UGANDA — In a significant move towards holistic healthcare, Uganda is spearheading a program to seamlessly integrate the management of noncommunicable diseases (NCDs) into HIV services.

This innovative initiative allows individuals living with HIV to address comorbidities such as hypertension, diabetes, and cervical cancer within the same healthcare facility where they receive HIV management.

Noncommunicable chronic diseases, encompassing conditions like cancers, cardiovascular diseases, diabetes, and chronic lung illnesses, are characterized by long-term health consequences, necessitating extended treatment and care. Globally, NCDs stand as the leading cause of death and disability.

Uganda, with over 1.4 million HIV-positive individuals, faces a significant overlap, as diabetes accounts for 5.8% of this population, ranking among the primary causes of death within this group. In the broader context, NCDs contribute to 36% of all deaths in the country annually.

Recognizing the urgent need to address the looming threat of diabetes, a program integrating NCD care into HIV services was initiated in 2019.

This collaborative effort involves the Ugandan government, the World Health Organization (WHO), the United Nations Development Programme, and the United States President’s Emergency Plan for AIDS Relief.

Notably, over US$6 million has been mobilized to expand the program’s implementation in 2022 and 2023.

These combined efforts, coupled with enhanced access to HIV treatment, have yielded promising results, reflected in a decline in HIV-related deaths from 24,245 in 2017 to 16,450 in 2023.

Dr. Noella Owarwo, Deputy Director of the Infectious Diseases Institute, highlights the positive impact on diabetes-related complications, emphasizing early detection and timely management as key contributors to this success.

Mable Azairwegye, an HIV and diabetes patient receiving care at the Infectious Diseases Institute, expressed satisfaction with the services provided under the noncommunicable disease/HIV initiative.

This program is adept at managing NCDs prevalent among HIV patients and is operational across the country’s 1800-plus HIV treatment centers.

These centers are equipped to screen for and manage conditions such as cervical cancer, diabetes, and hypertension.

Dr. Hafisa Kasule, WHO technical officer overseeing noncommunicable diseases, underscores the imperative of scaling up this intervention universally, emphasizing the ongoing need for sustained investment.

Dr. Franck Mugabe, Principal Medical Officer for Noncommunicable Diseases at the Ministry of Health, highlights the successful implementation of WHO guidelines and tools, resulting in a nearly one-third reduction in HIV-related deaths since 2017.

However, challenges persist in the program’s implementation, including the need to ensure widespread access to medication, continuous education on chronic diseases, encouragement for regular screening, promotion of treatment adherence, reduction of stigma, and the adoption of a healthy lifestyle.

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