**4. The effect of CVD on poverty in Africa**

CVDs occur approximately two decades earlier in SSA than in the rest of the world [5]. In the context of poverty and weak healthcare systems, patients with CVD in SSA have higher all-cause mortality and shorter lifespans than in the other parts of the world due to often limited access to healthcare. Over 50% of these patients die between 30 and 69 years of age, approximately ten years or more below the equivalent group in higher-income countries [45]. Consequently, death and disability attributable to CVD occur in the middle and economically productive age, affecting young families and the much-needed workforce in the region [45, 46]. Available evidence implicates stroke as the cause of the majority of CVD-related mortality in SSA [46]. With the absence of universal health coverage and robust health insurance systems among most SSA countries, patients and their families bear the costs of CVD care costs [47]. In some instances, patients forego treatment due to costs [47]. The impoverishing effect of out-of-pocket payments is increasingly pushing many individuals and families into poverty with family members affected by CVD [6].
