Recognizing the roles of primary health care in addressing non-communicable diseases in low-and middle-income countries : lesson from Covid-19, implications for the future

Non-communicable diseases (NCDs), a leading cause of global morbidity and mortality, are key challenges to achieving the 2030 Sustainable Development Goals. Looking at trends over the years, the surge in NCDs is anticipated to continue, with the greatest impact on the poor and marginalized groups, mainly from low and middle-income countries (LMICs) [1]. During the COVID-19 pandemic, people with one or more underlying NCDs were particularly vulnerable given the increased risk of severe disease and death [2]. Despite being vulnerable, people living with NCDs (PLWNCDs) faced challenges meeting their health care needs, attributed to the preventive measures against COVID-19 such as physical distancing and nationwide lockdowns and restrictions, which further exacerbated their physical and mental health outcomes [1]. COVID-19 disrupted the regular health services as the demand for acute care surged and strained the already weak public health system of many countries, especially in those hardest-hit by COVID-19, such as India, Nepal, Bangladesh, Brazil, Iran, and some other LMICs, stretching them beyond their capacity. In fact, the pandemic in some LMICs contributed to a near collapse of health service delivery [1]. Given their increase vulnerability to COVID-19, although PLWNCDs required greater support and care to manage their conditions than ever before, overwhelmed health care systems failed to meet their needs