000			02940nam a22002657a 4500
001			20240611084340.0
003			20240611084340.0
005			20240611085643.0
008			240611b |||||||| |||| 00| 0 eng d
040			_cddc
041			_aEnglish
100			_qGodfrey A Kisigo
245			_aIntegrating HIV, hypertension, and diabetes primary care in Africa
260			_aMwanza, Tanzania : _b Catholic University of Health and Allied Sciences [CUHAS-Bugando] : _c2023
300			_aPages 01-03
300			_aIncludes References
490			_vwww.thelancet.com Vol 402 October 7, 2023
520			_a Hypertension and diabetes are to 2023 what HIV was to 2003—a global health crisis causing countless premature deaths and stunting global economic development with an epicentre in sub-Saharan Africa. There is good news: in the past two decades, astounding progress has been made in averting HIVrelated deaths globally. Proving wrong the pessimists who believed that HIV treatment would never be possible in Africa, we learned that the real problems were the unreasonably high cost of antiretroviral therapy and the low standard of care in primary care health systems.1 National governments partnered with global donors to build excellent, equitable HIV primary care systems where antiretroviral therapy is provided free of cost. The world set ambitious goals for HIV diagnosis (90% diagnosed), antiretroviral treatment (90% on treatment), and HIV viral load suppression (90% suppressed). Tremendous progress has been made towards those goals, particularly in Africa, with approximately 25 million premature deaths averted.2 However, a dramatic wave of non-communicable diseases (NCDs) in Africa threatens to reverse the health gains made by combating HIV. According to WHO global health estimates, NCDs accounted for 17 million premature deaths in 2019, and 86% of these premature deaths occurred in lower-income countries. NCDs are projected to be the most common cause of premature death in Africa by 2030.3 Once again, the problem in Africa appears to be related to primary care health systems, which are currently much weaker for NCDs than for HIV,4 resulting in disturbingly low rates of diagnosis, treatment, and control for NCDs.5 Once again, pessimists believe that NCD care will be too complicated and too costly. The obvious questions are what can be learned from the highly successful HIV programmes in Africa to address the growing problem of NCDs, and can we build on existing HIV infrastructure to address NCDs without compromising HIV programmes? These questions have been reverberating but, until now, we did not have the clinical trial evidence to answer them.6,7
600			_xHypertension
600			_xDiabetes
600			_xAfrica
700			_qRobert N Peck
856			_uhttps://doi.org/10.1016/S0140-6736(23)01884-6 _yhttps://doi.org/10.1016/S0140-6736(23)01884-6
942			_2ddc _cVM _n0
999			_c28049 _d28049