INTRODUCTION: On the African continent, there is epidemiological transition with an increasing burden of non-communicable diseases (NCDs). Accordingly, the Africa Centre for Disease Control (Africa...Show moreINTRODUCTION: On the African continent, there is epidemiological transition with an increasing burden of non-communicable diseases (NCDs). Accordingly, the Africa Centre for Disease Control (Africa CDC) published a NCD control policy. The Africa CDC aims to achieve health equity; yet its approach to health equity has not been analyzed. OBJECTIVES: This paper questions how health equity is integrated into the NCD policy. Thereby, analyzes power dynamics and implications for health equity, but also applies a novel, qualitative framework for health equity analysis. METHODS: The methodology is guided by the Systematic Equity-Action analysis (SEA) framework developed by Plamondon et al (2023). SEA considers how the themes worldview, coherence, potential, and accountability relate to health equity. The findings of the SEA were set in conversation with secondary sources from the academic and grey literature. RESULTS: NCD Strategy acknowledges the Africa CDC’s authoritative and productive power as a continental public health institution and avoids the “responsibilization” of health to individuals. Further, the broader political-economic context of African health is identified, i.e., power imbalances in Global Health research and practice. Relatedly, the NCD Strategy centralizes African actors as key stakeholders; and focuses on collaborative relationships with people with lived experience in the policy process. This facilitates shifting power-knowledge and can decrease marginalization and discrimination. However, the NCD Strategy employs a one-dimensional approach to health inequity drivers, primarily focusing on socio-economic status. Moreover, the NCD Strategy does not address the redistribution of resources and wealth which is often seen as key to achieve health equity. CONCLUSIONS: Despite health equity being a key objective of the NCD Strategy, it is not consistently integrated. The findings underscore the need for comprehensive conceptualization of health equity in policy to increase the potential of advancing it; and that power limits and facilitates achieving health equity. RECOMMENDATIONS: The Africa CDC should pursue a more intersectional approach, consider human rights-based approaches to health to facilitate state accountability, and emphasize redistributive mechanisms to enhance health equity.Show less
