Brigham and Women’s Hospital announces a $16 million grant from The Leona M. and Harry B. Helmsley Charitable Trust to support the implementation and evaluation of an integrated service delivery model (PEN-Plus) for severe chronic noncommunicable diseases (NCDs) such as type 1 diabetes, rheumatic heart disease, cardiomyopathies, and sickle cell disease in eight low- and lower-middle-income countries in sub-Saharan Africa and South Asia.
“We’re grateful to the Helmsley Charitable Trust for investing in this crucial effort to improve healthcare delivery and global health policy for those who have been historically underserved and live in poverty with severe chronic diseases,” said Robert S.D. Higgins, MD, MSHA, president of the Brigham and executive vice president at Mass General Brigham.
PEN-Plus builds on the World Health Organization's Package of Essential Noncommunicable Disease Interventions (PEN) to enable nurses and other mid-level providers to deliver services such as echocardiography, insulin administration, hydroxyurea, anticoagulation, and heart failure management at intermediate-level facilities such as district hospitals in poor, rural areas. The initiative aims to enable an additional one million of the world's poorest children and young adults to receive high-quality care for severe chronic NCDs by 2030.
Gene Bukhman, MD, PhD, an associate physician in the Brigham’s Divisions of Global Health Equity and Cardiovascular Medicine, and Ana Olga Mocumbi, MD, PhD, of Universidade Eduardo Mondlane (UEM) in Mozambique, will lead these efforts. Bukhman and Mocumbi co-chaired the Lancet NCDI Poverty Commission and now serve as co-chairs of the NCDI Poverty Network Steering Committee. They also lead the Secretariat of the Network, a joint effort of the Brigham, Harvard Medical School, Partners In Health, and UEM, with hubs in Boston and Maputo, Mozambique. With this funding, Bukhman and his colleagues will also launch the Center for Integration Science in Global Health Equity, based at the Brigham, which will provide an institutional home for the NCDI Poverty Network Secretariat.
“This grant from Helmsley is truly unprecedented and transformative,” Bukhman said. “Right now, less than $100 million—or just 0.3 percent of global health spending—is allocated to noncommunicable diseases in countries where the world’s poorest billion people live. It’s past time that we form a global movement to better serve people doubly afflicted by NCDs and extreme poverty.”
This grant will also support select efforts of the NCDI Poverty Network, a group of 21 lower-income countries that was formed in December 2020 to implement the recommendations of the Lancet Commission on Reframing NCDs and Injuries (NCDI) of the Poorest Billion (Lancet NCDI Poverty Commission). As of 2022, 14 of the 21 countries in the NCDI Poverty Network will be initiating or expanding PEN-Plus strategies, with the remaining seven countries working towards implementation. Helmsley supported an earlier phase of work by the NCDI Poverty Network and a first wave of PEN-Plus expansion through an $8 million grant.
“At Helmsley, we have seen first-hand how PEN-Plus facilities can decentralize critical care, build local capacity, and save lives,” said James Reid, Program Officer for Helmsley’s Type 1 Diabetes Program. “As the COVID-19 pandemic continues to exacerbate health inequities and underscore the urgent need to manage underlying NCDs, I believe that PEN-Plus is a timely, effective way to integrate services and create safer healthier communities.”