Noncommunicable disease surveillance in the World Health Organization African region: Status, gaps, and priorities

Background: Noncommunicable diseases (NCDs) are the leading cause of death globally and account for over one-third of mortality in the World Health Organization (WHO) African Region. Surveillance systems are essential for tracking progress toward the global NCD targets for 2025 and Sustainable Development Goal 3.4, yet capacity across countries in the region remains uneven. Materials and Methods: We conducted a descriptive study of NCD surveillance systems in the WHO African Region. Data sources included the 2023 WHO NCD Country Capacity Survey (CCS) and the WHO internal database of STEPwise risk-factor surveys (STEPS). CCS responses were triangulated with WHO taxation datasets, International Agency for Research on Cancer registry listings, and WHO-Global Database on the Implementation of Food and Nutrition Action. Analyses were descriptive, using frequency tables, composite policy indices, choropleth maps, and heat maps. Results: Of 47 countries, 46 responded to the CCS. Eighteen countries (38.3%) were on-cycle for STEPS, 25 (53.2%) were off-cycle, and 4 (8.5%) had never conducted a survey. Standardized patient-level data systems were reported by 71.7% of countries, with cancer registries present in 80.4%, but registries for stroke and myocardial infarction were almost absent. National NCD strategies existed in 51.1% of countries, whereas 78.7% had clinical guidelines. Adoption of upstream policies was low, particularly for healthy diet (8.5%) and physical activity (10.6%). Only two countries had functional Civil Registration and Vital Statistics (CRVS) systems for cause-specific mortality. Conclusion: The WHO African Region has made progress in STEPS and cancer registries, but critical gaps remain in CRVS and upstream policy adoption. Strengthening surveillance, expanding registries, and prioritizing CRVS are essential for achieving the 2025 and 2030 NCD targets.