Rwanda needs to invest more in preventing non-communicable diseases (NCDs) before they progress to severe illness and prolonged hospital care, Dr. Theoneste Maniragaba, Director of the Cancer Programme at the Rwanda Biomedical Centre (RBC), has said.
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Maniragaba said NCDs are now the leading cause of death in Rwanda, with cardiovascular diseases and cancer accounting for much of the burden.
The latest national vital statistics show that NCDs accounted for 49.5 per cent of deaths recorded in health facilities and 58.8 per cent of deaths in communities in 2025. Cardiovascular diseases were the leading cause of death, followed by cancer.
"When NCDs are not prevented early, they don’t become walk-in, walk-out. They become walk-in, stay-in,” Maniragaba said during the Rwanda First National Dialogue on NCDs in Kigali on September 4.
He said prevention was one of the four pillars of the government's 2020-2025 NCD strategy, alongside leadership and resource mobilisation, surveillance and evidence, and treatment.
Care closer to communities
Maniragaba said NCD services have been integrated into health centres, reducing the distance patients have to travel for care.
He noted that some patients from remote places who used to travel tens of kilometres to get medicines for cardiovascular diseases can now receive the medicines from nurses at health centres.
Cancer services have expanded, with the number of centres providing cancer treatment increasing from four to five. The fifth centre, at Butare University Teaching Hospital (CHUB), is the latest to be established, and cancer services are covered under community-based health insurance.
Maniragaba explained that public health institutions now have basic cancer imaging services, including MRI, as well as the equipment and health workers needed to provide cancer care. However, some specialised cancer services are still not covered under the existing insurance package.
Maniragaba said any further expansion of coverage must take into account the country’s available resources and the costs and benefits of covering additional treatments.
A broader approach to NCD care
"The 2026-2030 NCD strategy will consider closer links between NCD services, infectious disease programmes and mental health. People living with HIV, for example, are at [a higher] risk of cardiovascular and renal diseases, so we need to look at their health needs together,” Maniragaba said.
"We don’t treat the disease; we manage the patients. That requires us to also look at how NCD care is financed. As we prepare the new strategy, we need domestic financing targets and fiscal measures, including health taxes that can reduce NCD risk factors and generate revenue for healthcare.”
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He added that Rwanda should also work towards providing advanced cancer investigations and major surgical procedures for cancer, cardiovascular and renal diseases, including transplantation, in the country.
Dr. Joseph Mucumbitsi, chairperson of the Rwanda NCD Alliance, said people living with NCDs and civil society organisations should have a meaningful role in shaping the country’s next five-year NCD strategy.
Among their demands is full access to specialised services under community-based health insurance without co-payments for the most vulnerable people.
Mucumbitsi said people living with NCDs often need long-term treatment, regular monitoring, diagnostic tests and, in some cases, specialised services.
He stressed the need for stronger measures to prevent NCDs, including action on tobacco use, alcohol consumption, unhealthy diets, physical inactivity and air pollution.
Mucumbitsi said there should be health taxes, with at least five percent of the revenue generated used for NCD prevention, control and care.
He said the next strategy should be measurable, and included in government planning, with resources set aside for its implementation.