Managing multiple chronic diseases - commonly referred to as multimorbidity - has become an urgent challenge for healthcare systems globally. This challenge is even more pronounced in resource-limited settings with a high disease burden like South Africa, where non-communicable diseases often co-exist with other chronic health conditions.

Little is known about the prevention of multimorbidity at the population level in sub-Saharan Africa. Most clinical practice guidelines and healthcare training and delivery focus on single diseases, leading to care that is sometimes inadequate and potentially harmful. Effective multimorbidity interventions are complex and require multifaceted approaches.

A Cluster of Research Excellence (CoRE) on Multimorbidity has been launched by the African Research Universities Alliance (ARUA), in collaboration with The Guild of European Research-Intensive Universities (The Guild), as one of 20 newly formed clusters of research excellence. These CoREs will bring some of the best researchers from Africa and Europe together to address key societal and scientific challenges, framed by the African Union (AU)-European Union (EU) Innovation Agenda.

Research into this global public health challenge is being coordinated by two co-leads: one from ARUA (Prof George Obeng Adjei from the University of Ghana) and one from The Guild (Prof Paramjit Gill from the University of Warwick, UK). Six universities and research institutions from the two continents are involved as core partners. These include the University of Pretoria, Stellenbosch University and the University of Liberia from Africa, and King’s College London (UK), and Aarhus University and Copenhagen University Hospital (Denmark). Other partners are Last Mile Health (Liberia) and the University of Health and Allied Sciences, and the Princess Marie-Louise Children’s Hospital (Ghana).

Each institution will focus on research towards achieving the common goal, but addressing a focus area in which it has identified areas of research excellence. The University of Pretoria’s CoRE will be led by Prof Tivani Mashamba-Thompson, Deputy Dean: Research and Postgraduate Studies in the Faculty of Health Sciences. The focus of UP’s research aimed at optimising the development and implementation of multi-morbidity point-of-care diagnostics for resource-limited settings and underserved populations to improve health outcomes. Prof Mashamba-Thompson is globally recognised research leader in the field of point-of-care diagnostics, she is also a lead PI of REASSURED-d@UP research group at University of Pretoria.  This is a field in which it is a leader in the subcontinent.

Prof Mashamba-Thompson expressed her vision for this initiative, saying that it represents a crucial step towards addressing the complex challenges posed by multimorbidity, particularly in disease-burdened settings and resource-limited settings. “Our collaboration aims to bring collaborative cutting-edge research and innovation to the forefront of healthcare delivery, ultimately improving the lives of patients facing multiple chronic conditions and contributing to health systems strengthening.”

The CoRE will leverage digital technology and artificial intelligence to address key gaps in quantification, clustering, trend prediction and the evaluation of new interventions to improve diagnostics, safety and the effectiveness of interventions for the prevention, treatment and control of multimorbidity on the subcontinent.

It is well aligned with the Faculty’s research internationalisation and transformative research priorities, and will collaborate with research entities and groups at UP, governments, and industry and partner agencies to develop an enabling environment for universities in Africa and Europe. This will enhance the training of the next generation of healthcare practitioners across the spectrum of patient care for multimorbidity in all the partner countries.