Where a child lives should never determine whether a child lives. Yet children with type 1 diabetes in rural areas of sub-Saharan Africa often die within a year of diagnosis. This tragedy is as medically unnecessary as it is unjust. No disease should be treatable in one country and yet a death sentence in another.
Noncommunicable diseases, which now represent the biggest gap in universal health coverage for the world’s poorest billion, have been identified as global health priorities. Yet policies and funding devoted to these diseases still focus almost entirely on those often linked to lifestyle-associated risk factors. This agenda effectively excludes the world’s most vulnerable populations, who suffer a heavy burden of noncommunicable diseases without preventable causes.
For the world’s poorest children and young adults, severe, chronic noncommunicable diseases lead to more than 560,000 avoidable deaths among each year. Just four conditions—type 1 diabetes, sickle cell disease, and rheumatic and congenital heart disease—account for as many as 100,000 of those deaths. These tragedies persist even though proven, cost-effective treatments for these diseases have long been routinely available in high-income countries—often for decades and, in the case of insulin, for more than a century.
Fortunately, there is a solution: PEN-Plus, an integrated care-delivery model that enables people living with severe, chronic, noncommunicable diseases to receive lifesaving care in settings of extreme poverty. Working with ministries of health in 22 resource-poor countries, the NCDI Poverty Network works to implement PEN-Plus programs in rural areas of sub-Saharan Africa and South Asia, where 90 percent of the world’s poorest live.
