Integrating non-communicable disease care into primary health systems in the Horn of Africa: opportunities and challenges

Non-communicable diseases (NCDs) account for nearly three-quarters of global mortality, with low-income and middle-income countries (LMICs) bearing the greatest share of premature deaths. Sub-Saharan Africa, long characterised by a predominance of communicable diseases, is undergoing a rapid epidemiological transition, resulting in a persistent double burden of disease. The Horn of Africa—comprising Ethiopia, Somalia (including the self-declared Republic of Somaliland), Djibouti, and Eritrea—illustrates this transition, as rates of cardiovascular disease, diabetes, cancer, and chronic respiratory disease rise amid fragile health systems, conflict, displacement, and food insecurity.