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📍  DAR ES SALAAM

The first annual International Conference on PEN-Plus in Africa (ICPPA 2024) aimed at addressing severe non-communicable diseases (NCDs) in Africa got under way on Tuesday (April 23) in Dar es Salaam, Tanzania.

Representing President Samia Suluhu Hassan, the host nation's health minister, Ummy Ally Mwalimu, opened the conference at the Julius Nyerere International Convention Centre.

In attendance were as many as 600 delegates, who included World Health Organization (WHO) officials, United Nations (UN) representatives, ministries of health officials from different countries as well as health service stakeholders.

The three-day conference, which is running until Thursday, is themed around prioritizing a person-centred approach to chronic and severe NCDs.

In her opening remarks, Mwalimu said NCDs have become a formidable threat to the health and wellbeing of humans, silently affecting the lives of Tanzanian citizens and communities, and consequently undermining the progress they strive to achieve as a nation.

She, however, said as a country, they will invest in the fight against NCDs.

“Together, we have chosen to confront these non-communicable diseases heads-on, armed with knowledge, innovation, and a united determination to create a healthier and more prosperous society."

The Tanzanian health minister said despite the efforts made, most low- and middle-income countries — including Tanzania — are off track in the fight against NCDs.

NCDs account for around 41 million deaths each year, which is equivalent to 71 percent of all deaths globally, according to official statistics.

Beyond the health factor, these diseases also trap people in poverty, undermine workforce productivity, and threaten economic prosperity in particularly low- and middle-income countries.

Dr Yonas Tegegn Woldemariam, the WHO Representative to Uganda in attendance

Elke Wisch, the UNICEF representative to the United Republic of Tanzania, urged African leaders to step up to the challenge of strategic decisions on health, other agendas and measures to build partnerships to protect their populations against diseases like NCDs.

“The NCD burden is not only just a health system problem, it is everyone's problem," she said.

"We need to bring NCDs into daily conversations with minister of finance, transportation, education, agriculture, the regulatory bodies, food, beverage and pharmaceutical industry, and importantly, with the public, and also in the context of the environment crisis."

Dr Impouma Benido, the director of the Communicable and Noncommunicable Cluster of the WHO African Region, addressed the need for African governments to invest more in NCDs fight.

He said country local initiatives must be accelerated based on the NCD implementation roadmap 2023 to 2030 by applying the Best Buy and who has these technical packages, which include reorienting healthcare, and reinforcing health systems.

“Unfortunately, this rapid evolution with higher mortality rates has not been recognized because we're not investing," said Benido.

"Through domestic or natural and unnatural channels, you must develop strategies for preventing and controlling NCDs within cities and  communities in low-and middle-income nations."

Uganda is being represented at the conference in Dar es Salaam

The conference in Dar es Salaam is convened by the WHO in the African region to address severe NCDs at first-level referral health facilities.

It is being seen as a platform to raise awareness of severe NCDs and share lessons from countries implementing PEN-Plus and identify opportunities to strengthen NCD management. 

The PEN-Plus strategy, adopted in August 2022, urges countries to establish standardized programmes to combat chronic and serious NCDs to ensure that esesential medicines, technologies and diagnostics are available and accessible in district hospitals.

Although PEN-Plus follows an integrated outpatient package delivery approach, it focuses on severe-spectrum NCDs, such as type 1 diabetes, rheumatic and congenital heart disease, and sickle cell disease, as well as palliative care.

Type 1 diabetes, which is often diagnosed in children or young adults, is treated with insulin, and monitored by the testing of blood-sugar levels

Burden of NCDs

NCDs kill millions in most low- and middle-income developing countries. In Uganda, these disease are cause the death of an estimated 100,000 people annually.

According to the WHO, children who survive acute rheumatic fever in low and lower-middle-income countries have a 20 percent chance of dying before their 15th birthday and a greater than 70 percent chance of dying before the age of 25.

Every day in Africa, as many as 1,000 children are born with sickle cell disease. Without access to treatment, half of them will die before their fifth birthday.

Unlike in high-income countries, children with type 1 diabetes in rural areas of sub-Saharan Africa often die within a year of diagnosis.

Reports show that NCDs affecting Ugandans include cancer, cardiovascular diseases, diabetes, chronic respiratory diseases, and mental health conditions, and substance abuse conditions.

In Uganda, nearly one in four adults dies from an NCD before the age of 70.