The World Health Organization (WHO) is helping 20 African countries strengthen their fight against severe non-communicable diseases (NCDs) by expanding access to essential healthcare through the PEN-Plus strategy. This initiative represents a major step forward in addressing the growing burden of chronic illnesses like sickle-cell disease, type 1 diabetes, and rheumatic heart disease, which often go untreated in low-resource settings.

Launched with support from the Leona M. and Harry B. Helmsley Charitable Trust, the approach was detailed in the WHO Africa report titled “Understanding the PEN-Plus Approach to Care,” published on April 14, 2025. PEN-Plus is a decentralized healthcare model designed to bring life-saving services closer to underserved communities by equipping local facilities and training frontline health workers to manage complex NCDs.

This model is already proving effective in saving lives by bridging the healthcare gap in remote and rural areas of the WHO African Region, where access to specialized care is often limited or nonexistent. By empowering local health systems, PEN-Plus not only improves patient outcomes but also builds long-term resilience against chronic disease in some of the world’s most vulnerable populations.

Africa’s Increasing NCD Burden

In 2019 alone, 2.8 million fatalities were attributed to NCDs in the WHO African Region, which is equivalent to 7,900 deaths every day. NCDs currently account for 37% of all fatalities, up from 24% in 2000, although the region’s total death toll decreased from 8.7 million in 2000 to 7.8 million in 2019.

In sub-Saharan Africa, where diagnosis and treatment are limited, children and young people are disproportionately affected by severe NCDs, such as severe hypertension and persistent asthma. These illnesses cause avoidable fatalities in the absence of treatment, especially for those living in extreme poverty. The PEN-Plus model expands upon the WHO’s Package of Essential Non-communicable Disease (PEN) treatments by providing treatment for these potentially fatal illnesses at secondary-level healthcare facilities.

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PEN-Plus: A Game-Changer for NCD Care

PEN-Plus, which was first created in Rwanda, prepares clinical officers and nurses to diagnose, treat, and offer psychosocial support for severe non-communicable diseases. Rwanda, Malawi, and Liberia are just a few nations where the approach has demonstrated impressive effectiveness. More than 15,000 individuals received treatment in implementing nations through training for local healthcare personnel as of January 2025.

Over 440 physicians and nurses have been trained in Malawi due to the national scale-up, and more than 300 patients with severe NCDs are currently being treated in six secondary facilities. PEN-Plus tackles health inequities head-on by empowering mid-level practitioners, alleviating the burden on overworked hospitals, and bringing care closer to rural and underserved populations.

The importance of PEN-Plus as a model for sustainable health systems is emphasised in the report. More excellent investment and cooperation are needed to boost coverage and guarantee that NCDs remain a top health concern worldwide. Communities, funders, and policymakers can use the report to promote better healthcare infrastructure, especially in African Nations in the fight against severe non-communicable diseases. The model’s performance gives hope for improved outcomes for Africa’s most vulnerable populations by demonstrating the effectiveness of integrated, localised treatment in addressing complicated health issues.

By lowering the terrible toll of NCDs and increasing resilience to future health emergencies, sustained initiatives to expand PEN-Plus could revolutionise the region’s health environment.

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