Strengthening non-communicable disease health systems through sustainable health partnerships in the Horn of Africa using lessons from the Wolverhampton-Somaliland Global Health Partnership.

Non-communicable diseases (NCDs) are rapidly emerging as major causes of morbidity and mortality across the Horn of Africa, compounding persistent infectious diseases, humanitarian crises and fragile health systems. This Perspective examines how sustainable, nationally led health partnerships can strengthen health systems to address this growing burden. Drawing on regional evidence and the Wolverhampton-Somaliland Global Health Partnership as an illustrative case study, it argues that partnership effectiveness depends on local ownership, institutional capacity strengthening, integration within primary health care, reliable data systems and sustainable financing. Although partnerships have supported governance, workforce development, service integration, access to medicines and surveillance, many remain fragmented, donor-dependent and insufficiently embedded within national systems. The case study demonstrates how these principles have been translated into implementation activities within a fragile and resource-constrained setting, while acknowledging that their long-term impact remains to be evaluated. Future NCD partnerships should therefore be developed as nationally aligned, long-term health-system-strengthening platforms capable of supporting resilience in fragile and crisis-affected settings.