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Non- Communicable diseases (NCDs), also known as chronic diseases, are diseases that are not transmitted from person to person. NCDs are of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.[1]

In the Africa region there are four main types of NCDs: cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. There are four main risk factors that predispose one to an NCD: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet. The factors acting singly or in combination, significantly contribute to common NCDs and other related conditions.[2]

In the year 2000, the WHO Africa Regional Office released a non- communicable diseases strategy for the region. The strategy pre-empted that NCDs might become the leading cause of morbidity and mortality by 2020 if no steps were taken to tackle them.[3]

Fast forward to 22 years later and this has come to pass with the WHO estimating that global deaths due to NCDs are likely to increase by 27% over the next 10 years in the Africa Region compared to a global increase of 17%. This shows a disproportionate rise in NCDs in Africa and it is estimated that it will cause 28 million additional deaths. This is made worse by the fact that communicable, maternal, perinatal and nutritional diseases still present a significant threat on the African continent.[4]

Africa has been compelled to analyse strategies that align with global and regional [5] efforts of building back better post-COVID with a view to restore country economies and strengthen their health systems. One of the health system casualties caused by the COVID-19 pandemic was a decline in seeking and access to care for NCD conditions. Patients’ access to cardiology clinics (for hypertensive and heart failure patients), diabetic clinics, oncology clinics (for cancer patients) and chest clinics declined during the pandemic due to lockdowns, the public’s fear of contracting COVID in a health facility, and closure of private health facilities due to diminishing client footfall.

One of these strategies is the launch of the New Public Health Order by the Africa Centres for Disease Control and Prevention (Africa CDC) in December 2021. With this order, there was a re-emphasis of people-centred health systems that are inclusive and equitable. This is especially true in bridging the gap in primary healthcare models that enabled the NCD clinics to be taken to where people are during the various COVID-19 waves. However, despite this progress, we must be cognizant of the fact that inadequate human resources for health is still an issue in our region. In this regard, the new public health order highlights the gaps in the number of healthcare workers as well the gaps in leadership and governance in healthcare which must be addressed in tandem.

To achieve all this, there is a need to ensure that current and future regional institutions and initiatives are functioning optimally and that regional efforts are decentralised to become country efforts. Initiatives must be embedded within primary healthcare structures of each country so that the intended benefits reach the most vulnerable in the hardest to reach areas in Africa. This can be attained by strong, high-level partnerships e.g. between private and public sector, another pillar highlighted by the order.

Now is the time for action and finding solutions on how we can overcome NCD challenges in the region from a primary healthcare lens. Unfortunately, we are already lagging in our set targets. A study by Tesema AG et al revealed that no African country has met all the recommended indicators to integrate NCD services into Primary Healthcare and that only 30% of African countries had nationally approved guidelines for NCD management as of October 2020 [6]. We must therefore increase our efforts to accelerate the reach of primary healthcare through our universal healthcare frameworks.

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