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Health Aff (Millwood). 2015 Sep;34(9):1506-13. doi: 10.1377/hlthaff.2015.0382.

Noncommunicable Diseases In East Africa: Assessing The Gaps In Care And Identifying Opportunities For Improvement.

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Trishul Siddharthan ( is a Fogarty Global Health Fellow in Kampala, Uganda, and a fellow in the Department of Pulmonary and Critical Care at the Johns Hopkins University, in Baltimore, Maryland.
Kaushik Ramaiya is a lecturer at Muhimbili University of Health and Allied Sciences, in Dar es Salaam, Tanzania.
Gerald Yonga is head of the NCD Research to Policy Unit in the Department of Internal Medicine at Aga Khan University, in Nairobi, Kenya.
Gerald N. Mutungi is the head of the Noncommunicable Diseases Prevention and Control Program at the Ministry of Health, in Kampala, Uganda.
Tracy L. Rabin is an assistant professor in the Department of Internal Medicine at the Yale School of Medicine, in New Haven, Connecticut.
Justin M. List is a Robert Wood Johnson Foundation/VA Clinical Scholar and clinical lecturer in the Department of Internal Medicine at the University of Michigan, in Ann Arbor.
Sandeep P. Kishore is a fellow in the Human Nature Lab at Yale University.
Jeremy I. Schwartz is an assistant professor in the Department of Internal Medicine at the Yale School of Medicine.


The prevalence of noncommunicable diseases in East Africa is rising rapidly. Although the epidemiologic, demographic, and nutritional transitions are well under way in low-income countries, investment and attention in these countries remain focused largely on communicable diseases. We discuss existing infrastructure in communicable disease management as well as linkages between noncommunicable and communicable diseases in East Africa. We describe gaps in noncommunicable disease management within the health systems in this region. We also discuss deficiencies in addressing noncommunicable diseases from basic science research and medical training to health services delivery, public health initiatives, and access to essential medications in East Africa. Finally, we highlight the role of collaboration among East African governments and civil society in addressing noncommunicable diseases, and we advocate for a robust primary health care system that focuses on the social determinants of health.


Chronic Care; Determinants Of Health; Disparities; Health Promotion/Disease Prevention; International/global health studies

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