In response to the growing burden of non-communicable diseases (NCDs), health experts have called for stronger cardiac and neurological care infrastructure across Africa to meet rising demand for specialised services such as cardiology, neurosurgery, and advanced diagnostics.

A Consultant Interventional Cardiologist at Aga Khan University Hospital (AKUH), Nairobi, Dr Hasham Mohamed, said Africa is undergoing a significant epidemiological transition in which infectious diseases that once dominated mortality patterns are being overtaken by non-communicable diseases such as heart disease and cancer.

Mohamed told The Guardian that while the continent has historically recorded high mortality from infections, malnutrition, and related causes, cardiovascular diseases are now rising rapidly. He projected that by 2030, cardiac diseases could become the leading cause of death in Africa, underscoring the urgent need for investment in cardiac care systems.

He said this shift has informed increased institutional focus on non-communicable diseases at AKUH, including targeted investments in heart and cancer care services designed to meet growing demand for specialised treatment.

According to him, cardiac services at the hospital are delivered through both outpatient and inpatient systems. Outpatient care caters to patients with less severe conditions, who undergo clinical consultations and diagnostic evaluations, including echocardiography, stress testing, and prolonged heart rhythm monitoring for suspected arrhythmias.

He explained that the cardiology unit comprises full-time faculty cardiologists working alongside affiliated specialists, bringing the total number of practitioners to about ten. The hospital, he added, also trains cardiologists from across the region, including trainees from Tanzania, Rwanda, Senegal, and Ethiopia, who return home after completing their fellowships.

Inpatient care, he said, is reserved for critically ill patients admitted to the Cardiac Care Unit (CCU) or Intensive Care Unit (ICU), particularly emergency cases such as heart attacks, where timely intervention is critical to prevent complications or death.

Mohamed said AKUH has been recognised as a centre of excellence for chest pain management and holds international accreditation for meeting global standards in the treatment of heart attacks. This, he said, ensures standardised emergency care regardless of the attending clinician or a patient’s immediate ability to pay during the initial phase of treatment.

He described interventional cardiology as a major advancement in cardiac care, involving minimally invasive procedures performed using catheters inserted through blood vessels to diagnose and treat heart conditions without open surgery. These procedures are carried out in catheterisation laboratories equipped with advanced imaging technology.

Mohamed noted that interventional techniques are used to treat conditions such as coronary artery disease through angiography, angioplasty, and stenting, as well as valve-related diseases and congenital heart defects. Modern approaches, he added, now allow high-risk patients, including the elderly, to undergo procedures such as transcatheter aortic valve replacement and be discharged within a short period.

He also disclosed that the hospital has introduced advanced cardiac device therapies, including leadless pacemaker implantation, which eliminates the need for connecting wires. He described this as a significant innovation in the region’s cardiac care.

In addition, he said the facility offers electrophysiology services for diagnosing and treating arrhythmias, including catheter ablation procedures that target and eliminate abnormal electrical pathways in the heart. According to him, such interventions can cure certain rhythm disorders in many patients.

He added that similar minimally invasive catheter-based techniques are also used in other areas of medicine, including embolisation procedures for treating fibroids and certain cancers by cutting off their blood supply.

Mohamed further noted that some forms of hypertension may be reversible if underlying causes are identified and treated, while most cases require long-term management. He also highlighted newer treatment options, such as renal artery denervation, for patients with resistant hypertension who do not respond to multiple medications.

Also speaking, Consultant Neurosurgeon, Dr Beverly Cheserem, emphasised the need to scale up neurological services alongside cardiac care, given the rising incidence of neurological disorders, cancers, and other NCD-related conditions.

Cheserem explained that as awareness improves and more patients seek diagnosis and treatment, hospitals must be equipped to manage increasing volumes of complex cases. She stressed that institutions like AKUH are specialised centres for advanced care, requiring robust systems, specialised equipment, and multidisciplinary teams.

On capacity, she noted that the hospital is designed to scale services as demand for oncology and neurosurgery grows. She contrasted current patient volumes with higher-demand settings, indicating that while some regions handle significantly larger caseloads daily, AKUH is positioned to expand capacity as needed.

According to her, the hospital has also developed systems to accommodate patients from different countries through flexible payment pathways and partnerships, ensuring that financial constraints do not hinder access to specialised care.

Cheserem further emphasised the strength of the hospital’s neuroscience ecosystem, describing it as one of the most comprehensive in the region. It brings together specialists in neurosurgery, neurology, neuroradiology, neuropathology, and rehabilitation, enabling a multidisciplinary approach to complex cases.

She added that this integrated model allows the hospital to manage a wide range of conditions, including brain tumours, vascular disorders, and neuroinflammatory diseases, supported by advanced diagnostic tools such as PET imaging and multidisciplinary team (MDT) meetings that guide diagnosis and treatment planning.