11 1 General Introduction The role of HIV in propagating the TB epidemic in Sub-Saharan Africa and other regions of the world is well documented. It constitutes the most important driver of TB disease and poor treatment outcomes in the last decade [8–10]. People living with HIV have increased susceptibility to TB relapse and new infections, delayed sputum conversion and poor treatment outcomes [9]. The rollout of antiretroviral therapy (ART) in most Sub-Saharan African countries and improvement in TB infection prevention and treatment services has contributed to a noted decline in new TB infections [11,12]. Increasing Diabetes Mellitus Burden in Low- and Middle-Income Countries Non-communicable diseases (NCDs) surpassed infectious diseases as the most common cause of death globally. An estimated 41 million people die from NCDs (74% of all deaths) annually, with 77% of all NCD-related deaths occurring in low- and middle-income countries (LMICs ) [13] (Figure 2). Similarly, about 86% of 17 million people who die prematurely annually (before age 70) are from LMICs [13]. Most of these NCD-related deaths are from cardiovascular diseases (44%), cancers (23%), chronic respiratory diseases (10%) and diabetes (5%) [13]. Physical inactivity, unhealthy diet, smoking, alcohol, overweight and obesity, elevated blood pressure and uncontrolled blood glucose are known risks of NCDs [13–15]. War and political instability, insecurity, lack of infrastructure for physical activities, natural disasters, and air pollution are external factors contributing to increased NCD prevalence and death in LMICs, particularly in Sub-Saharan Africa [16–18].
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