Expanding interventional cardiology in sub-Saharan Africa: Progress, barriers, and a path forward

Sammer Marzouk, Ketan Tamirisa, Faraan Rahim, Yaman Kanaan, Erick Mahatara, Peter Kisenge, Khuzeima Khanbhai

Abstract

Cardiovascular disease is an increasingly significant cause of morbidity and mortality in sub-Saharan Africa, driven by demographic growth, population ageing, and epidemiological transition. Despite the growing burden of ischaemic heart disease and other cardiovascular conditions, access to interventional cardiology services remains severely limited across the region. Critical shortages of percutaneous coronary intervention facilities, catheterisation laboratories, and trained interventional cardiologists contribute to delayed treatment and preventable mortality. Additional barriers include high infrastructure and equipment costs, limited financing mechanisms, inadequate insurance coverage, workforce shortages, and geographic inequities in access to care. Nevertheless, emerging programs in Uganda, Kenya, and Ethiopia demonstrate that sustainable progress is achievable through strategic partnerships, local workforce development, public-private collaboration, and regional professional networks. Expanding interventional cardiology capacity will require coordinated investments in infrastructure, training, financing, referral systems, and policy prioritisation. Strengthening these systems is essential to achieving equitable cardiovascular care and improving outcomes across sub-Saharan Africa.