On 23 August 2022, the 47 Member States of the WHO/AFRO region voted unanimously to adopt the regional PEN-Plus strategy to address severe NCDs at first-level referral health facilities in the region. Thirty-three of the region’s 47 Member States (70%) submitted statements in advance of the vote on the resolution – all in support.
Implementation of this strategy will increase the capacity of first-level health facilities in rural and peri-urban areas to diagnose and treat severe, chronic non-communicable diseases (NCDs) such as sickle cell disease, type 1 diabetes, and rheumatic heart disease. It will also – as the strategy points out – accelerate and strengthen implementation of WHO’s Package of Essential NCD Interventions (PEN) for prevention and management of less severe conditions at primary care level, which is currently being implemented in only 45% of the region’s Member States.
“WHO has been providing support to member states to implement PEN for primary health care in low-resource settings since 2008,” Dr. Benido Impouma, Director of the WHO/AFRO Regional Office’s Communicable and Noncommunicable Diseases Cluster, stated in presenting the resolution. “The region now needs to focus on specific severe NCDs such as type 1 diabetes, sickle cell disease, and rheumatic fever, ensuring that vulnerable populations with these diseases have access to diagnosis and treatment within their communities…. ”
“Implementing PEN-Plus is critical to reducing premature disability and deaths in those living with these diseases [severe NCDs such as type 1 diabetes, sickle cell disease, and rheumatic fever].”
— Benido Impouma, Director Communicable and Noncommunicable Diseases Cluster, WHO/AFRO
Adoption of the Regional Strategy marks the successful culmination of a process that began more than three years ago, when WHO/AFRO and the Rwanda Ministry of Health hosted a regional consultation on WHO PEN and PEN-Plus in Kigali, at which Prebo Barango of WHO/AFRO and collaborators from the secretariat of the Lancet NCDI Poverty Commission and NCDI Poverty Network presented a preliminary draft of the regional PEN-Plus strategy.
Since that consultation, WHO/AFRO has worked with the NCDI Poverty Network, UNICEF, the Helmsley Charitable Trust, and other partners to support national scale-up of PEN-Plus in Malawi; initiation of PEN-Plus clinics and training sites in eight other countries in the region – Ethiopia, Kenya, Uganda, Tanzania, Mozambique, Zambia, Zimbabwe, and Sierra Leone; and finalization of the draft Regional Strategy that has now been adopted.
Now, with adoption of the regional PEN-Plus strategy, WHO/AFRO has established ambitious goals to have 50% of Member States rolling out PEN-Plus services to district hospitals by the year 2025, 65% by 2028, and 70% by 2030.
“The adoption of the WHO PEN-Plus resolution and strategy by countries in the African region shows their commitment to helping those afflicted by severe chronic NCDs. These conditions include diseases such as type 1 diabetes, rheumatic heart disease, sickle cell disease, and others that have previously fallen through the cracks of global policy and action,” NCDI Poverty Network Co-Chairs Gene Bukhman and Ana Mocumbi said, following the vote. “Now, the NCDI Poverty Network’s PEN-Plus Partnership is organizing a movement to support these countries financially so that the poorest are not left behind,”