Tackling an emerging epidemic: the burden of non-communicable diseases among people living with HIV/AIDS in sub-Saharan Africa

Pan Afr Med J. 2020 Aug 12:36:271. doi: 10.11604/pamj.2020.36.271.22810. eCollection 2020.

Abstract

Sub-Saharan Africa (SSA) is at a crossroad. Over the last decade, successes in the scale up of HIV care and treatment programs has led to a burgeoning number of people living with HIV (PLHIV) in care. At the same time, an epidemiologic shift has been witnessed with a concomitant rise in non-communicable diseases (NCD) related morbidity and mortality. Against low levels of domestic financing and strained healthcare delivery platforms, the NCD-HIV syndemic threatens to reverse gains made in care of people living with HIV (PLHIV). NCDs are the global health disruptor of the future. In this review, we draw three proposals for low and middle-income countries (LMICs) based on existing literature, that if contextually adopted would mitigate against impending poor NCD-HIV care outcomes. First, we call for an adoption of universal health coverage by countries in SSA. Secondly, we recommend leveraging on comparably formidable HIV healthcare delivery platforms through integration. Lastly, we advocate for institutional-response building through a multi-stakeholder governance and coordination mechanism. Based on our synthesis of existing literature, adoption of these three strategies would be pivotal to sustain gains made so far for NCD-HIV care in SSA.

Keywords: HIV; non-communicable diseases; sub-Saharan Africa.

Publication types

  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / economics
  • Acquired Immunodeficiency Syndrome / epidemiology*
  • Acquired Immunodeficiency Syndrome / therapy
  • Africa South of the Sahara / epidemiology
  • Delivery of Health Care / economics
  • Delivery of Health Care / organization & administration
  • Developing Countries
  • HIV Infections / economics
  • HIV Infections / epidemiology*
  • HIV Infections / therapy
  • Humans
  • Noncommunicable Diseases / economics
  • Noncommunicable Diseases / epidemiology*
  • Noncommunicable Diseases / therapy
  • Universal Health Insurance