Non-communicable diseases (NCDs) have officially overtaken infectious diseases as the leading cause of death in Rwanda, marking a significant shift in the country’s disease burden and raising concerns about the impact on public health, the economy, and national development.
According to the Rwanda Vital Statistics Report 2022 prepared by the National Institute of Statistics of Rwanda, non-communicable diseases (NCDs) were the leading causes of institutional deaths among females aged 15 years and above. Among males, NCD-related deaths were most prevalent in adults aged 45 years and older, as well as boys aged 10 to 14 years.
These findings underscore the growing burden of non-communicable diseases in Rwanda and highlight the need for targeted prevention, early diagnosis, and treatment interventions across vulnerable age groups.
Speaking on the growing burden of NCDs, Alphonse Mbarashimana, Executive Director of the Rwanda Non-Communicable Diseases Alliance, disclosed that 47.7 percent of deaths recorded in health facilities are now caused by non-communicable diseases, compared to 42.9 percent attributed to infectious diseases.
The situation is even more alarming in communities, where 59.2 percent of all deaths are linked to non-communicable diseases, while infectious diseases account for just 28 percent. The remaining deaths are caused by injuries, road traffic accidents and other conditions.
“Non-communicable diseases have overtaken infectious diseases as the leading cause of death in Rwanda. This is no longer a future concern. It is happening now,” he said.
According to Mbarashimana, the impact of NCDs extends far beyond the health sector.
Unlike many infectious diseases that disproportionately affect children and the elderly, non-communicable diseases are claiming the lives of people in their most productive years.
“Most people dying from non-communicable diseases are between 18 and 69 years old. These are people who have gone through education, are raising families, building careers and contributing to the country’s development. Losing them means losing skills, expertise and productivity,” he explained.
He said this makes NCDs not only a health crisis but also a development challenge.
“When you lose someone in their forties or fifties, you are also losing years of experience and economic contribution. That has a direct impact on families, communities and national development.”
Mbarashimana further warned that the financial burden associated with treating chronic illnesses is pushing many households closer to poverty. Unlike infectious diseases, which are often cured after a short course of treatment, most non-communicable diseases require lifelong care.
“If someone develops diabetes, hypertension or another chronic disease, they require continuous treatment for the rest of their lives. The cost of medication, hospital visits and long-term care can become overwhelming for many families.”
He also highlighted disability as another often overlooked consequence of NCDs.
The four major non-communicable diseases in Rwanda- cardiovascular diseases, diabetes, cancer and chronic respiratory diseases can all lead to permanent disability if not detected and managed early.
People living with diabetes face an increased risk of amputations, while uncontrolled hypertension can lead to stroke and paralysis. Chronic respiratory diseases can significantly reduce physical capacity, while cancer can leave survivors with long-term complications depending on the type and stage of the disease.
“These diseases don’t only kill people. Many survivors live with lifelong disabilities that affect their ability to work and support their families,” he said.
Among Rwanda’s major non-communicable diseases, cancer is becoming an increasingly significant public health concern.
According to Samuel Haragirimana, Programmes Lead at the Rwanda Non-Communicable Diseases Alliance, cancer is one of the country’s four leading non-communicable diseases and contributes significantly to NCD-related deaths.
Many patients, he noted, are diagnosed late and spend their final days receiving palliative care at home.
“Many cancer patients are discharged for palliative care, which means a significant number of cancer-related deaths occur in communities.”
Haragirimana said the increasing number of reported cancer cases should not necessarily be interpreted as an explosion of the disease.
Instead, he attributes much of the rise to improved screening, diagnosis and public awareness.
“Previously, Rwanda did not have a well-structured programme for early cancer detection. It wasn’t that cancer did not exist; many cases simply went undiagnosed.”
In 2022, the Rwanda NCD Alliance partnered with the Rwanda Biomedical Centre (RBC) to launch a nationwide early cancer detection programme.
Community health workers were trained to recognise warning signs and symptoms, while residents were mobilised to seek screening at nearby health centres.
Patients with suspected cancer were referred to district hospitals, where specialist doctors were deployed to provide diagnosis and treatment closer to communities.
Health experts say that while Rwanda has made significant progress in strengthening its response to non-communicable diseases, preventing illness remains the most effective strategy.
The Rwanda NCD Alliance is calling for increased investment in prevention programmes, healthy lifestyles, routine screening and early diagnosis to reduce the growing burden of chronic diseases.
