Shifting HIV care to community-based systems in sub-Saharan Africa reveals systemic gaps in NCD integration
Original framing: “[Comment] Moving integrated care into the community in sub-Saharan Africa” — The Lancet
Scientific evidence supports the effectiveness of integrated care models in managing both communicable and non-communicable diseases. Studies show that integrating NCD services into existing HIV programs can improve patient outcomes and reduce costs. However, implementation success depends on adequate training, infrastructure, and policy support.
The transition from vertical HIV programs to integrated care in sub-Saharan Africa is not just a technical challenge but a systemic one, rooted in historical patterns of health governance and colonial infrastructure.
Indigenous knowledge systems and community-based models offer alternative pathways that align with the region’s cultural and social realities. By integrating traditional health practices, strengthening primary care, and leveraging digital tools, African health systems can better address the dual burden of HIV and NCDs. This requires not only policy reform but also a shift in power dynamics that center local voices and knowledge in health decision-making. Drawing on successful examples from other low-income countries, sub-Saharan Africa can build a more resilient, inclusive, and sustainable health system for the future.