faces a shortage of specialists such as geriatricians and neurologists64,65. However, instead of replicating the reliance of HICs on highly specialized professionals, the continent can adopt innovative workforce solutions. Primary care providers and community health workers, who serve as trusted first points of contact within communities, can be equipped with culturally sensitive screening tools and trained to identify dementia symptoms and provide basic care66,67. In addition, faith healers and traditional practitioners, who have an important role in many African societies, can be integrated into dementia care efforts, bridging cultural gaps and extending services to underserved populations.
To improve dementia awareness and overcome stigma, it will be essential to harness existing social and community networks. Village older people, religious leaders and women’s groups hold strong influence in many communities, making them valuable partners in raising awareness and promoting early interventions68,69. Repurposing community spaces such as schools and youth programs into hubs for intergenerational engagement can provide older adults with cognitive stimulation, while reducing social isolation.
Integrating dementia care into primary healthcare systems presents another effective strategy. Existing primary healthcare facilities can serve as hubs for cognitive screening, education and management. Embedding dementia care within NCD services, such as hypertension and diabetes management, will improve efficiency, expand outreach and enhance early intervention.
Education and training programs must also be prioritized as low-hanging fruit for repurposing efforts. Incorporating dementia care modules into the curricula of healthcare workers, teachers and social service providers will help build a well-equipped workforce. Upskilling healthcare professionals through targeted training programs such as ones focusing on imaging or cognitive scales can enhance their capacity to diagnose, manage and support individuals affected by dementia70,71.
The use of innovative solutions and cross-border collaboration—particularly in diagnostic and treatment infrastructure—can optimize resources and minimize wastage. For instance, establishing a network of accredited diagnostic laboratories and remote centers of excellence that transcend regional and national boundaries would enhance access to advanced diagnostics, foster regional cooperation and enable more efficient use of limited expertise.
This approach is particularly crucial in the context of medical imaging—especially magnetic resonance imaging facilities—which are essential for accurate dementia diagnosis but remain scarce and underutilized across much of the continent. Several complementary approaches could be considered to help improve access to imaging services, including deploying portable magnetic resonance imaging scanners, implementing modified scanning protocols tailored to low-resource settings and integrating artificial intelligence (AI) to assist with image interpretation. Furthermore, teleradiology can facilitate remote expert consultations, bridging geographical gaps and strengthening diagnostic capacity72,73.
Africa’s rich biodiversity and traditional medicinal knowledge present another untapped opportunity for brain health solutions74,75,76,77,78. When supported by evidence, investing in plant-based innovations and integrating traditional medicine with modern scientific research could unlock new treatments for patients with cognitive disorders. Strengthening research and development in this area would potentially improve not only healthcare outcomes but also economic growth.
Despite the potential of these approaches, it is important to emphasize that repurposing efforts (including task shifting), within the context of the healthcare workforce and care systems, should not be seen as a substitute for investment in standardized training and healthcare. Instead, it should be viewed as a complementary approach that could enhance outcomes and optimize value for money.
Priority 4: breaking down silos of people and data across Africa
A well-integrated research and data ecosystem is essential for identifying high-risk populations and implementing targeted dementia prevention and early intervention strategies. But Africa’s research and information ecosystems remain fragmented, with scarce and underutilized data due to weak data-sharing platforms, limited connectivity between research hubs, and a lack of standardized mechanisms for harmonization and reporting. This fragmentation leads to redundant data collection, inefficient resource allocation and diminished research impact. As a result, funders, policymakers and evaluators struggle to make evidence-based decisions, further hindering progress.
Many research projects suffer from short-termism, driven by narrowly focused goals and time-limited grant funding. Once these projects conclude, inadequate reporting and data-sharing practices often lead to the duplication of studies across different regions, wasting valuable time and resources while delaying critical policy advancements. Addressing these challenges requires a coordinated effort to strengthen data harmonization and sharing mechanisms.
This critical gap has long been recognized in Africa, and while some emerging African projects are working to address it, they remain small in scale. For example, the Health and Retirement Studies (HRS)79,80—including the HAALSI study in South Africa27,28, the Longitudinal Study of Egyptian Healthy Aging (AL-SEHA)81, the Longitudinal Study of Health and Aging in Kenya (LOSHAK)82 and the Cognitive Aging in Ghana study83 —aim to establish robust, harmonized and comparative datasets. Through data sharing and collective, informed decision-making, these studies are helping to break down silos—an essential step in advancing brain health research and policy in Africa.
To scale up these efforts and accelerate progress, Africa must prioritize dismantling institutional barriers and fostering collaboration across disciplines, sectors and regions. Establishing a Pan-African network of research centers can drive a harmonized, transdisciplinary approach to data generation and utilization. Strengthening cross-sector collaboration—through partnerships between health systems, governments, researchers and nongovernmental organizations—will be key to creating a more integrated research and policy landscape. Additionally, fostering global partnerships and strengthening collaborations with international research institutions will accelerate discovery and the implementation of evidence-based solutions.
Developing interconnected databases that consolidate health records, socioeconomic data, environmental risk factors and insights from emerging technologies—such as imaging, biomarkers and omics data—will enhance data accessibility and integration. Incorporating social determinants of health, including education, poverty and housing, alongside these clinical data will provide a more comprehensive understanding of dementia risk factors and outcomes. Digital health tools and cloud-based solutions can further bridge gaps in data sharing, ensuring researchers and policymakers have real-time access to vital information.
Most importantly, data-sharing platforms and research initiatives should receive formal endorsement from pan-African organizations, such as the African Union and regional health bodies. In addition, considerable investment should be directed toward establishing robust governance, ethical and training frameworks to regulate data sharing and protection. Unified data will empower policymakers to develop evidence-based brain health initiatives tailored to Africa’s diverse contexts. Furthermore, such a system will support large-scale research efforts, driving innovation in dementia care and policy development. Notably, Africa’s success in coordinating people and data to combat infectious diseases, as well as its unified response to COVID-19, has demonstrated the continent’s ability to break down silos. This collaborative approach should be adapted to advance a brain health agenda.
Priority 5: innovating tech-enabled community brain health systems
Africa’s mobile computing revolution has leapfrogged traditional landline infrastructure, creating a generation of ‘digital natives’ adept at using mobile technology for information exchange42,43,44,45. This digital shift, which spans across age groups, presents a transformative opportunity for Africa to leverage technology in addressing brain health challenges across the continent.
Digital health solutions offer accessible, scalable and cost-effective alternatives to traditional healthcare approaches84. The emergence of digital biomarkers is particularly promising, enabling earlier and more accurate detection, monitoring and treatment of brain disorders85. Digital phenotyping—using data from speech patterns, actigraphy and smartphone typing behaviors—allows for passive and remote monitoring of cognitive changes, facilitating timely intervention for neurodegenerative conditions and improving long-term outcomes86,87,88.
Beyond diagnostics, digital technologies can play a critical role in identifying and mitigating modifiable risk factors associated with cognitive decline. Tools that track sleep patterns, physical activity, social engagement and mental health indicators (such as depression), can provide real-time insights into brain health. By integrating behavioral nudges and personalized interventions, these technologies can promote healthier lifestyles, strengthen cognitive resilience and reduce dementia risks on a broad scale87.
However, realizing the full potential of these digital health innovations in Africa requires addressing key challenges. Without strategic planning, digital and mobile health tools risk deepening existing inequalities, exacerbating the so-called ‘digital divide’. Barriers such as limited internet access, low digital literacy among certain groups and geographic disparities in infrastructure could hinder equitable access to these innovations.
To prevent such disparities, digital health solutions must prioritize inclusivity and accessibility. For instance, interoperable platforms should be developed to function across widely available mobile operating systems rather than being restricted to expensive, proprietary ecosystems. Moreover, cognitive assessment tools must be adapted to reflect Africa’s linguistic and cultural diversity, ensuring that technological solutions are locally relevant and meaningful.
A major challenge in digital health equity lies in the development of AI-driven predictive algorithms, which are often trained on data from high-income populations with better access to healthcare and digital resources. Without representative datasets, these algorithms risk bias, reducing their effectiveness for African populations. This is especially critical for AI models assessing cognition, memory and behavior, as these are profoundly shaped by cultural, lifestyle, literacy and socioeconomic factors.
To address these gaps, there is a need for a pan-African strategy for AI and machine learning solutions in brain health. This strategy would play a central role in ensuring that digital health technologies and AI-driven tools for brain health are fair, valid and accessible across diverse African populations. It would develop technical guidelines, validate and customize algorithms, and work with governments to establish a harmonized regulatory framework. By encouraging innovation while maintaining rigorous quality standards, the strategy would help ensure that evidence-based, high-quality digital brain health solutions are widely available without unnecessary delays or barriers.
Priority 6: strengthening funding for the African Brain Health Agenda
In recent years, several African countries have taken steps toward implementing universal health coverage that incorporates aspects of brain health, although progress remains uneven89. Despite some advances, overall resource allocations for health systems are insufficient, and funding specifically dedicated to brain health research and policy development is nearly nonexistent. Scaling up sustainable, dedicated financing is essential to advancing an effective and inclusive brain health agenda across the continent.
To attract investment from both public and private sectors, brain health leaders must present a compelling economic and social case. Framing brain health in isolation is unlikely to gain broad traction, especially given the enduring perception of Africa as primarily burdened by infectious diseases—a view that, while partly rooted in history, overlooks the continent’s evolving health landscape. As outlined in the above priority areas, a more strategic approach is to integrate brain health into existing healthcare priorities such as maternal and child health, NCDs and social determinants of health. These areas are deeply interconnected, and emphasizing their links to brain health can strengthen advocacy, unlock cross-sector collaboration and position brain health as a core component of resilient health systems.
This integrative framing will resonate strongly with global funders—such as the Gates Foundation (https://www.gatesfoundation.org/), the US National Institutes of Health (NIH; https://www.nih.gov/), the Wellcome Trust (https://wellcome.org/) and others—who increasingly prioritize intersectional, systems-based approaches in their funding strategies. Private philanthropic family foundations, traditionally focused on HICs, are also expanding their reach into the Global South. This shift creates new opportunities for Africa to secure funding and strengthen brain health initiatives. Notably, several African family offices—such as Heirs Holdings (https://www.heirsholdings.com/) and the Sawiris Foundation (https://sawirisfoundation.org/)—are beginning to explore and deploy resources toward local social and health programs. Leveraging these emerging funding opportunities can play a crucial role in advancing sustainable brain health efforts across the continent.
Beyond international support, securing long-term sustainability requires a fundamental shift toward domestic investment. While external and philanthropic funding provide critical short-term and medium-term support, long-term resilience depends on African governments and private sector engagement within the continent. Establishing national and regional funding mechanisms dedicated to brain health will be key to promoting financial independence and self-reliance.
Capitalizing on existing public–private partnerships across many African countries offers a valuable opportunity to strengthen and strategically repurpose these collaborations toward brain health and broader health system innovation. Simultaneously, tapping into venture capital resources in Africa—such as LeapFrog Investments (https://leapfroginvest.com/), HealthCap Africa (https://healthcap.co/) and Vital Capital (https://vital-capital.com/)—can open new pathways for health tech innovation through start-ups and scale-ups. Unlike traditional donor funding or development loans from institutions like the African Development Bank (https://www.afdb.org/en/) or International Monetary Fund (https://www.imf.org/en/Home/), this approach offers potential for more organic, market-driven and sustainable growth.
Health tech entrepreneurship can unlock employment and self-actualization opportunities for millions of educated but underemployed young Africans. Expanding the continent’s health-related manufacturing base—particularly for medical equipment and digital health technologies—can reduce costs, create jobs and enhance mental well-being, self-worth and overall productivity. Additionally, growing the brain health sector—through professional training, innovative technologies and pharmaceutical advances—can further stimulate economic growth.
This growth model echoes elements of China’s post-1978 economic reforms90, which leveraged manufacturing, innovation and foreign investment. Although Africa’s governance structures differ and globalization faces new challenges, the principle of combining public policy, private capital and localized innovation remains highly relevant.
Supporting older adults to live longer, healthier lives represent a major economic opportunity; a thriving aging population drives demand for new markets, services and industries, increasing economic output and contributing to GDP growth. These benefits will encourage funders and doners to recognize brain health as not only a public health imperative but also a strategic investment in Africa’s future economic development. To sustain momentum, establishing robust auditing and monitoring systems is crucial for measuring the economic and social returns of brain health investments, attracting further funding, and ensuring effective use of resources. Most importantly, none of these goals can be fully achieved without addressing corruption—a complex and persistent challenge that requires ongoing commitment and vigilance.
Next steps
To effectively implement the priority areas outlined in the 6 × 5 Plan, we launched a pan-African task force on brain health in March 2025. This task force is coordinated and supported by the DAC (https://www.davosalzheimerscollaborative.org/)—a nonprofit initiative committed to finding a cure for ADRD. DAC aims to mirror the success of global efforts against infectious diseases such as HIV/AIDS, COVID-19 and malaria.
The task force adopts a multi-level, multisectoral structure (Fig. 2), bringing together diverse expertise across various sectors. Members include researchers, clinicians, government officials, policymakers, grassroots organizers, community leaders, nongovernmental organizations and other critical stakeholders from across Africa’s five geopolitical zones. This inclusive structure ensures contextually relevant, regionally balanced contributions to addressing brain health challenges.The six working groups of the task force are now fully operational, each one tasked with implementing one of the six priorities and assigned designated leaders. At the outset, we defined key strategic success metrics to guide and evaluate the task force’s progress over the next 5 years, ensuring measurable progress and accountability. The task force will convene regular meetings (beginning with a special event at the G20 Summit 2025) providing opportunities to assess progress, align on next steps and strengthen regional and international cooperation.
Conclusion
The 6 × 5 Plan calls for a paradigm shift in how ADRD and broader brain health challenges are understood and addressed across Africa. The plan offers a clear, actionable roadmap to drive this transformation—aimed at improving health, social and economic outcomes for all Africans.
We believe this initiative will serve as a powerful catalyst for accelerating the continent’s preparedness for the next phase of its demographic transition. With its unique strengths, growing innovation ecosystems and community resilience, Africa is well positioned to leapfrog conventional approaches used in other regions, setting a new global standard for inclusive, sustainable brain health strategies.
It is important to note that our plan is intended to complement—not replace—existing national and regional policies. While we have prioritized the most impactful and achievable strategies for the immediate term, we are committed to ongoing evaluation and refinement of our priorities to ensure they remain responsive, relevant and effective in the years ahead.
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