Health leaders, policymakers and development partners across Africa have renewed commitment to accelerate the implementation of the PEN-Plus strategy to significantly expand access to care for severe noncommunicable diseases (NCDs).
Held under the theme “Advancing Implementation of PEN-Plus for Severe NCDs in Africa: Technical Innovations, Operational Insights, and Scalable Solutions,” the second International Conference for PEN-Plus in Africa served as a crucial follow-up to the inaugural 2024 gathering in Dar es Salaam. This year’s meeting focused on reviewing country-level progress, sharing operational experiences, and strengthening the technical foundation for the strategy’s scale-up.
Hosted by the Government of Nigeria, in collaboration with World Health Organization (WHO) in the African region and other partners including The Leone M. and Harry B. Helmsley Charitable Trust, the three-day event provided a platform for NCD stakeholders and policy makers to develop actionable recommendations countries can use to accelerate PEN-Plus implementation and draft country-specific strategies to sustain and expand PEN-Plus, an innovative healthcare delivery model birthed in Africa.
“In the last couple of years, global attention has shifted to NCDs because of the morbidity and mortality from these diseases. This conference marks a pivotal moment in our collective efforts to combat the growing burden of NCDs in Africa,” said Dr Iziaq Adekunle Salako, Nigeria’s Honorable Minister of State for Health and Social Welfare. “PEN-Plus addresses a critical gap in healthcare for the world’s poorest billion. By scaling up the model, we can ensure that lifesaving care reaches those who need it most, regardless of their location.”
In 2022, WHO in Africa set 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. PEN-Plus offers a promising approach to tackle the growing burden of severe chronic diseases. The model equips district and community hospitals with a specialized team of mid-level healthcare providers, such as clinical officers and nurses, specifically trained to manage severe complex NCD conditions.
Since its adoption by African Member States, the implementation of the model has shown promising results in Liberia, Malawi and Rwanda, with a significant increase in the number of people accessing treatment for severe noncommunicable diseases and improvements in health.
Twenty countries have since increased access to services for severe chronic disease such as type 1 diabetes, sickle-cell disease and rheumatic and congenital heart diseases. In addition to training local experts on severe NCD care, the services provided through PEN-Plus are free of charge – helping to reduce the significant financial burden on families caring for children living with severe chronic diseases.
“PEN-Plus has not only improved patient outcomes in implementing countries, but it has also strengthened health systems by providing training, mentorship, and referral pathways,” said Dr Mohamed Yakub Janabi, WHO Regional Director for Africa. “It is now time to scale up the model and bring lifesaving care to the people who need it most”
Despite this progress, participants at the ICPPA conference noted that scaling up the model requires more investments by countries. Previous implementing countries assessments underscored the urgency to improve the availability of critical medications like insulin and diagnostic equipment in district hospitals. Participants also stressed the “grossly inequitable access to prevention, diagnosis, treatment, and ongoing care” for severe NCDs conditions, particularly in rural areas where healthcare services are severely limited.
A key highlight of the meeting was the finalization of the African Agenda for the upcoming United Nations High-Level Meeting (UNHLM) on NCDs in September 2025. The agenda outlines Africa’s priorities, commitments and expectations for the global stage, with PEN-Plus positioned as a central pillar in the region’s response to severe NCDs.
“Scaling up and investing in PEN-Plus will save and improve millions of lives and take the continent a step towards ending diseases and achieving global health goals Scaling up PEN-Plus to address NCDs burden in Africa requires adequate and sustained resources,” said James Reid, Programme Officer at the Helmsley Charitable Trust. “By working together and pledging the necessary resources, countries can drive collective action to improve health and quality of life for millions of people around the world.
With support from Helmsley Charitable Trust, and collaboration of the NCDI Poverty Network, the WHO Regional Office for Africa has been supporting countries to provide technical expertise and guidance to countries on various aspects of the PEN-Plus programme, developing training materials, supporting assessment, conducting supervisory visits to identify challenges at implementing facilities, coordinating partners and co- organizing platforms such as the ICPPA for countries to share and learn from successful PEN-Plus models.
Distributed by APO Group on behalf of World Health Organization (WHO) – Nigeria.