LocationsA case for Prevention of Non-Communicable Diseases as a development priority for Zambia
Getting Ahead of the Curve
July 31, 2026
As economies expand and incomes rise, another pattern tends to emerge alongside it – threatening progress and affecting livelihoods. On the path to middle- and high-income status, communicable diseases slowly recede, and heart disease, cancer, diabetes, chronic respiratory illness and mental health conditions move to the front. Demographers call this the epidemiological transition. In one sense it is a marker of progress — the diseases of early development giving way to the diseases for more urban, more settled lifestyles.
This new burden, however, tends to arrive before the health system or the economy is ready to carry it, and it arrives without the urgency of an outbreak to command attention.
Zambia has made concerted efforts in pursuit of middle-income status as a central development ambition, articulated in its Vision 2030. These sustained efforts aim to grow its economy and deliver on commitments under Agenda 2030, Agenda 2063, the Paris Agreement and its Nationally Determined Contributions, among others. Yet, like many countries moving toward middle-income status, it carries a double load. On one hand, Zambia is tackling the unfinished business of infectious disease and maternal and child health, and on the other, it is balancing the fast-rising tide of non-communicable diseases (NCDs).
The Scale
The World Health Organization's NCD Progress Monitor estimates that non-communicable diseases now account for roughly one in three deaths in Zambia (WHO, 2025). Cardiovascular disease, cancers, diabetes, chronic respiratory conditions, mental health disorders and injuries are already among the leading causes of premature death, disability and diminished quality of life.
What distinguishes this as a development matter and not solely a health concern, is where the cost falls. The Zambia NCD Investment Case estimates that these diseases cost the country around 6% of GDP each year — through treatments, loss of productivity, absenteeism, disability and lives cut short in people's most economically active years (Ministry of Health and WHO, 2025). This is because NCDs draw on the same resources as and thriving economy does, a healthy and productive population. Left unaddressed, NCDs can slow an economy, impeding development progress and eroding the human capital every other national ambition rests on.
It is, in effect, a tax on the whole development project — one with a high cost and no reward. Unlike many development challenges, however, this trajectory is not inevitable. The major drivers of NCDs are well understood, the most cost-effective interventions are already known, and many can be implemented through policies that extend far beyond the health sector. The opportunity is therefore not simply to treat more disease, but to prevent it before it places an even greater burden on households, public finances and economic growth.
"Non-communicable diseases are not only a health challenge. They are a development challenge."Ms Beatrice Mutali, UN Zambia Resident Coordinator.
The Investment Case
While the reward of tackling NCDs before they become a large and unavoidable burden is high, they are not the most fashionable choice in development programming. There is no single emergency to rally around or stark dramatic before-and-after, it is a gradual erosion that can chip away quietly until they suddenly become impossible to ignore.
This is a costly miscalculation. Few development investments offer returns comparable to preventing NCDs. The interventions are well established, affordable and capable of delivering substantial health and economic gains. The interventions are known and, for the most part, inexpensive. For instance, raised blood pressure — the leading driver of stroke and heart disease — is often managed with a simple daily tablet that costs very little to the individual. Cervical cancer, the most common cancer among Zambian women, is very nearly preventable through vaccination, screening and early treatment, and Zambia has already shown what is possible by building on the strengths of its HIV programme. As a result, tobacco and alcohol controls, healthier food environments and cleaner air are matters of policy as much as they are medical questions.
The Investment Case estimates that scaling up cost-effective interventions could save more than 13,000 lives over 15 years, while generating real economic returns (Ministry of Health and WHO, 2025). As the Permanent Secretary – Technical Services at the Ministry of Health, Dr Kennedy Lishimpi, put it, investing in NCD prevention and control "is not merely a health imperative, but a sound economic and developmental investment". Few development choices offer that combination of being low cost with a proven effect, and a payoff measured in both lives and livelihoods by the thousands.
The Domestic Investment Case
Crucially, the financing behind this strategy is designed to be domestically led because when a government funds a priority from its own resources, it signals ownership and is an indicator os sustainable development. Domestic financing is what makes a national commitment durable.
Domestic, however, does not mean government alone. The private sector is a central partner both as a potential source of capital and as a productive one. Joint ventures could, for example, establish regional hubs to manufacture and distribute the essential medicines that NCD control depends on including insulin and other treatments for diabetes, hypertension and related conditions, reducing reliance on imports and serving markets beyond Zambia’s borders under frameworks such as the African Continental Free Trade Area.
Where NCDs are a drag on a growing economy, preventative action is curiously not merely vaccine but rather a response that can itself generate economic activity by building domestic industry and opening regional trade, allowing Zambia to address the health burden while sidestepping the growth penalty that NCDs impose, and even accelerating development in the process.
The Government of Zambia has already begun translating this commitment into action. Following the production of the Investment Case, government ministries, civil society organisations, UN agencies, including UNDP, WHO and UNICEF, and mental health organisations gathered in July 2026 to review a draft roadmap for developing a National Multisectoral Strategy for the Prevention and Control of NCDs. The plan, set to run from 2027 to 2031, is expected to include a costed implementation plan and a sustainable financing and resource-mobilisation framework – with domestic funding embedded into this plan.
The Livelihoods
Speaking at the workshop for the Multisectoral Strategy, Ms Beatrice Mutali, the United Nations Resident Coordinator in Zambia, reminded the participants that while these efforts carry real economic benefits, the strategy's ultimate measure of success will be reflected in the lives of people. "Let me begin not with a statistic, but with a person," she said (Mutali, 2026), before telling the story of a woman in her fifties, cooking each day over a charcoal brazier, supporting her family and raising grandchildren. This woman, like a growing number of people living in urban and peri-urban communities, has dangerously high blood pressure but no idea of it, because it has never been measured. If she suffers a stroke, her household may lose more than one source of support: her own, and that of the daughter who leaves paid work to care for her.
According to the most recent national survey, three in four adults found to have raised blood pressure were receiving no treatment at all because they were never screened, so the diagnoses never came. They are also gaps through which already struggling households, rural communities and women, who face greater barriers to care, are the most likely to fall. "These are gaps within systems," Ms Mutali further noted, "and gaps within systems can be addressed".
"NCDs are no longer a health sector problem alone, but a whole-of-government and whole-of-society challenge." —Dr Kennedy Lishimpi, Permanent Secretary – Technical Services, Ministry of Health
Course Correction
Every country that has treated NCDs as tomorrow's problem has ended up paying for them late, and paying more – financially and in lives lost in rising statistics. Zambia does not have to repeat that trajectory. A preventive approach is a chance to get ahead of the curve and correct the development path now, while it is still affordable to do so.
That is the logic behind the National Multisectoral Strategy for the Prevention and Control of NCDs (2027–2031). It is a Zambian process, led by government, and deliberately multisectoral because, as Dr Lishimpi observed, NCDs are "no longer a health sector problem alone, but a whole-of-government and whole-of-society challenge". Their causes lie well beyond the clinic, in finance, education, agriculture, trade, transport, environment and beyond. No single sector can meet the challenge alone, which is why the strategy is being built to move the country, in Dr Lishimpi's words, "from fragmented effort to unified national action"
At UNDP, working together with WHO and UNICEF and through the United Nations Health for Life project, supported by the Health4Life Fund and administered by the UN Multi-Partner Trust Fund Office, the role is to support that leadership with technical expertise, convening, and solidarity. This is Zambia's strategy to own and to implement. The evidence for acting is clear, the tools are affordable, and the moment to choose prevention over a deferred and heavier bill is now.
