Integrated Public Health and Health Service Delivery for Non-Communicable Diseases and Comorbid Infectious Diseases and Mental Health

Authors: Matt Magee, Mohammed Ali, Dorairaj Prabhakaran, Ajay Vamadevan, KM Venkat Narayan

Abstract:

This chapter uses the example of diabetes as a prototypical noncommunicable disease, and highlights the urgent need for integrated approaches to addressing three key comorbidities in patients with diabetes—mental health disorders, tuberculosis, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS)—by (1) exploring the epidemiology of joint burdens, risk factors, and prognoses of these co-occurring conditions; (2) summarizing the available evidence; and (3) addressing the challenges of integrating public health and services for persons jointly affected by diabetes and the three comorbidities. National health programs and public health agencies need to address this need, but funding gaps will likely arise, and identifying additional resources will prove challenging. Funding agencies historically committed to the control of infectious diseases also need to promote efforts to gather data, implement interventions, and test integrated prevention and treatment programs for both communicable and noncommunicable diseases. Expanding the growing list of global health priorities to include the integration of care will likely lead to primary prevention, improved disease prognosis, and enhanced knowledge regarding implementation sciences and health care delivery.