Introduction

Dear Friends,

Four years ago, a coalition of leaders representing nongovernmental organizations, governments, hospitals, philanthropies, universities, and communities joined forces to launch the NCDI Poverty Network. We pledged to work together with lower-income countries to address the unmet burden of severe, childhood-onset noncommunicable diseases (NCDs).

As documented by the Lancet Commission on Reframing NCDs and Injuries for the Poorest Billion, our agenda had historically fallen into a huge gap between the global NCD and child health movements. As a result, the burden of these devastating diseases was still being carried disproportionately by the youngest and poorest of the world.

Our commitment is what we now call the PEN-Plus Partnership, both a rallying cry and a coordinated, multi-sector effort to support countries’ progress in ensuring high-quality, fully integrated, person-centered care for people living with severe, chronic NCDs.

Our shared efforts across the Network to bring PEN-Plus interventions to everyone who needs them have already made rapid progress. Since 2020, the number of countries implementing PEN-Plus has grown from 4 to 15. Already more than 11,000 people are enrolled in PEN-Plus clinics. For nearly all those patients, the clinics represent the first time in their young lives they have had access to sustained, expert care for their condition.

In 2022, all 47 member states of the World Health Organization’s African Region endorsed PEN-Plus as their official strategy for reaching people living with severe NCDs. As early funders—including The Leona M. and Harry B. Helmsley Charitable Trust and Breakthrough T1D—expanded their support, the Network itself grew in reach and influence. Institutions such as UNICEF, the World Diabetes Foundation, St. Jude Children’s Research Hospital, the Foundation for Cardiovascular Care in Africa, and the American Heart Association have since added their support and expertise to this movement.

The strength, success, and sustainability of PEN-Plus interventions lie with country government leadership. At the same time, we recognize that systemic global inertia, human resource constraints, and financing challenges remain threats to meaningful progress toward care for children living with severe NCDs everywhere. These threats are most acute for the poorest countries.

This plan encapsulates the work that we, as nongovernment actors within the NCDI Poverty Network, will do together over the next crucial three years to address these threats and to meet the promise that is PEN-Plus. We invite you to join us in this transformative work.

With gratitude and optimism,

Dr. Gene Bukhman and Dr. Ana Mocumbi

Co-Chairs, NCDI Poverty Network


September 2024

A Proven Strategy

PEN-Plus is a package of clinical services that enables frontline providers in low-income health systems to provide care for people living with severe, chronic noncommunicable diseases that require complex and precise ongoing management, such as type 1 diabetes, sickle cell disease, and rheumatic and congenital heart disease.

PEN-Plus clinics change the lives of people with these conditions in rural settings. The clinics are decentralized and fully integrated into public health systems, so they bring affordable care closer to home. With well-managed care, patients and their families have more resources, time, energy, and hope to pursue their futures. For families living in deep poverty, the impact is transformative.

THIS IS THE PROMISE OF PEN-PLUS.