Multimorbidity: time to stop defending our silos

Richards’s reflections on NHS England’s new major conditions strategy resonate with me.1 Most of the global burden of multimorbidity is now seen in low and middle income countries, in younger people and women.2 Here, responsibility for care lies with overstretched health systems that puts the strain on the NHS into perspective.The US Presidents Emergency Plan for AIDS Relief has been tackling HIV for two decades. The proportion of people over 50 on antiretroviral treatment (ART) is expected to exceed one third of the total by 2025. Many are now at risk of non-communicable diseases and have poor mental health. Yet less than 25% are treated for these conditions—a sobering thought given their frequent contact with services and largely favourable ART outcomes. The plan advocates for person centred care alongside ART, but the language is timid and stops short of recommending integrated care.3It’s hard to know how to shift to truly…
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