Fabian Ndenzako, WHO representative to Botswana and the Southern African Development Community, made the remarks at the Fifth African Ministers of Health Session on Palliative Care, held as part of the eighth International African Palliative Care and Allied Services Conference from Tuesday to Friday in Gaborone, the capital of Botswana.
Ndenzako emphasized that Africa continues to bear the highest burden of life-threatening diseases while facing significant legal and logistical barriers to accessing essential pain-relief medications.
He commended the progress made by many governments in the region. “Many governments have included palliative care in their universal health coverage documents, strategies, and guidelines,” he said, also noting advances in training health professionals and supporting community and home-based care models.
Lawrence Ookeditse, Botswana’s acting minister of health, acknowledged the country’s strides, such as the launching of its National Hospice and Palliative Care Policy. However, he cited ongoing challenges, including political prioritization, financing, coverage, and commodity availability.
Ookeditse reiterated the government’s commitment to bolstering both community home-based care and palliative care. “Together we will advocate for stronger support, a higher level of investment, and better policies that prioritize the needs of our most vulnerable populations,” he said.
Rwanda’s Health Minister, Dr Sabin Nsanzimana, who coauthored the report, announced its release in a post on X.
“One year later, our @NEJM study (out today) reports how science-guided detection and rapid action stopped Rwanda’s first Marburg outbreak in weeks, achieving the lowest recorded fatality,” he wrote on September 11.
The outbreak, declared on September 27, 2024, began in two major hospitals in Kigali after a cluster of viral hemorrhagic fever cases was identified. Within a week, more than 20 health care workers had been infected.
A total of 6,340 suspected cases were tested, of which 66 were laboratory-confirmed, including 51 health workers. The outbreak’s case fatality rate was 23%, significantly lower than previous MVD outbreaks in Africa, which have ranged from 83% to 90%.
Epidemiological investigations traced the index patient to a 27-year-old miner exposed to Egyptian fruit bats, indicating a zoonotic origin. Subsequent transmission occurred primarily among health care workers and family members. Rigorous contact tracing, surveillance, and hospital protocols helped limit the spread.
Clinical management combined advanced supportive care with investigational therapies. Fifty-two patients received remdesivir, with only three fatalities, while ten patients received the monoclonal antibody MBP091. No immediate adverse effects from either treatment were reported.
Rwanda also deployed the ChAd3-MARV vaccine within 13 days of the outbreak declaration, prioritising frontline health workers and high-risk contacts. By the end of October, 1,710 individuals had been vaccinated under emergency use authorisation and a concurrent phase 2 clinical trial.
The study emphasises the role of early detection, aggressive clinical care, investigational treatments, and emergency vaccination in reducing mortality. It also highlights the importance of infection prevention in health care settings, particularly given that 77% of cases occurred through nosocomial transmission.
The authors note that Rwanda’s experience provides a model for responding to filovirus outbreaks in urban settings, showing that rapid, coordinated, science-driven interventions can save lives and prevent widespread transmission.
Rwanda, with its partners, including the World Health Organisation (WHO), declared the end of the Marburg Virus Disease (MVD) outbreak on December 20, 2024. The declaration followed 42 consecutive days without new cases.
A total of 1,631 suspected cases have been recorded.
The statement said the data was reported during a meeting chaired by Public Health Minister Abdelmadjid Abderahim to discuss strategies to prevent the disease from spreading.
Chad has received 1,120,295 doses of cholera vaccine, the statement said, adding that the vaccines are being deployed to the eastern area for a vaccination campaign.
The government has urged Chadians to strictly follow hygiene measures to help curb the spread of infections.
The first cholera case was detected in the Dougui refugee camp in the eastern Ouaddai region on July 13. The camp hosts approximately 20,000 Sudanese refugees.
The Africa Centers for Disease Control and Prevention warned in early September that cholera remains the major public health concern in Africa in terms of the number of cases and fatalities.
Some 23 cholera-affected African countries have reported a total of 239,754 cases and over 5,274 related deaths since the beginning of this year, data showed.
The Cabinet approved 18 hectares for the campus on July 30, 2025, during a cabinet meeting chaired by President Paul Kagame.
In an exclusive interview with IGIHE, Dr. Edgar Kalimba, Deputy CEO in Charge of Medical Services at King Faisal Hospital Rwanda (KFHR), detailed that the institution aims to transform healthcare not only in Rwanda but across Africa by training skilled professionals and reducing the need for patients to seek specialised care abroad.
“The land provided by the government will allow us to develop a comprehensive campus with all the facilities necessary for workforce training, research, and medical education,” Dr. Kalimba said.
Launched in September 2024 by KFHR in partnership with the Ministry of Health, AHSU is a key component of Rwanda’s “4×4 reform” to quadruple its healthcare workforce, with a vision to serve the broader African region.
The university currently runs residency programs in six specialities—paediatrics and child health, obstetrics and gynaecology, general surgery, anesthesiology and critical care, emergency medicine and critical care, and internal medicine—alongside a school of midwifery, offering a Bachelor of Science with Honours in Midwifery.
The first cohort, which began training in September 2024, is expected to graduate in 2028, producing roughly 60 specialists and 40 midwives.
The Rusororo campus, still in the strategic planning phase, will be a state-of-the-art facility designed to establish AHSU as a leading medical school for Africa.
“It’s going to serve as an international medical school,” Dr. Kalimba emphasised. “The ambition is to set a high standard, making it comprehensive with undergraduate, postgraduate, and research programs that attract students from across the region.”
Plans are underway to start additional master’s degrees and introduce Ph.D. programs, including a combined medical and research degree (MBBS-PhD track) to train doctors who will lead medical research and teach future healthcare professionals.
The campus in Rusororo is expected to be operational within five years, according to Dr. Kalimba, and will complement KFHR’s ongoing expansion, which aims to triple its capacity by early 2028. The expansion will introduce specialised services previously unavailable in Rwanda, reducing the need for patients to seek care elsewhere in East Africa.
To ensure sustainability and regional reach, AHSU is adopting a mixed funding model. Rwandan residents are sponsored but commit to five years of service in public and teaching hospitals under a Ministry of Health retention contract.
Meanwhile, AHSU is actively recruiting students from across the continent, with growing interest evident in application statistics.
“This is not just for Rwanda. It’s an African medical school, and we want it to grow into a proper international institution,” Dr. Kalimba said.
International students will pay fees, ensuring long-term financial viability while training professionals who can elevate healthcare standards across the continent.
AHSU’s impact is already taking shape through partnerships with level 2 teaching hospitals and district hospitals like Kibuye, Kibungo, Kacyiru, and Muhima, where 30 faculty specialists have been deployed to train residents and enhance care.
“This has reduced referrals to tertiary hospitals and improved patient care, creating a model that can be replicated regionally,” Dr. Kalimba explained.
Global collaborations with several institutions like the University of Michigan, University of Wisconsin, and specialized hospitals in India and in other overseas centers are strengthening AHSU’s programs, with residents gaining exposure through external rotations at advanced medical centres. These partnerships position AHSU to share expertise and resources with other African nations.
Despite the progress, Dr. Kalimba acknowledged ongoing challenges, particularly in recruiting qualified faculty and developing infrastructure.
“Getting skilled personnel is a challenge everywhere,” he said, emphasising that training a medical specialist can take more than ten years, from undergraduate studies through postgraduate residency.
At the same time, Rwanda’s growing population, with approximately 300,000 births annually, epidemiological shift of diseases and progressively higher demand on the healthcare providers underscores the urgency of closing the doctor-to-population gap (and healthcare provider-to population gap), which remains far below the World Health Organisation’s recommended ratio of one doctor per 1,000 people.
Dr. Kalimba noted that support from the Government of Rwanda, along with the involvement of expatriate specialists, is helping to address these hurdles. Meanwhile, the KFHR expansion, scheduled for completion by late 2027 or early 2028, will provide a state-of-the-art environment for training and healthcare, benefiting both Rwanda and the wider region.
Dr. Kalimba envisions AHSU and KFHR as catalysts for making Rwanda a healthcare hub for Africa.
“Instead of people having to travel overseas from within African countries, why wouldn’t they come to Rwanda and be given equally good services that they would get from elsewhere?” he asked.
By combining world-class infrastructure, comprehensive training, and a focus on research, the Rusororo campus aims to reduce reliance on overseas care, boost medical tourism, and train professionals who will serve across the continent.
As construction plans advance, AHSU is set to play a pivotal role in elevating healthcare standards in Rwanda and beyond, fulfilling a vision of regional excellence.
The numbers have been rising. In 2019, 707 people were diagnosed, dropping slightly to 495 in 2020, before climbing to 603 in 2021.
By 2022, the figure had jumped to 926, then doubled to 1,845 in 2023. In the first half of 2024 alone, 1,349 people were recorded.
The data comes from four major hospitals: the University Teaching Hospital of Butare, the University Teaching Hospital of Kigali, King Faisal Hospital, and Mediheal Hospital and Fertility Centre.
In response to the growing need, Rwanda’s Parliament passed a new law regulating healthcare services on 4 August 2024, introducing a clear legal framework for assisted reproduction.
The legislation covers in-vitro fertilisation (IVF), surrogacy, and the preservation of eggs and sperm for future use. It allows married couples or individuals whose infertility has been confirmed by a qualified medical professional to access these services.
Surrogacy will also be regulated. It involves fertilising an egg with sperm in a laboratory to create an embryo, which is then transferred to a surrogate’s womb, typically via IVF. The new law requires a formal agreement between the surrogate and the intended parents, overseen by doctors, to ensure all parties understand their roles and obligations.
Minister of State in the Ministry of Health, Dr. Yvan Butera, said the law was a “major milestone” in improving access to healthcare.
“We continue to receive a high number of requests for assisted reproduction from people who cannot conceive naturally. This law establishes clear guidelines on how such services will be provided, removing barriers for those who currently have to seek them abroad,” he recently posted on X.
Infertility in Rwanda is linked to a variety of causes. Dr. Butera noted that 30 percent of cases are related to men, 30 percent to women, another 30 percent to both partners, and 10 percent to unknown factors.
The IVF process, often used when other treatments fail, involves stimulating a woman’s ovaries with hormones to produce eggs, which are then retrieved and fertilised with sperm in a lab.
The resulting embryos are monitored for several days before two are typically implanted into the uterus to increase the chances of pregnancy. This approach explains why IVF often results in twins or multiple births.
The procedure is becoming more common in Rwanda. At Kanombe Hospital alone, more than 108 babies had been born through IVF by July 2024. Globally, IVF contributes to the birth of over half a million babies each year.
The law also permits the storage of eggs and sperm for individuals at risk of infertility due to illness or other medical conditions. Approval will be granted by a doctor, and the preserved material can be used later when the individual is ready to conceive.
Health officials say that with demand for assisted reproduction climbing each year, the new legal framework will make these services more accessible within Rwanda, ensuring they are delivered safely, ethically, and without the need to travel abroad.
The initiative, led by the Rwanda Biomedical Centre (RBC), aims to address missed or delayed diagnoses of syphilis in pregnant women—a key driver of congenital syphilis, which can cause stillbirths, low birth weight, neurological damage, or even neonatal death.
Dr. Charles Berabose, Director of Sexually Transmitted Infections at RBC, says the new test will deliver results within 30 minutes, allowing immediate treatment during routine antenatal visits.
“The test can be done right in the antenatal room. That will help us catch infections earlier and start treatment right away. Rwanda has already trained lab technicians nationwide to carry out the RPR test and plans to train health workers on the new kits ahead of their launch,” Dr Berabose told the New Times.
The test is part of a “triple elimination” package that also screens for HIV and hepatitis B. Unlike the current lab-based RPR method, which takes hours and often delays treatment, the new approach will be conducted directly in antenatal rooms.
Rwanda’s high antenatal care attendance, with 98% of pregnant women attending at least one visit, offers a strategic entry point for early screening and intervention.
Health workers are being trained in preparation for the rollout, which is expected early next year.
The aircraft, equipped as a state-of-the-art teaching hospital, has been stationed at Kigali International Airport since July 21 and will remain until August 1, 2025.
Rwanda is the 84th country to host Orbis since the program launched in 1982.
The initiative is a collaboration between Orbis International, the Ministry of Health, the Rwanda International Institute of Ophthalmology (RIIO), and Kibagabaga Hospital.
Over 100 Rwandan eye specialists have already received hands-on training using advanced technology, and more than 140 patients, 40 aboard the aircraft and 100 at Kibagabaga Hospital, are expected to benefit from surgeries.
Speaking at the launch of the Orbis Flying Eye Hospital mission, Health Minister Dr. Sabin Nsanzimana hailed the initiative as a milestone in advancing high-tech healthcare in Rwanda and across Africa.
He highlighted the partnership between the Ministry of Health, Orbis International, and local institutions like RIIO as vital for expanding capacity and improving eye care services across the country.
He also underscored the importance of integrating artificial intelligence and digital tools in ophthalmology, which can predict complications early and prevent blindness.
Reflecting on past successes, he noted a recent nationwide cataract screening campaign that operated on thousands of patients, emphasising the ongoing efforts to reach even the most remote communities.
Dr. Nsanzimana noted that the government is working hard to increase the number of eye specialists in Rwanda from the current 30 to at least 120 over the next five years, as part of a broader strategy to quadruple the total number of doctors.
“Let’s increase the number of ophthalmologists from 30 to 120 in the next five years. This is achievable.”
The Flying Eye Hospital’s director, Maurice Geary, praised Rwanda’s warm reception and infrastructure support, calling it a historic collaboration.
Dr. Ciku Mathenge, Orbis Medical Advisor for Africa and RIIO co-founder, shared powerful stories of patients, including a young man treated for parasitic worms in his eye and Esther, a 26-year-old woman whose sight was saved through AI-supported diagnosis and treatment for diabetic retinopathy.
“Esther’s story is really a testament to why this work that Orbis is supporting Rwanda to do matters. Lasting, happy change happens when we invest in people, when we foster strong partnerships, and when we strengthen the foundations that your ministry has so ably set down in the health system in Rwanda,” said Dr. Mathenge.
“As a doctor, as a mother, as a proud African woman, and as a passionate advocate for eye care, I know firsthand the life-changing difference that sight makes in an individual. Seeing all of you here today with your dedication and belief fills me with a lot of joy, and it confirms that all of you understand why our mission is so critical.”
The Orbis Flying Eye Hospital will continue operating until August 1, with further training and surgeries planned in close collaboration with RIIO and Rwandan universities.
RIIO, founded 14 years ago by Brig Gen Prof. John Nkurikiye and Prof. Mathenge, was established to address the gap in eye care services in Rwanda and continues to play a central role in building a sustainable, high-quality ophthalmology workforce in the country.
The sharp rise is being driven by preventable factors such as hepatitis infections, obesity-related liver conditions, and alcohol consumption, researchers say.
In Rwanda, as in many countries around the world, liver cancer remains a pressing health concern. According to 2020 data, it was responsible for 706 deaths, accounting for 1.22% of all deaths in the country. The age-adjusted death rate stood at 11.48 per 100,000 population, placing Rwanda 24th globally in liver cancer mortality.
The new study, conducted by an international team of experts and drawing from data in the Global Cancer Observatory, warns that if current trends continue, liver cancer will remain among the world’s most lethal diseases, already ranking as the third deadliest cancer globally. By 2050, it is expected to claim 1.37 million lives each year, up from current figures.
Researchers stress that three out of five cases could be prevented through targeted public health interventions.
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The study highlights several key risk factors fueling the rise in liver cancer cases, including viral hepatitis B and C, alcohol abuse, and metabolic dysfunction-associated steatotic liver disease (MASLD), a condition previously known as non-alcoholic fatty liver disease.
MASLD is increasingly linked to rising rates of obesity and diabetes, particularly in high-income countries and urban areas in Asia, Europe, and North America.
Alcohol consumption alone is projected to cause more than 21% of liver cancer cases by 2050, up from 19% in 2022. Similarly, cancers related to liver fat buildup from obesity are expected to increase to 11%, also up more than two percentage points from current levels.
The study’s authors emphasise that these are largely modifiable risks that require stronger public health messaging and lifestyle interventions.
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Despite the availability of effective vaccines, hepatitis B continues to pose a major global threat. The virus remains the leading cause of liver cancer worldwide and is expected to be responsible for millions of deaths if vaccination rates do not improve.
The study warns that hepatitis B could cause up to 17 million deaths between 2015 and 2030 unless vaccine coverage, especially in poorer regions such as sub-Saharan Africa, is significantly expanded.
Vaccination at birth is considered the most effective prevention method, but many low-income countries still face barriers in implementing widespread immunisation programs. The study calls for renewed international investment in public health infrastructure to increase access to vaccines and antiviral treatments.
The authors of the study stress the urgent need for global action to reverse these trends. They recommend increasing public awareness around the preventable nature of liver cancer, especially among populations with obesity or diabetes, who may not be aware of the risks associated with fatty-liver disease.
The report also advocates for enhanced screening programs for high-risk individuals and more resources to support early detection, particularly in regions where late-stage diagnoses are common.
Liver cancer occurs when abnormal cells grow uncontrollably in the liver, forming a malignant tumour. The liver, a vital organ located in the upper right abdomen, is responsible for filtering harmful substances from the blood, producing bile for digestion, and storing nutrients.
There are two main types of liver cancer. Primary liver cancer originates in the liver itself, with hepatocellular carcinoma (HCC) being the most common form. Other less common types include cholangiocarcinoma (bile duct cancer) and angiosarcoma.
Secondary or metastatic liver cancer, on the other hand, begins in another part of the body—such as the colon, breast, or lung—and spreads to the liver. This type is more common in many parts of the world than primary liver cancer.
The risk of developing liver cancer is heightened by several factors, including chronic infection with hepatitis B or C, cirrhosis (scarring of the liver often caused by alcohol abuse or chronic hepatitis), obesity, diabetes, heavy alcohol consumption, smoking, and certain inherited liver diseases such as hemochromatosis. Exposure to environmental toxins like aflatoxins can also contribute.
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One of the challenges in combating liver cancer is that it often develops silently. In its early stages, liver cancer may not cause noticeable symptoms. As the disease progresses, however, patients may experience pain or discomfort in the upper right abdomen, swelling or a hard lump under the rib cage, jaundice (yellowing of the skin and eyes), unexplained weight loss, fatigue, nausea, loss of appetite, vomiting, chalky stools, dark urine, or fever.
Because these symptoms often appear in advanced stages, early detection is critical. Regular screening, particularly using ultrasound, is recommended for individuals with chronic liver disease or other risk factors.
Held under the theme “Enabling Healthcare Access through Digital Innovation,” the event brought together industry leaders, insurers, healthcare providers, and government stakeholders to celebrate Smart’s suite of cutting-edge solutions designed to streamline healthcare access across Rwanda and beyond.
The Smart Access app, now available on Google Play, allows users to manage their healthcare needs seamlessly, with features such as biometric verification, real-time insurance information, provider location services, and wellness tracking.
With roaming capability across 12 African countries, members can access healthcare services without pre-authorisation or coverage concerns, making it a vital tool for regional mobility. The platform also supports uninsured patients by enabling them to locate nearby healthcare providers and access educational health content, promoting inclusive access to care.
“Today marks a pivotal moment in Rwanda’s journey toward a digitally empowered healthcare system,” said Cleophas Obiero, Country Manager for Smart Applications International Rwanda.
“Our goal is simple yet powerful: to enable every individual, regardless of where they are, to access quality healthcare with dignity and ease.”
Reflecting on his own experience in 2013, when a hospital visit in Kigali took three hours due to manual insurance verification, Obiero highlighted the app’s transformative impact.
“With Smart Access, you provide your member number, place your fingerprint, and you’re served. Claims are sent instantly, and hospitals are paid on time.”
Operating in 680 Rwandan healthcare facilities and over 9,000 across 12 African countries, Smart Applications manages transactions worth approximately 290 billion Rwandan Francs (Ksh29 billion) for 1.7 billion people on the continent.
Obiero emphasised the company’s commitment to local innovation, citing how the app eliminates the need for physical insurance cards.
“A child in Burera can now get treatment with just a member number and a fingerprint, without someone travelling from Kigali,” he said.
Harrison Muiru, Group Managing Director of Smart Applications International Limited, praised Rwanda’s progressive approach to digital healthcare.
“Rwanda ranks first in East Africa in the Universal Health Coverage Essential Services Index, thanks to its commitment to digitisation and patient-centred care,” Muiru said, noting Rwanda’s 53% score on the World Health Organisation’s Universal Health Coverage Essential Services Index.
“Rwanda’s conducive environment for digitisation allows us to contribute to patient-centred care,” Muiru added, emphasising compliance with global data privacy and protection standards like HIPAA and GDPR.
He highlighted how Smart Applications has supported this progress by integrating identity management, claims processing, and data analytics into a unified ecosystem that serves insurers, hospitals, and patients alike.
“This digital ecosystem eliminates cumbersome paperwork and lengthy communication processes,” Muiru noted. “It enables real-time data-driven decision making for better inventory management, underwriting, and ultimately, improved health outcomes.”
The Group Managing Director and his team showcased the company’s broader ecosystem of solutions, including SmartHealth+ (a hospital management ERP), SmartInsure (a medical insurance ERP), SmartAnalytics (real-time data dashboards), and SmartLink, which enables seamless patient access to hospital services.
“Every second, about 80,000 healthcare transactions are managed on our platform,” Muiru said.
Lessons from the app’s 2022 launch in Kenya have shaped its rollout in Rwanda, with a focus on versatility and user-centric design.
“We’ve made the app navigable and empowering, catering to scenarios like a child falling sick at school,” he explained.
Andrew Kulayige, CEO of Britam Insurance (Rwanda) Ltd and Chair of the Association of Insurers in Rwanda, praised Smart’s solutions as a catalyst for increasing insurance penetration, currently at 2%.
“Platforms like Smart Access allow us to reach every corner of this country, offering accessibility, reliability, and flexibility,” he said.
Mendies Mhiribidi, Chairperson of the Rwanda Insurance Brokers Association, called Smart Access a “human face to insurance.”
She noted its role in reducing fraud and enhancing transparency, allowing members to view benefits, entitlements, and hospital charges in real time.
“Hospitals can’t overcharge or add unnecessary services anymore,” Mhiribidi said.
Urging the public to embrace the technology, she added, “This innovation simplifies your life and improves your healthcare experience.”
With the Smart solutions and the visionary leadership in the country, the leaders affirmed that Rwanda is well-positioned to leverage Smart’s solutions for medical tourism and universal health coverage.
The company’s AI-driven tools, real-time analytics, and interoperable platforms like SmartLink further enhance operational efficiency, from inventory management to claims processing, aligning with national digital health initiatives.
Integration of AI to enhance service delivery, such as generating and previewing e-claims, is designed to minimise rejections, ensuring efficiency and accuracy.
“We are here to work together for smart, secure, seamless healthcare,” Muiru noted, calling for continued collaboration.
The Africa CDC, in its latest study titled “Mapping Antimicrobial Resistance and Antimicrobial Use Partnership,” released Wednesday, said the “alarming rate” of antimicrobial resistance across 14 African countries poses an urgent continental public health threat.
The study, the largest of its kind conducted in Africa, analyzed more than 187,000 test results from 205 laboratories between 2016 and 2019 in 14 countries, including Ethiopia, Ghana, Kenya, Malawi, Mali, and Nigeria, revealing a growing ineffectiveness of antibiotics against common bacterial infections.
Drug resistance occurs when bacteria change in ways that make antibiotics used to treat infections less effective. The phenomenon results in common infections becoming harder to treat, more expensive to manage, and more likely to spread, according to the study.
It highlighted drug resistance as a growing epidemic affecting multiple countries across the continent. One of the “most concerning” findings is that resistance to a powerful group of antibiotics, known as third-generation cephalosporins, is exceptionally high in Ghana and Malawi.
The study also revealed demographic disparities in drug-resistant infections, with older adults and hospitalized patients being particularly vulnerable. It said the existing demographic disparities underscore the need for targeted interventions to protect at-risk populations.
The Africa CDC also highlighted “serious gaps” in laboratory infrastructure and data collection systems. Findings reveal that fewer than 2 percent of health facilities were equipped to test for bacterial infections, and only 12 percent of drug resistance records were linked to patient information.
