PEN-Plus Partnership High-Level Advisory Group Convenes in New York City

The High-Level Advisory Group of the PEN-Plus Partnership met in New York City on 19 September to discuss the progress and future of PEN-Plus, an integrated care model that diagnoses and treats severe noncommunicable diseases in rural areas of low- and lower-middle-income countries, where more than 90 percent of the world’s poorest people live.

Participants included NCDI Poverty Network Co-Chairs Gene Bukhman and Ana Mocumbi, as well as global health leaders, funders, and advocates representing Africa CDC, the American Heart Association, the Foundation for Cardiovascular Care in Africa, the Global Sickle Cell Disease Network, the Helmsley Charitable Trust, JDRF International, St. Jude Children’s Research Hospital, Mass General Brigham, Partners In Health, UNICEF, the World Diabetes Foundation, and the World Health Organization Regional Office for Africa.

The presentations and discussions highlighted significant advancements since the group’s last meeting in March and conveyed a deep commitment to expanding PEN-Plus in underserved communities.

Success of PEN-Plus in Mozambique

Dr. Mocumbi reported on the positive impact of PEN-Plus in Mozambique. Since the PEN-Plus clinic in Nhamatanda opened in February 2023, she said, the number of type 1 diabetes patients enrolled has increased significantly, and a type 1 diabetes care club has formed to promote self-management. The PEN-Plus team has conducted the first-ever sickle cell disease screening using point-of-care testing, marking a monumental step forward in tackling the high prevalence of sickle cell disease in northern Mozambique.

The group was heartened to hear that João Mindo, a 14-year-old living with rheumatic heart disease in a rural community outside of Nhamatanda, has improved significantly since a successful mitral valve repair surgery in Maputo. When the High-Level Advisory Group first met João during a visit to Mozambique in March, he had been recently diagnosed with rheumatic heart disease after years of debilitating symptoms, including difficulty breathing.

The PEN-Plus clinic in Nhamatanda made logistical arrangements for João’s surgery, including travel to Maputo for him and his brother. João has recovered well and will receive long-term support from the PEN-Plus clinic, including money to travel to the clinic for monthly checkups, a cellphone to enable follow-up calls with his care providers, and anticoagulation medicine.

Progress of PEN-Plus Implementation and Infrastructure

Emily Wroe, program director for the NCDI Poverty Network, shared insights on the status of PEN-Plus implementation across sub-Saharan Africa and South Asia. She gave an overview of PEN-Plus infrastructure, including clinic construction and renovation to enhance on-site diagnostic capabilities. Dr. Wroe also reported that the PEN-Plus team has already trained 437 clinical staff across ten countries and 19 clinics to care for more than 5,000 patients with severe NCDs.

PEN-Plus Advocacy and the Strategic Plan for 2025-2028  

Network Associate Advocacy Director Apoorva Gomber highlighted the advocacy goals for PEN-Plus, which are focused on building a global solidarity movement, engaging people living with NCDs in underserved communities, and advocating for international funding.

Dr. Bukhman concluded the presentations with an overview of the strategic plan for PEN-Plus expansion. Goals include initiation and expansion in multiple countries to serve at least 15,000 new patients, ongoing collaboration with the High-Level Advisory Group and PEN-Plus implementers, and cultivation of U.S. congressional support.

The High-Level Advisory Group will meet again during the WHO/AFRO Regional PEN-Plus Summit in Dar es Salaam, Tanzania, to be held April 23–25, 2024.

The PEN-Plus Partnership continues to make strides in addressing severe NCDs in low and middle-income countries with the support of global leaders and Network partners committed to advocating for and improving healthcare delivery to those in need.