Ischemic heart disease burden and healthcare system readiness across sub-Saharan Africa
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Sub-Saharan Africa is experiencing a rapid rise in ischemic heart disease, creating new challenges for regional health systems. As populations grow and urbanize, lifestyle, metabolic, nutritional and environmental factors are reshaping the burden of noncommunicable diseases. Yet health systems, historically oriented toward communicable diseases and maternal health, show variable capacity to prevent, diagnose and treat ischemic heart disease. Despite increasing recognition, systematic assessments of country-level disease burden and healthcare capacity are limited, leaving gaps for evidence-based policy. Here we address this gap by assessing healthcare system readiness across four domains: health system capacities, primary care, secondary and tertiary care, and health system context. We highlight how limitations in workforce, essential medicines, diagnostics and policy intersect with upstream drivers such as obesity, hypertension, diabetes, smoking, dietary transitions, urbanization and environmental stressors. Meeting these challenges will require coordinated investment, equitable resource allocation and integrated prevention strategies.