Justification

Non-communicable diseases (NCDs), including cardiovascular diseases, cancers, diabetes, chronic respiratory diseases, chronic kidney diseases, obesity and mental health disorders, are now a major public health challenge worldwide. According to the World Health Organization, they are the leading cause of death globally and are responsible for a growing proportion of premature deaths, particularly in low- and middle-income countries.

Africa is no longer spared from this dynamic. The region is experiencing an epidemiological transition characterized by a double burden of disease: the persistence of communicable diseases and the rapid increase of chronic diseases linked to demographic changes, accelerated urbanization, changes in dietary habits, physical inactivity, tobacco use and harmful alcohol consumption.

In the Democratic Republic of Congo (DRC), this transition is occurring in a context of a fragile health system, historically structured around combating infectious diseases and health emergencies. The progressive increase in hypertension, diabetes, obesity, strokes and certain cancers poses a major challenge, especially since these conditions are often diagnosed late, at a stage of disabling and costly complications. The lack of NCD-specific epidemiological surveillance systems limits the availability of reliable data to guide public policies. Furthermore, access to screening services, essential medicines and long-term follow-up remains unequal, particularly in rural areas.

These health challenges are compounded by important structural and socio-economic constraints. Health care financing still relies largely on direct household payments, exposing families to catastrophic expenditures and an increased risk of impoverishment. The management of chronic diseases requires continuous follow-up, regular examinations and lifelong treatment, which increases pressure on health systems and patients' financial resources. The deficit in qualified human resources, the lack of continuing education on NCDs and the insufficient integration of these conditions in primary health care also constitute major obstacles to an effective and sustainable response.

In this context, the advent and progressive implementation of Universal Health Coverage (UHC) represents a strategic opportunity to reposition NCD prevention and control at the heart of national priorities. Promoted by the World Health Organization within the framework of the Sustainable Development Goals, UHC aims to guarantee access for all populations to quality essential health services without financial difficulties.

Integrating NCDs into the UHC essential services package is essential for reducing premature mortality, preventing disabling complications and limiting inequalities in access to care. It involves strengthening primary health care, implementing effective primary prevention strategies (promoting healthy eating, fighting tobacco use, encouraging physical activity), early screening for risk factors, as well as improving the availability of medicines and basic technologies.

The prioritization of NCDs within the UHC framework is justified not only by their growing burden in terms of morbidity and mortality, but also by their major socio-economic impact. Chronic diseases reduce productivity, affect working-age populations and compromise national economic development. Investing in the prevention and integrated management of NCDs is therefore an essential lever for improving population health, strengthening equity and supporting sustainable growth. For the DRC and all African countries, meeting the challenge of non-communicable diseases in the era of Universal Health Coverage is no longer an option, but a strategic necessity to ensure harmonious and sustainable health, social and economic development.