The CIS is a joint initiative of the Program in Global Noncommunicable Disease and Social Change at Harvard Medical School, the NCD Synergies project at Partners In Health, and the Fellowships in NCDs and Global Health Equity at BWH.

Much of the historical progress on global health equity has been driven by vertical initiatives around priority infectious diseases. In the 21st century, however, there remains a “long tail” of infectious and non-infectious conditions that are seldom lethal in high-income countries, but are still a death-sentence for the poorest children and young adults in lower-income countries. This long tail of severe conditions includes diseases such as type 1 diabetes, rheumatic heart disease, sickle cell disease, and multi-drug resistant tuberculosis for example.

The Lancet Commission on Reframing Noncommunicable Diseases and Injuries for the Poorest Billion (Lancet NCDI Poverty Commission) identified illustrative integrated care teams that could bridge this vast gap in care if they were financed and implemented at scale.

In order to act on the recommendations of this Lancet Commission, a group of 21 countries (and growing) have organized an NCDI Poverty Network. The CIS – together with the Universidade Eduardo Mondale in Mozambique – serves as the co-secretariat for the NCDI Poverty Network, supporting Network countries to progress through a 4-phase theory of change, ultimately leading to national implementation of integrated delivery models.

One integrated delivery model developed by CIS leadership is the Package of Essential Noncommunicable Disease Interventions – Plus (PEN-Plus). PEN-Plus supports decentralized, integrated case-management for severe chronic NCDs such as type 1 diabetes, rheumatic and congenital heart disease and sickle cell disease. PEN-Plus has been adopted as the official strategy of the 47 member states of the World Health Organization’s African region.

Between 2023 and 2028, the primary objectives of the CIS will be to:

  1. Develop the theoretical basis for a Science of Integration in Global Health Equity
  2. Support all phases of the NCDI Poverty Network’s activities, including PEN-Plus initiation, expansion, and evaluation
  3. Incubate new integrated service delivery models in areas such as breast and gynecological health, newborn screening, and high-dependency/acute care