Development has contributed to significant increases in life expectancy and quality of life in much of sub-Saharan Africa, and these changes are creating a transformation in the regional epidemiologic profile. As some infectious diseases have decreased in prevalence, the incidence and prevalence of other diseases * both communicable and non-communicable * have increased. While development projects, especially those that improve access to clean drinking water, sanitation facilities, and adequate nutrition, are critical for reducing childhood illness and mortality and increasing adult health and productivity, these improvements can also lead to a new set of health concerns. In this paper, we will examine less commonly recognized disease burdens that have (or will) become more frequent, more severe, or prevalent across a larger geographic region as a direct result of social and environmental changes related to socioeconomic development. For example, water development projects, such as building dams and irrigation canals, have resulted in the increased prevalence of schistosomiasis, a parasitic worm disease that requires a fresh water habitat for infection transmission. Higher-income adults in Africa may be at risk of severe hepatitis A disease because improved water supplies have prevented the development of antibodies to fight the viral infection. Chronic diseases like diabetes are becoming more common as diets and lifestyles change. We will examine the social, biological, and environmental mechanisms responsible for the emergence of development-related diseases and will identify the key diseases which may intensify as the infrastructure and economies of sub-Saharan Africa grow.