A new report released on World Thyroid Day has exposed thyroid disease as one of Africa’s largest, most preventable and most neglected public health crises, with up to 28% of the continent’s population affected and only two of 54 countries operating newborn screening programmes capable of catching the condition at birth.
The report, From Margins to Mandate: Elevating Thyroid Care in Africa, published by Economist Impact and supported by Merck, draws on analysis across all 54 African countries and expert testimony from leading endocrinologists across the continent. It finds that despite thyroid disease being among the world’s most common endocrine disorders, it remains largely undiagnosed, untreated and absent from most national and continental health agendas.
“Congenital hypothyroidism is the leading, preventable cause of neurodevelopmental disability,” said Dr. Menbere Kahssay, Paediatric Endocrinologist and Consultant Paediatrician at Aga Khan University Hospital in Nairobi, Kenya, urging governments to implement publicly funded neonatal screening within the first two weeks of life.
The cost of inaction is already visible in children. In one Kenyan hospital, 63% of children diagnosed with congenital hypothyroidism, a leading cause of preventable intellectual disability, had already developed cognitive delays by the time they were identified. Egypt and Seychelles are the only African countries with national newborn screening programmes that cover the condition. Forty countries have no screening infrastructure at all, including no pilot or private options.
The report also projects an 84% rise in thyroid cancer incidence across Africa by 2040, the largest projected increase of any region in the world.
Access to diagnosis compounds the problem. In Kenya, a standard thyroid diagnostic test costs approximately USD 116, equivalent to roughly 20% of average monthly income. In Nigeria, where the test costs around USD 24, more than 60% of the population lives on less than USD 5 per day. The financial barrier effectively locks most patients out of early diagnosis, leading to more advanced disease and harder long-term management.
Social stigma further delays care. In Nigeria, 72% of goitre patients attributed their condition to witchcraft rather than a medical cause, reflecting deep gaps in public health education that continue to drive preventable suffering. Women carry a disproportionate burden, facing job discrimination, social isolation and in some cases domestic abuse linked to visible thyroid symptoms.
The report identifies iodine deficiency as a critical driver of disease across the continent, with only 10 of 54 countries meeting World Health Organization (WHO) standards on iodised salt consumption. Africa also records the highest global prevalence of Hashimoto’s thyroiditis at 14.2%.
Structurally, Africa remains the only continent without a dedicated regional thyroid association, limiting coordinated research, policy development and the sharing of clinical standards across borders.
The report calls for an immediate scale-up of newborn screening using existing health platforms, stronger iodine salt fortification programmes, improved affordability of diagnostics, formal recognition of thyroid disease within WHO and national non-communicable disease (NCD) frameworks, and the establishment of an Africa Thyroid Association to drive continental coordination.
Elizabeth Sukkar, senior research manager who led the study at Economist Impact, described early newborn screening as a critical lever capable of delivering significant long-term health, social and economic benefits, but said closing the gaps in care would require coordinated investment across screening, diagnostics and treatment alongside stronger integration of thyroid health into national policy frameworks.
