This week on Womanity, Dr. Amaleya Goneos-Malka speaks with Dr Sebastiana Kalula, emeritus associate professor, specialist physician in geriatric medicine, Director of the Albertina and Walter Sisulu Institute of Ageing in Africa, and Co-Director of the International Longevity Centre South Africa at the University of Cape Town.

As global life expectancy rises, Dr Kalula unpacks one of the most pressing issues of our time: how to ensure that longer lives are also healthier, dignified, and equitable — especially for women.

From Rural Zambia to Global Leadership in Ageing

Dr Kalula reflects on her journey from growing up in rural eastern Zambia, supported by parents who valued education despite not having had the opportunity themselves, to qualifying in medicine and eventually discovering geriatric medicine in the UK. What began as a practical career pathway became a calling. She describes geriatrics as a specialty that blends science and humanity — one that looks beyond a single disease to consider the whole person: physical health, mental well-being, social context, and functional ability.

Her career has since positioned her at the forefront of ageing research and advocacy across Africa, where the demographic shift toward older populations is accelerating rapidly.

Health Span vs. Lifespan: A Critical Distinction

One of the most powerful insights from the conversation is Dr Kalula’s emphasis on extending health span rather than simply lifespan. Living longer, she cautions, is not the goal if those additional years are marked by disability and poor quality of life.

She explains that while genetics contribute approximately 25% to longevity, the majority of our health outcomes are shaped by social determinants: education, income, access to healthcare, safe environments, and lifestyle choices. The conditions in which we are born, grow, work and age profoundly shape how long, and how well, we live.

Her practical advice is clear:

Prioritise whole foods over processed diets
Stay physically active at every age
Protect sleep and manage stress
Remain socially connected
Invest in preventive healthcare early in life

Healthy ageing, she reminds us, is a life-course process, not a switch we flip at 60.

The Gendered Reality of Ageing in Africa

Dr Kalula explains that women live longer than men, which means they carry a disproportionate burden of age-related conditions such as dementia. But biology tells only part of the story.

Lifetime inequalities, such as limited access to education, unpaid caregiving roles, economic insecurity, and widowhood, compound women’s vulnerability in later life. Chronic stress, she explains, elevates cortisol levels, weakens immunity, increases inflammation, and raises the risk of conditions such as diabetes and vascular disease, all of which can contribute to cognitive decline.

In the African context, the challenges can be even more severe. Widowed older women often face social exclusion, loneliness, poverty, and in some communities, even harmful stigma. The emotional and psychological toll of these realities can itself increase dementia risk.

Dr Kalula calls for stronger legal protections, income security through pensions, age-friendly healthcare systems, and, critically, better age- and gender-disaggregated data to inform policy.

Dementia, Vascular Health and Prevention

The conversation also tackles dementia — a growing global health concern. Dr Kalula highlights that in Africa, vascular disease (including strokes and poor circulation to the brain) is a major contributor to dementia. This underscores the importance of managing blood pressure, diabetes, and cardiovascular risk factors early in life.

She also emphasises the importance of brain stimulation. Education, meaningful work, continuous learning, and challenging routines all help maintain cognitive reserve. The brain, like the body, needs exercise.

Leadership, Mentorship and Building Sustainable Success

Beyond medicine, Dr Kalula shares powerful reflections on leadership. She speaks about the importance of mentorship at every stage of life, humility in leadership, and building respectful teams where others can flourish. She is also a member of the African Research on Ageing Network (AFRAN), the Global Aging Research Network (GARN), the South African Geriatrics Society (SAGS) and the International Association of Gerontology and Geriatrics (IAGG

Balancing an academic medical career with family life required resilience, clarity of priorities, reliable childcare, and strong support systems at home and work. “No one succeeds alone,” she reflects, emphasising the value of quality friendships and supportive networks.

Her philosophy of success moves beyond achievement to sustainability, well-being, and community impact.

A Call to Action for Women

In her closing message to girls and women, Dr Kalula encourages continuous self-development:

Be the best version of yourself wherever you are
Seek mentors
Keep learning
Challenge your mind
Compete against yourself, not others
Define where you want to be — and work toward it deliberately

Ageing, she reminds us, is universal: “We are all getting there, if we are lucky.” The question is whether we will build societies that allow women to age with dignity, inclusion, and vitality.

Tune in for more