There is a strange kind of arithmetic taking over the way we talk about health. Everyone, it seems, wants to reach a hundred. There is a supplement for it, a blood test for it, a clinic somewhere charging several hundred dollars a month to tell you your “biological age.” Scroll far enough and you will find someone promising that with the right protocol, the right discipline, the right morning routine, you too can make it to triple digits.

But sitting with a cup of tea recently, a question kept nagging at me. What is the point of a hundred years if your knees cannot carry you up the stairs, if your body is technically alive but no longer willing? We have become so fixated on the number that we have quietly stopped asking what actually fills the years underneath it.

This is where two words, often used as if they mean the same thing, start to matter. Lifespan is simply how many years you are given. Healthspan is how many of those years you actually get to live in, moving, thinking clearly, free from the kind of illness that turns daily life into a series of appointments and medications. One is a count. The other is a quality.

In theory, medicine has been remarkably generous to us. Vaccines, better maternal care and improved treatment have added years that our grandparents never had. In practice, though, a great many of those extra years are spent managing chronic illness rather than enjoying life. Diabetes, high blood pressure, joint pain and fatigue have quietly become the price of longer life, not the exception to it.

The numbers are sobering when you look closely. Globally, there is now a gap of roughly nine and a half years between how long people live and how long they live well. In our own region, that gap widens considerably. In South Africa, healthy life expectancy sits at around fifty three years, against a total life expectancy closer to sixty seven. That is well over a decade lived with significant health burden. Zambia tells a similar story: an overall life expectancy of around sixty six years, but a healthy life expectancy closer to fifty three. Thirteen years, give or take, spent not quite well.

What makes our version of this story different is not just the size of the gap, but what is causing it. In wealthier countries, the healthspan conversation tends to centre on excess, too much processed food, too little movement, chronic disease creeping into lives that are already comfortable. Here, the picture is layered differently. A history of infectious disease still shapes how our bodies age, even as lifestyle related illness rises quickly alongside it. Southern African clinicians treating people ageing with HIV, for instance, have recently begun rewriting their own guidelines, shifting the language from “life span” to “health span,” and deliberately choosing an approach suited to our context rather than simply copying protocols designed for wealthier health systems. I find that quietly encouraging. It suggests we do not have to import someone else’s definition of ageing well. We can write our own.

And yet the longevity industry, largely built elsewhere, keeps optimising for the wrong finish line. It sells the birthday, not the years leading up to it. It measures success in candles rather than in mornings you wake up without pain, afternoons spent laughing with people you love, evenings where your body simply lets you be present.
For those of us living between two worlds, in Lusaka one season and London or Dubai the next, this conversation carries an extra layer. We are often caught between systems: the pace and convenience of life abroad, and the slower, more communal rhythms we grew up with at home. It is tempting to assume the diaspora life, with its gyms and health apps and easy access to specialists, is automatically the healthier one. But convenience is not the same as wellness. A body can be perfectly monitored and still be lonely, still be stressed, still be quietly unwell in ways no app can measure. The healthiest version of us is often the one that manages to take the best of both, the discipline and access we gain abroad, and the connection and slower pace we inherit at home.

Somewhere along the way, “living longer” became the goal, and “living well” became an afterthought, something to address later once the years themselves were secured. But wellness cannot be retrofitted onto a life that was never built for it. The habits that allow you to enjoy your eightieth year have to begin decades earlier, not as punishment or deprivation, but as intention. A daily walk now is worth more than a scramble for mobility later. Food eaten with people you love now matters more than any supplement bought in a panic at fifty.

I think of my own community often when I consider this. So many of us are chasing achievement, chasing years, chasing the next milestone, while quietly neglecting the body that has to carry us there. We check our bank balances more often than our blood sugar. We plan for retirement more carefully than we plan for how we will feel once we reach it.

Perhaps the better question was never how long we will live. Perhaps it was always how many of those years will still feel like ours, ours to walk through unaided, ours to enjoy rather than endure, ours to spend with the people who make the whole exercise worthwhile.

That, to me, is the only statistic actually worth tracking. Not the number on the cake, but the quality of the years that led to it.

Kaajal Vaghela is a cultural wellness advisor with over three decades of lived experience managing Type 1 diabetes in Zambia and the diaspora. Having previously served as Chairperson of the Lusaka branch of the Diabetes Association of Zambia, she remains a passionate advocate for breaking down myths and building awareness about diabetes. For more personalised coaching or corporate wellness workshops, visit: www.kaajalvaghela.com and for any feedback: [email protected])