Africa's health ministers endorse a strategy to address chronic diseases

In the light of the rising burden of chronic diseases like diabetes, cardiovascular disease, mental and neurological disorders across Africa, health ministers have endorsed a new strategy to improve access to the diagnosis, treatment and care of these illnesses.

The aim is to support building the capacity of district hospitals and other first-level referral facilities to diagnose and manage severe noncommunicable diseases early, to reduce deaths.

Known as PEN-Plus, A Regional Strategy to Address Severe Noncommunicable Diseases at First-Level Referral Health Facilities, the strategy was adopted at the ongoing 72nd session of the World Health Organization Regional Committee for Africa in Togo's capital Lomé.

"Africa is grappling with an increasingly hefty burden of chronic diseases whose severe forms are costing precious lives that could be saved with early diagnosis and care," Dr Matshidiso Moeti, WHO regional director for Africa said.

Moeti went on to say, "The strategy adopted is pivotal in placing effective care within the reach of patients and marks a major step in improving the health and wellbeing of millions of people in the region."

In the new strategy, countries are required to institute standardized programs to tackle the diseases by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals.

Helmsley Charitable Trust termed the strategy as a critical step towards closing the gap for the poorest billion and achieving universal healthcare coverage.

"Through investment in integrated core delivery strategies like PEN-Plus, we can avoid unnecessary death and suffering among the world's most vulnerable children and young adults," the organization wrote in its twitter account.

The PEN-Plus strategy builds on existing WHO initiatives for integrated detection, diagnosis, treatment, and care of noncommunicable diseases in primary health care facilities.

The strategy has shown promising results in Liberia, Malawi, and Rwanda, with a significant increase in the number of patients accessing treatment for severe noncommunicable diseases and, a concomitant improvement in outcomes for these patients.

In Malawi, six secondary level health facilities are providing PEN-Plus care, which focuses on delivery and support for noncommunicable diseases at rural district hospitals in addition to training more healthcare workers using an adapted WHO curriculum.

Since the implementation of the programme in 2019, 444 clinicians and nurses have been trained and more than 300 patients are now receiving noncommunicable disease services locally.

Over the next five years, the Malawian Ministry of Health plans to scale up the initiative to incorporate 26 district and community hospitals across the country's three regions, with support from the World Diabetes Foundation and the United Nations Children's Fund.

The most prevalent severe noncommunicable diseases in Africa include sickle cell disease, type 1 and insulin-dependent type 2 diabetes, rheumatic heart disease, cardiomyopathy, severe hypertension and moderate to severe and persistent asthma.

In most of the countries across the continent, severe noncommunicable diseases are treated at tertiary health facilities, which are mostly in large cities.

This exacerbates health inequities, as it puts care beyond the reach of most rural, peri-urban and lower-income patients, who can often only easily access district hospitals and local health centers.

These facilities lack the capacity and resources to effectively manage severe noncommunicable diseases.

According to 2019 WHO survey, only 36 percent of African countries had essential medicines for noncommunicable diseases in public hospitals.