WHO estimates that annual premature deaths from all noncommunicable diseases in Africa are projected to rise to
3.8 million by 2030 if urgent action is not taken.

The WHO Package of Essential Noncommunicable Disease Interventions Plus (PEN Plus) strategy addresses this by extending integrated chronic care for severe conditions to district hospitals. Building upon WHO PEN for common conditions at primary care level, PEN Plus decentralises care for Type 1 Diabetes, Rheumatic Heart Disease, sickle cell disease, and congenital heart diseases, conditions that previously required costly travel to distant tertiary facilities.