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Download the full article from the Journal of Asian Pacific Society of Cardiology. This piece argues that heart failure (HF) is an increasingly important but under-addressed health-system challenge in sub-Saharan Africa (SSA). Unlike in high-income countries, HF often affects younger adults in SSA, with hypertension, cardiomyopathy, and rheumatic heart disease among the leading causes. Patients frequently present late, contributing to substantially higher mortality and rehospitalization rates than global averages. The authors (including Krishna Udayakumar, and G Titus Ngeno, of Duke Global Health Innovations Center), emphasize that the challenge extends beyond clinical capacity. Limited financing, high out-of-pocket costs, inadequate insurance coverage, shortages of trained health workers, limited diagnostic capacity, and concentration of services in tertiary hospitals all constrain access to effective HF care. Even when guideline-recommended medicines are available, their cost can make sustained treatment…