As the Federation of African Immunological Societies (FAIS) prepares for its 2026 Congress, taking place from 30 November to 3 December in Cape Town, South Africa, we explore an important area of scientific research: the intersection of cardiovascular disease, infectious diseases and immunology.

The Congress theme, “The Heart of Integrated Immunity: Advancing African Solutions for Global Health,” highlights the importance of connecting scientific disciplines, strengthening African research capacity and advancing innovative approaches to health challenges affecting the continent and beyond.

Cardiovascular disease represents a growing challenge across Africa, where infectious and noncommunicable diseases frequently coexist. Understanding the role of inflammation, immune responses and infectious diseases in cardiovascular health offers important opportunities for scientific discovery and collaboration.

To explore these questions, FAIS brings together perspectives from two experts: Prof. Pasquale Maffia, Professor of Cardiovascular Immunology, who shares insights into the international research landscape and the challenges facing Africa, and Prof. Ntobeko Ntusi, President and CEO of the South African Medical Research Council, who examines cardiovascular research capacity, emerging priorities and opportunities for African-led innovation.

Cardiovascular Immunology: The Global Landscape and African Context

“Cardiovascular diseases are not simply disorders of blood vessels and the heart: immune responses and inflammation are central to their initiation, progression and clinical consequences. My research focuses on understanding these mechanisms across atherosclerosis, hypertension and heart failure, connecting fundamental immunology with translational, clinical and population-based studies. Our work has moved from tracking antigen-presenting cells and defining vascular immune responses to integrating single-cell and spatial transcriptomics, spectral flow cytometry and proteomics with experimental models and human studies. The aim is to identify immune pathways that can improve cardiovascular prevention, diagnosis and treatment.

Africa presents a striking scientific paradox. Although it is the world’s youngest continent, it faces an enormous and growing cardiovascular disease burden. Conventional cardiovascular risk factors cannot, on their own, fully explain the diversity and patterns of disease across African populations. This raises urgent questions about additional influences, including environmental exposures, infections, multimorbidity, immune ageing and the continent’s exceptional population diversity. Rather than assuming that mechanisms established in the Global North apply everywhere, we need to investigate how these factors interact in African settings and what they reveal about cardiovascular biology.

Infectious diseases are especially important to this agenda. Malaria, HIV and tuberculosis can influence cardiovascular health through distinct and overlapping pathways involving immune activation, persistent inflammation and tissue injury. Yet we still understand too little about why some individuals develop accelerated vascular disease, hypertension or heart failure, or how previous and ongoing infections alter cardiovascular risk over the life course. Studying these interactions offers an opportunity to uncover mechanisms that might otherwise remain invisible in populations with different exposure histories. Such discoveries could inform risk stratification and new therapeutic approaches in Africa and globally.

This is why the next generation of cardiovascular research in Africa must bring immunologists into sustained partnership with cardiologists, infectious-disease researchers, epidemiologists and population scientists. Africa has developed substantial expertise and sophisticated research platforms to study infection and host immunity. We should now extend access to these capabilities, including immunophenotyping, molecular profiling, biobanking and longitudinal cohorts, to cardiovascular and cardiometabolic diseases. Crucially, this requires training African scientists who can move confidently between immune mechanisms, clinical cardiovascular phenotypes and population-level evidence, and who can lead the questions as well as the discoveries.

The global case is compelling. Africa will account for an increasing share of the world’s population and births in the coming decades, and its health needs will increasingly influence international research priorities. Investing in cardiovascular immunology in Africa is therefore not only a response to an urgent regional burden. It is an opportunity to place African populations and scientific leadership at the centre of discovery, to reveal previously underappreciated drivers of cardiovascular disease and to generate insights with relevance to the Global North and the rest of the world. The future of cardiovascular science will be stronger if the tools, expertise and collaborative networks developed for infectious diseases are also mobilised to understand immune-driven cardiovascular disease.”

Prof. Maffia’s observations provide a broader context for understanding the opportunities and challenges facing cardiovascular immunology in Africa.

Building on this perspective, Prof. Ntobeko Ntusi examines the current state of cardiovascular research on the continent, the importance of the cardiovascular–infectious disease–immunology interface, and the priorities for developing sustainable African-led research and innovation.

Cardiovascular Research, Immunology, and Innovation in Africa

Introduction

Cardiovascular disease (CVD) is now one of the most important health challenges facing Africa, and the leading cause of mortality in many countries in the region. The continent is experiencing a profound epidemiological transition, characterised by rapid urbanisation, demographic ageing, changing diets, physical inactivity, environmental exposures and persistent socioeconomic inequalities. Simultaneously, Africa continues to carry a substantial burden of infectious diseases. The convergence of infections and noncommunicable risk factors is creating a complex landscape in which cardiovascular health can no longer be considered separately from infectious diseases, immunology, metabolic health and the broader determinants of health.

Against this background, cardiovascular research in Africa has never been more important. There has been significant progress in building research capacity, developing centres of excellence, establishing clinical and population cohorts, and increasing African participation in international research collaborations. African investigators are increasingly leading important studies that address hypertension, heart failure, cardiomyopathies, rheumatic heart disease, stroke, coronary artery disease and cardiovascular complications of infectious diseases. There is also growing expertise in cardiovascular imaging, genomics, epidemiology, implementation science and clinical trials.

However, progress remains uneven. Cardiovascular research capacity is concentrated in a relatively small number of institutions and countries, while many regions have limited access to specialised infrastructure, research funding, biobanks, advanced imaging, genomic platforms, clinical trial networks and sophisticated data systems. The continent also continues to experience a shortage of adequately supported clinician-scientists, cardiovascular researchers, research methodologists, data scientists and other specialised research professionals. These constraints limit both the scale and sustainability of African-led research.

A further challenge is that much cardiovascular evidence continues to be generated outside Africa, with the continent contributing to less than 6% of cardiovascular clinical trials, with even fewer led from the region. While international collaboration is essential and highly valuable, African research agendas must increasingly be shaped by African priorities, populations and health-system realities. Evidence generated elsewhere cannot always be assumed to translate directly to African populations, where genetic diversity, environmental exposures, patterns of infectious disease, socioeconomic conditions and health-system constraints may be substantially different.

Challenges and priorities moving forward

The future cardiovascular research agenda in Africa should therefore focus not only on producing more research, but on building an ecosystem capable of generating high-quality, locally relevant evidence and translating that evidence into better health outcomes.

First, sustainable investment in cardiovascular research is essential. Funding must extend beyond individual projects to support research infrastructure, longitudinal cohorts, data platforms, biobanks, research administration, implementation science, and career development. Long-term investment is particularly important because many of the most important cardiovascular questions, such as understanding disease trajectories, prevention, multimorbidity and treatment outcomes, require longitudinal research.

Second, Africa needs stronger research networks. Collaboration across countries can overcome fragmentation, increase sample sizes, improve statistical power and enable studies that reflect the continent’s extraordinary diversity. Pan-African networks can also facilitate harmonised protocols, shared platforms, training and mentorship, and strengthen Africa’s ability to participate in and lead multinational clinical trials.

Third, research capacity development must be regarded as a strategic investment rather than an ancillary activity. We need to develop the next generation of cardiovascular scientists through structured mentorship, doctoral and postdoctoral programmes, clinician-scientist pathways and opportunities for African researchers to assume intellectual and scientific leadership.

Fourth, implementation science should become much more central to cardiovascular research. Africa has considerable knowledge about effective interventions, yet hypertension, diabetes, dyslipidaemia and other cardiovascular risk factors remain inadequately detected and controlled. The challenge is therefore not simply discovering what works, but understanding how to deliver what works equitably, affordably and at scale.

The cardiovascular–infectious disease–immunology interface

One of the most exciting areas for future research lies at the intersection of cardiovascular disease, infectious diseases and immunology. Africa provides a unique natural laboratory for understanding these relationships because populations experience a high burden of infectious diseases alongside rapidly increasing cardiometabolic disease.

Infections can directly affect the cardiovascular system. Conditions such as HIV, tuberculosis, COVID-19, rheumatic fever and other infections can contribute to myocardial injury, vascular disease, arrhythmias, pulmonary hypertension and heart failure. At the same time, chronic immune activation and inflammation may contribute to cardiovascular risk long after an acute infection has resolved.

HIV provides an important example. With effective antiretroviral therapy, people living with HIV are living substantially longer, but may experience increased cardiovascular risk associated with chronic inflammation, immune dysregulation, traditional risk factors and, potentially, treatment-related metabolic effects. Similarly, tuberculosis, malaria, and other chronic infections can interact with cardiovascular disease through systemic inflammation, myocardial involvement and effects on vascular biology. These relationships highlight the importance of moving beyond traditional disease silos.

Immunology provides a powerful framework for understanding how persistent inflammation, immune activation and dysregulated host responses influence cardiovascular pathology. This creates opportunities to investigate shared biological pathways across infectious and non-communicable diseases. Africa’s population diversity, combined with its distinctive infectious disease and environmental exposures, provides an important opportunity to generate new biological insights that may have global relevance.

The need for African-led research and innovation

The next phase of cardiovascular research in Africa should be ambitious, collaborative and distinctly African-led. Several opportunities stand out.

First is the development of large, longitudinal African cardiovascular cohorts integrating clinical, genomic, environmental, behavioural and socioeconomic data. Such cohorts could provide an unparalleled resource for understanding disease trajectories and identifying context-specific risk factors.

Second is the application of genomics, precision medicine and multi-omics to cardiovascular disease. African populations remain substantially underrepresented in global genomic datasets. Expanding African genomic research could improve understanding of cardiovascular susceptibility and contribute to a more representative foundation for precision medicine.

Third, digital health and artificial intelligence offer opportunities to address geographical and workforce constraints. Artificial intelligence can support cardiovascular imaging, risk prediction, remote diagnosis, clinical decision support and population surveillance. However, African innovation must ensure that algorithms are developed and validated using representative African data and that they strengthen rather than widen existing health inequities.

Fourth, Africa can become an increasingly important centre for clinical trials and translational research. Building high-quality trial networks, strengthening regulatory and ethics capacity, and developing sustainable partnerships can enable African investigators to lead trials addressing questions that matter locally while contributing to global evidence.

Finally, cardiovascular research should increasingly embrace multidisciplinary and multisectoral collaboration. Cardiologists, immunologists, infectious disease specialists, epidemiologists, geneticists, data scientists, implementation scientists, economists and social scientists must work together. Partnerships between universities, research councils, health systems, governments, industry and communities will be essential.

Conclusion

Africa stands at a pivotal moment in cardiovascular research. The continent faces a substantial and growing cardiovascular burden, but it also possesses extraordinary scientific talent, biological diversity and opportunities for innovation. The priority should be to transform these assets into a sustainable African cardiovascular research ecosystem; one that is adequately funded, connected across borders, rooted in African priorities and capable of translating discovery into population health impact.

The intersection of cardiovascular disease, infectious diseases and immunology offers particularly fertile ground for discovery. By investing in people, platforms, data, partnerships and African scientific leadership, the continent can move from being predominantly a contributor of research participants and data to becoming a leader in defining the questions, generating the evidence and developing the innovations that will shape the future of cardiovascular health in Africa and globally.

Looking Ahead to FAIS 2026: The Heart of Integrated Immunity

The contributions from Prof. Maffia and Prof. Ntusi highlight the importance of bringing together expertise across cardiovascular medicine, infectious diseases and immunology to address Africa’s evolving health challenges.

Their perspectives also emphasise the need for stronger scientific networks, sustained investment in research capacity and greater African leadership in shaping the future of cardiovascular research.

These priorities resonate with the vision of the FAIS 2026 Congress, which seeks to encourage interdisciplinary collaboration, scientific exchange and African-led approaches to global health challenges.

Under the theme “The Heart of Integrated Immunity: Advancing African Solutions for Global Health,” the Congress will provide an opportunity to strengthen connections across research disciplines and explore how immunological knowledge can contribute to improving health outcomes in Africa and beyond.

Discover the FAIS 2026 Congress here!