Diabetes Is Rising in Africa. Could It Lead to New Breakthroughs?
NEWS | 12 May 2025
Across the African continent, the focus on disease has long been on infectious killers such as HIV and tuberculosis. But in early February, around 700 policymakers, academics, and philanthropists convened in Kigali, Rwanda, to discuss the alarming rise of noncommunicable diseases in the region. Of particular concern: spiraling rates of type 2 diabetes. Earlier this year, a new study indicated that the number of people in sub-Saharan Africa with type 2 diabetes rose from 4 million in 1980 to 23.6 million in 2021, with projections suggesting that these cases will more than double to 54.9 million by 2045, driven, as in many other parts of the world, by rapid lifestyle changes including shifting diets and declining physical activity. It’s a problem that needs urgent attention, but it could also provide an opportunity to better understand this deadly disease and even lead to more effective—and inclusive—treatments. Segun Fatumo, a genetics professor at Queen Mary University of London who is currently leading studies of type 2 diabetes in Uganda and Malawi, says many of these patients are drug naïve, meaning their disease progression has yet to be altered by medication. “This gives researchers a rare window into the natural history of the disease—how it develops, progresses, and responds to different environmental and genetic factors,” he says. “It’s like being able to study a book from the first chapter, rather than jumping in halfway through.” The remarkable genetic diversity across the African continent may also represent an opportunity for diabetes research. “Because human populations have lived in Africa the longest, they’ve had more time to accumulate genetic diversity, and this diversity is a scientific gold mine,” says Fatumo. Research in sub-Saharan African populations has already challenged some basic understandings regarding the biology of type 2 diabetes. While the disease has traditionally been linked to obesity, with a steady accumulation of visceral fat in the liver and the pancreas progressively impacting the pancreas’ ability to produce insulin and control blood sugar levels, it appears that this isn’t the driving factor in many African patients. In 2019, a major genetics study of more than 5,000 type 2 diabetes patients in Ghana, Nigeria, and Kenya pointed to a particular gene called ZRANB3 as being associated with the disease. The study indicates that some individuals carry variants of ZRANB3 which mean that they either produce fewer insulin-producing beta cells or struggle to maintain an adequate number of these cells, making them less responsive to surges in blood sugar. The gene may therefore represent a potential new drug target, says Tinashe Chikowore, a researcher at Brigham and Women’s Hospital and Harvard Medical School who is also leading studies of type 2 diabetes patients in the region. “We now need to find out just how many diabetics carry this African-specific mutation, both in sub-Saharan African populations and those of African ancestry around the world,” he says. African men also appear to be particularly at risk of the disease. Earlier this year, the Lancet Global Health medical journal published a study of more than 6,500 middle-aged adults from four sub-Saharan African countries which found that, after family history, simply being male was one of the biggest predictors of type 2 diabetes risk.
Author: Sandro Iannaccone. David Cox. Emily Mullin. Kate Knibbs. Jorge Garay. Zeyi Yang. Geraldine Castro. Natasha Bernal. Molly Taft. Fernanda González.
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