pexels-pixabay-40568
African countries are asserting leadership in tackling severe chronic diseases by scaling up PEN-Plus, a healthcare model designed and developed in Africa to bring specialized care closer to underserved populations.
The Government of Nigeria hosted a three-day high-level meeting in Abuja from July 8–10, bringing together health ministers, policymakers, clinicians, and development partners from across the continent.
The event was in collaboration with the World Health Organization (WHO) Regional Office for Africa and key supporters such as the Leona M. and Harry B. Helmsley Charitable Trust.
The conference focused on turning momentum into tangible country-level action for PEN-Plus implementation and sustainability.
“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 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.”
A Model Born in Africa, Built for the Poorest
PEN-Plus—short for the Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-resource Settings—is tailored to expand access to care for severe noncommunicable diseases (NCDs).
This includes type 1 diabetes, sickle-cell disease, and rheumatic and congenital heart diseases.
By equipping district and community hospitals with mid-level healthcare providers—such as nurses and clinical officers—who are specially trained to treat complex conditions, the model bridges a longstanding service delivery gap.
Importantly, PEN-Plus services are provided free of charge, significantly reducing the financial burden on families caring for chronically ill children.
Since 2022, when African Member States formally adopted the strategy, 20 countries have expanded their NCD service offerings using the PEN-Plus model.
Countries like Liberia, Rwanda, and Malawi have already documented improvements in patient access and outcomes, particularly among vulnerable populations.
Uniting Around an African Agenda
Held under the theme “Advancing Implementation of PEN-Plus for Severe NCDs in Africa: Technical Innovations, Operational Insights, and Scalable Solutions,” this year’s gathering served as a follow-up to the inaugural 2024 conference in Dar es Salaam.
It also represented a major step forward in aligning regional priorities ahead of the upcoming UN High-Level Meeting on NCDs in September 2025.
A key highlight was the endorsement of the African Agenda on NCDs, which outlines the continent’s shared vision, policy priorities, and global expectations.
With PEN-Plus positioned as a cornerstone strategy, leaders called for stronger domestic financing, improved medicine and diagnostic availability, and increased training for frontline providers.
“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.”
Progress and Persistent Gaps
Despite progress, conference participants acknowledged the urgent need for investment.
While many countries have adopted the model, access to insulin, diagnostic tools, and referral systems remains limited in rural and under-resourced districts.
In addition to infrastructure and supply issues, health systems must also address workforce shortages and expand the technical capacity of providers.
Countries are already responding with innovative strategies, such as tele-mentoring, mobile clinics, and integration with maternal and child health programs.
The PEN-Plus model, when properly supported, has the potential to shift the paradigm for managing chronic diseases that were long ignored in global health financing and delivery models.
The Partners
The Leona M. and Harry B. Helmsley Charitable Trust is a major U.S.-based philanthropic institution that supports health, science, and social impact programs globally.
Since 2008, it has committed more than $3 billion to initiatives that aim to expand access and equity, including its ongoing support for the PEN-Plus scale-up in Africa.
“We believe health systems should be able to serve all patients, not just the wealthy or the urban,” said James Reid, Programme Officer at the Helmsley Charitable Trust.
“PEN-Plus is one of the few models delivering on that promise at scale.”
The NCDI Poverty Network, another key partner, works to integrate noncommunicable disease interventions into broader poverty-reduction strategies. It provides technical support to governments, helps design data systems, and promotes inclusive policy planning.
Together with WHO AFRO, these partners support:
- The development of training materials.
- Facility assessments and on-site supervision;
- Peer learning platforms like the International Conference for PEN-Plus in Africa (ICPPA).
“Scaling up and investing in PEN-Plus will save and improve millions of lives,” added Reid.
“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.”
The Road Ahead: African-Led Health Innovation
With the 2025 goal approaching—targeting 50% of African countries rolling out PEN-Plus at the district level—the Abuja conference marked a turning point.
More than a technical model, PEN-Plus reflects a deeper shift in African health governance: solutions conceived on the continent, shaped by local realities, and championed by regional leadership.
As PEN-Plus continues to scale, it offers more than treatment for NCDs—it signals a new era in African public health, grounded in equity, innovation, and self-determination.
