Efforts to expand PEN-Plus across sub-Saharan Africa received a major boost when the Leona M. and Harry B. Helmsley Charitable Trust announced a $9 million grant to the World Health Organization Regional Office for Africa to expand care for people living with severe noncommunicable diseases (NCDs).
Following a landmark 2022 resolution to curb chronic diseases, WHO in Africa is leading the continent-wide implementation of PEN-Plus, a model that trains providers in remote communities to diagnose and treat a suite of severe NCDs, including type 1 diabetes, rheumatic and congenital heart disease, and sickle cell disease. Building on the model’s current success, the grant will support the efforts of WHO to scale and spread PEN-Plus to 20 selected African countries, with a goal of reducing deaths from severe NCDs by 15 percent within three years of implementation.
“Chronic diseases are projected to become the leading cause of death in sub-Saharan Africa by 2030,” said Dr. Matshidiso Moeti, WHO regional director for Africa. “To lower the burden, we’re working with countries to enhance the availability and quality of care for severe chronic diseases at district hospitals through the PEN-Plus strategy. The support from Helmsley will be key in the region’s efforts to bridge the gap in access to treatment and care and help reduce premature deaths from these diseases.”
With Helmsley’s funding, the WHO Regional Office for Africa will advance the implementation of PEN-Plus by:
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Developing communication materials in multiple languages to garner country support;
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Adapting NCD assessments and evidence-based tools for district-level healthcare facilities;
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Exploring sustainable financing frameworks to strengthen local governance;
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Integrating NCD care protocols to enable consistent and high-quality healthcare; and
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Designing an evaluation framework, including measurable key performance indicators.
The Helmsley Charitable Trust has supported the development of PEN-Plus since 2014 through Partners In Health, the NCDI Poverty Network, and the Center for Integration Science in Global Health Equity at Brigham and Women’s Hospital. As the world’s largest private philanthropic funder of type 1 diabetes programs, Helmsley is committed to shaping markets for essential medicines and expanding integrated systems of care through its Global Access portfolio.
“At Helmsley, we build partnerships that center people — not diseases — and that strengthen whole health ecosystems,” said Gina Agiostratidou, program director for type 1 diabetes at the Helmsley Charitable Trust. “WHO Africa’s diverse NCD programming and regional expertise make them an ideal partner in our mission to ensure that everyone with a severe NCD has access to quality care and support — no matter where they call home.”
The PEN-Plus model complements the WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care by equipping nurses and mid-level providers with the skills to effectively treat severe chronic NCDs and ensuring the availability of lifesaving medicines and supplies. In collaboration with Rwanda’s Ministry of Health, Partners In Health first introduced the model at two rural hospitals more than a decade ago. PEN-Plus proved so successful that the Rwandan Ministry of Health expanded it to every district hospital in the country.
With support from the NCDI Poverty Network, an additional 13 global partners — Chhattisgarh State in India, Ethiopia, Haiti, Kenya, Liberia, Malawi, Mozambique, Nepal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe — have since implemented PEN-Plus in at least one district-level clinic. Another eight countries — Bangladesh, Benin, Burkina Faso, Cambodia, Cameroon, the Democratic Republic of Congo, Ghana, and Nigeria — have begun initiating PEN-Plus.
With the new grant, WHO Africa will significantly extend the geographic reach of PEN-Plus.
“PEN-Plus has proven its value for expanding lifesaving care in resource-limited areas,” said Dr. Ana Mocumbi, co-chair of the NCDI Poverty Network. “In Rwanda, we watched the model’s impact grow exponentially when the Ministry of Health integrated PEN-Plus into its national strategy for NCD care. Under WHO Africa’s leadership, we cannot wait to see the model create new pathways to critical care for communities across the continent.”
In May 2023, Helmsley separately announced $10 million to support the implementation of the Global Diabetes Compact through the World Health Organization in Geneva. Together, these grants aim to advance progress in diabetes diagnosis and care on both global and national levels.