Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality worldwide, representing 60% of all deaths. Contrary to common perception, 80% of chronic disease deaths occur in low- and middle-income countries. This invisible epidemic is an underestimated cause of poverty and hinders the economic development of many countries. Sub-Saharan Africa carries the highest burden of disease in the world, the bulk of which still consists of the communicable diseases HIV/AIDS, tuberculosis and malaria. However, the prevalence and incidence of diabetes and its long-term complications in sub-Saharan Africa are increasing, and will have a devastating human and economic toll if the trends remain unabated in the future. This report describes the links between two chronic diseases, diabetes and HIV/AIDS, in sub-Saharan Africa and its implications for healthcare systems.