Millions of teenagers in Africa are suffering from asthma without formal diagnoses, a concerning trend linked to rapid urbanization, according to researchers. A recent study published in the Lancet Child and Adolescent Health reveals that among 27,000 students from urban regions in Malawi, South Africa, Zimbabwe, Uganda, Ghana, and Nigeria, over 3,000 reported asthma symptoms, yet only about 600 received a formal diagnosis.

Many of these young individuals are missing school or experiencing disrupted sleep due to wheezing. “If our data can be generalized, there are millions of adolescents with undiagnosed asthma symptoms in sub-Saharan Africa,” said Dr. Gioia Mosler, research manager from Queen Mary University of London.

The human toll of non-communicable diseases (NCDs) is staggering and on the rise, with around 41 million of the 56 million global deaths each year resulting from these illnesses—three-quarters occurring in the developing world. NCDs are caused by a mix of genetic, environmental, and behavioral factors rather than infectious agents. They encompass major health issues such as cancers, chronic respiratory diseases, diabetes, and cardiovascular conditions. Alarmingly, about 80% of these diseases are preventable, yet they continue to surge worldwide as urbanization and older populations contribute to health crises.

Traditionally viewed as diseases impacting wealthier populations, NCDs are now significantly affecting poorer communities. Inequality is exacerbated as those in lower socioeconomic situations are less likely to receive accurate diagnoses or treatment. Investment in combating these prevalent and chronic conditions—responsible for approximately 71% of global deaths—remains woefully insufficient, despite their heavy toll on families, economies, and communities.

In low-income countries, NCDs are starved of funding, with resources heavily directed toward communicable diseases. Consequently, the death rate from cancer has outpaced that of malaria, tuberculosis, and HIV/AIDS combined.

Dr. Rebecca Nantanda from Makerere University in Kampala, who led the research in Uganda, emphasized the urgent need for medicines and diagnostic tests in the region. Screening showed that while 12% of participants reported asthma symptoms, only 20% of those had received a formal diagnosis. Lung function tests indicated that nearly half of the undiagnosed participants with severe symptoms were “very likely” to have asthma. Alarmingly, about a third of those with a formal diagnosis were not using any medication to manage their condition.

“Undiagnosed and poorly controlled asthma significantly impacts the physical and psychosocial wellbeing of affected children and their caregivers,” Dr. Nantanda noted. She called for immediate attention to the burden of severe undiagnosed asthma and highlighted the need for increased access to medicines and diagnostics.

Prof. Jonathan Grigg from Queen Mary University stressed that asthma is aggravated by pollution, with the implications of climate change still unfolding. “In some areas of sub-Saharan Africa, climate change may increase exposure to dust and natural fires, while mitigation efforts could reduce exposure to pollutants from fossil fuels,” he stated.

He also pointed out that the pharmaceutical industry has been hesitant to invest in asthma research and initiatives in low-resource countries, often feeling that they cannot support research in markets where they don’t plan to sell their products. Innovations such as handheld wheeze detectors and in-school asthma clinics could significantly alleviate the asthma burden in these vulnerable communities.