Abstract:
Delivery of kidney care in Africa is significantly constrained by various factors. In this review, we used International
Society of Nephrology–Global Kidney Health Atlas (ISN–GKHA) data for Africa to address sub-regional differences in
care delivery in the continent with focus on infrastructure, workforce, and the economic aspects of kidney care. Forty two African countries participated in the survey conducted in 2018. North Africa had the highest proportions of
nephrologists [12.53 per million population (pmp)], nephrology trainees (2.19 pmp) and haemodialysis (HD) centres
(8.58 pmp); whereas southern Africa had the highest proportions of peritoneal dialysis (PD) centres (0.89 pmp) and
kidney transplant (KT) centres (0.29 pmp); West Africa had the greatest nephrology workforce shortages. The annual
median costs of HD (US$22,731 [interquartile range (IQR): US$1,560–43,902]) and PD (US$34,165 [US$34,165–
34,165]) were highest in Central Africa and only Algeria, Egypt and South Africa reported zero co-payment for all
modalities of kidney replacement therapy in the public sector. Policies on chronic kidney disease and non-communicable
diseases were scarcely available across all African sub-regions. The ISN–GKHA African data highlight a stark difference
in kidney care measures between North and sub-Saharan Africa and also suggest the need for a more cohesive
approach to policy formulations that support and protect patients with kidney disease in the continent, especially from
the excessive costs associated with care. Using the World Health Organization (WHO) Global Action Plan for non communicable diseases, this paper proposes an African roadmap for optimal kidney care.
Keywords: chronic kidney disease; kidney failure; dialysis; transplantation; cost; polic
