“The next generation of global solidarity must be more strategic, more efficient, and more country-driven. The dialogue begun many years ago, globally recognized at the United Nations High-Level Meeting on Non-Communicable Diseases, and carried on in these pages is a wonderful start, but we have much work to do in creating a future in which the greatest risk factor for dying of a non-communicable disease is not where one is born.” Hon. Minister Agnes Binagwaho, Minister of Health, Government of Rwanda
Meeting the Challenge of NCD: We Cannot Wait, Global Heart (2012)
Goals of the partnership with NCD Synergies
Building off of years of collaboration between the Rwanda Ministry of Health and Partners In Health, NCD Synergies supported a Senior Management Consultant from 2015-2017 to support the NCD Division at Rwanda Biomedical Center in strategic and operational planning work. NCD Synergies continues to work in collaboration with the Rwanda Ministry of Health, Rwanda Biomedical Center, and PIH’s sister site in Rwanda, Inshuti Mu Buzima (IMB) to support technical assistance through the National NCDI Poverty group and other mechanisms.
- In July 2013, the Rwanda Ministry of Health hosted the inaugural NCD Synergies conference in Kigali, Rwanda, which officially launched the NCD Synergies Network. At the 2013 NCD Synergies Conference in Kigali, Rwanda, more than 170 health officials from 18 ministries of health and numerous partner organizations discussed how to expand access to treatment for NCDs to all people in low-income countries, including the very poor.
- Since 2013, the Rwanda Ministry of Health and Rwanda Biomedical Center have shown impressive national leadership in NCD national planning and service delivery and have hosted key meetings for the NCDI Poverty network, including an East Africa Learning Collective meeting in Kigali focused on integrated care teams for severe, chronic NCDs at first-level hospitals in March 2018, and the 2nd in-person meeting of the global Lancet NCDI Poverty Commission in September 2016.
- Rwanda established a National NCDI Poverty Commission in March 2017 and continues to make progress in assessing Rwanda’s NCD and injury burden and country-level fiscal space.
- Through support from the Helmsley Charitable Trust from 2014-2020, PIH Rwanda and NCD Synergies have been working closely with the Rwanda Ministry of Health and partners such as the Rwanda Diabetes Association on scale-up of district hospital-level services for severe, chronic NCDs such as type 1 diabetes.
Rwanda NCDI Poverty Group
In March 2017, Rwanda established a national NCDI Poverty Group, focused on national priority-setting for NCDs in settings of poverty. The group has been reviewing Rwanda-specific disease burden data across NCDs and injuries and has been assessing country-level fiscal space.
Dr. Jeanine Condo, the Director General of the Rwanda Biomedical Center, and Jean Pierre Nyemazi, the Permanent Secretary of Health of the Republic of Rwanda, chair the group. Dr. Condo and Dr. Nyemazi are joined by fifteen other national experts spanning the Rwandan government, implementing organizations, and researchers.
The story of NCDs and injuries in Rwanda
Rwanda is a country of 11 million people in East Africa that has achieved impressive health gains in the past two decades. Compared to 1990 figures (pre-genocide), the life expectancy has nearly doubled, and HIV / AIDS, tuberculosis, maternal and under 5 mortality rates have dropped by two-thirds.
Health leaders in Rwanda are global champions for extending Rwanda’s overall health system successes to the realm of NCDs and injuries. All Rwandans have access to universal health coverage, provided by a trained workforce of over 45,000 community health workers, 8,500 nurses, and 600 physicians. The NCD Unit has successfully implemented several national programs targeting NCDs and injuries, spanning screening, referral and treatment.
Effective treatment for NCDs must be provided at the community and district levels, and must respond to the double burden of NCDs and poverty faced by many patients. Data, including preliminary review of the 2013 STEPS survey, illustrates that prevalence of lifestyle risk factors may not explain the total burden of NCDs in Rwanda. Thus draft Rwandan NCD strategies recognize the need to make treatment for dozens of NCDs available to all populations – including the poorest and hardest to reach.