HMN 2026: What is the coordinated action to close Africa’s bone health gap

A new editorial appearing in Osteoporosis International, titled “Beyond the fracture: coordinated action for bone health equity in Africa,” sets out a roadmap to address osteoporosis and fragility fractures across the continent. The paper is authored by members of the International Osteoporosis Foundation (IOF) Board of Governance from the African region.

The editorial warns that alarmingly high post-fracture mortality reaches 20–30% across the continent and that hip fractures alone are projected to double by mid-century. Despite the evidence of rising fracture burden, preventable disability, and premature mortality, bone health remains largely absent from national health priorities, medical training, and health system planning across most of Africa.

In response, the authors issue a call to action, embedded in five strategic priorities for the next four years:

• Integrate bone health into national non-communicable disease (NCD) strategies and Universal Health Coverage (UHC) service packages, ensuring alignment with existing health system priorities.
• Establish Fracture Liaison Services (FLS) within tertiary and regional hospitals, beginning with countries where the burden of fragility fractures is highest and where there is sufficient health system readiness to implement and sustain these services effectively.
• Embed bone health into medical, nursing, and public health education, strengthening the capacity of future health professionals to diagnose, prevent, and manage musculoskeletal conditions.
• Set up regional fracture registries and musculoskeletal observatories to generate robust data, inform clinical guidelines, and monitor outcomes across contexts.
• Mobilize catalytic partnerships with the private sector and philanthropic foundations, those able to provide early, strategic support that enables broader uptake and investment, to expand access to diagnostics, training, and community awareness initiatives.

Professor Leith Zakraoui, IOF Board member and Lead Author, Centre Médical Hannibal, University of Tunis El Manar, Tunisia, notes, “We envisage a targeted, Africa-driven strategy that is informed by local realities and harmonized with international standards. By transforming evidence into action, we can build bone health into the fabric of health systems, education, and policy so that prevention and care become accessible where they are needed most.”

The authors highlight promising signs of progress already underway—Fracture Liaison Services have been piloted in Algeria, Egypt, South Africa, and Tunisia, and DXA diagnostic access is expanding in several countries—demonstrating that change is both possible and achievable.

Professor Nicholas Harvey, IOF President and Director of the MRC Lifecourse Epidemiology Centre, University of Southampton, UK, added, “We should not stand by as disability and premature death increase due to preventable fractures. Together, we have both the opportunity and the responsibility to reshape the future of bone health across Africa, by strengthening communities and developing health care systems that are equipped to meet the challenges of an aging population.

“We call on academic and scientific institutions, governments, public health agencies, philanthropic organizations, health care platforms, and private sector leaders to join IOF and leading experts in the region in driving concerted, meaningful action in Africa. The time to act is now.”

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