Liberia: Liberia Benefits Pen-Plus Strategy to Treat Sickle Cell, Diabetes, and Heart Diseases


Liberia is along with Malawi and Haiti to benefit from a Partner in Health and the World Health Organization’s medical program, called the Pen-Plus Strategy.

The aim of the Strategy is to ensure Africans living with severe non-communicable diseases (NCDs) like Type 1 Diabetes, Rheumatic Heart Disease, and Sickle Cell diseases will have access to lifesaving medicines and care.

According to a recent press release, the strategy which was first developed by Partners in Health and Rwanda’s Ministry of Health, used the PEN-Plus model and focused on training providers, securing medicines and equipment, and coordinating pathways to expand local Non- Communicable Diseases (NCD), care so it is accessible to the most vulnerable. And 47 African member states that have adopted the new strategy PEN-Plus program, is a model proved successful in Rwanda that the Ministry of Health expanded it to every district hospital in the country, and the PIH worked with ministries of health to initiate PEN-Plus services in Malawi, Liberia and Haiti.

Speaking in an interview, via mobile regarding the program, Dr. Gene Bukhman, Associate Professor at Harvard Medical School and Director of the Center for Integration Science at Brigham and Women’s Hospital, said the organization that is supporting the Ministry of Health with PEN-Plus implementation in Liberia is the non-governmental organization, Partners in Health. And globally, the PEN-Plus Partnership is an initiative of the NCDI Poverty Network (Non-communicable Disease and Injuries of Poverty Network).

“Liberia is one of the leading countries in Africa and has already started to establish training sites for nurses who are providing the Pen-Plus services in Maryland County in Liberia. So we developed this strategy to support nurses and clinical officers. The Pen-Plus program is a big strategy to get treatment to people living with severe non-communicable diseases like Type One Diabetes, Sickle cell Disease and dramatic health disease, who do not have access to treatment in rural areas.”

Dr. Bukhman said generally, the diseases which are not curable, but with medical treatment, people can live long and healthy lives and people with sickle cell can live much longer with the right medication.

“In Liberia, there is something to diagnose sickle cell, and once the problem is diagnosed, it is reported and that person is treated. Pen-Plus program is particularly in rural areas where people can get treatment once they are diagnosed, because it goes very well with screening,” he said     

He said the government of Liberia has developed plans and outlines in how to use the training facilities to provide the same services in other parts of Liberia, but Liberia will need more resources to be able to go beyond Maryland County.

However, expanding beyond Maryland will depend on Liberia to mobilize new resources to support expansion.

“This is a great opportunity, because Liberia is one of the countries who over the last few years have developed the strategy and the training sites to expend Pen-Plus services. Liberia is very much ready to go beyond Maryland County, but she needs the resources, and we hope that will happen in a very short period,” he said. 

Estimating how much in terms of dollars and cent would be needed to facilitate a Pen-Plus Center in other rural counties, Dr. Bukhman said to technically operate a clinic like that of the Pen Plus yearly, it will roughly be between US$50,000 to 100,000 for about 500 to 1000 patients with severe conditions, what he calls the operating cost.

“This includes the electricity of the building; the up-keep of staff and medication. Starting a new clinic also includes construction of buildings and the buying of new equipment which will be around US$15 to 20,000 of that amount.”     

Dr. Bukhman is a Cardiologist and Medical Anthropologist, who has been focused on global non-infectious disease policy and programs for the past 20 years.

The press release further said that in sub-Saharan Africa, severe NCDs remain a virtual death sentence for children and young adults who don’t have access to the same standard, cost-effective treatments that are routinely available in high-income countries. As early as 2013, African ministries of health have been calling for scalable approaches to address severe NCDs. Now, the Helmsley Charitable Trust, UNICEF, and other global health funders have supported its expansion to eight other countries in Africa. And with this week’s vote, Member States are committed to region-wide adoption.