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

摘要

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.