EU project BEACON-HD: TUM researchers develop innovative approaches to improve chronic disease care in Rwanda and Uganda

The Assistant Professorship of Behavioral Science for Disease Prevention and Health Care, headed by Prof. Dr. Nikkil Sudharsanan, is Coordinator and Lead-partner in the newly launched four-year Horizon Europe project “Building Equitable Health Systems through Telemedicine and Community-Based Models for Hypertension and Diabetes Care” (BEACON-HD). Together with eleven international partners from Rwanda, Uganda, Germany, the Netherlands, the United Kingdom, Greece, Serbia, and the United States, the project aims to strengthen primary healthcare systems in rural Rwanda and Uganda by improving care for people living with hypertension and type 2 diabetes.

Cardiovascular diseases are the leading cause of death among non-communicable diseases in Sub-Saharan Africa. Although effective treatments for hypertension and type 2 diabetes have long been available, many people do not receive adequate long-term care. In the rural project regions of Rwanda and Uganda, around 30–40% of adults aged 40 and older have hypertension, while fewer than 5% achieve controlled blood pressure. BEACON-HD aims to address these gaps by strengthening primary healthcare systems through patient-centered, scalable implementation strategies.

“The challenge is not developing a new treatment—we already know that effective medications for hypertension and diabetes exist. The challenge is making sure people can access these treatments and continue using them over the course of their lives,” explains Prof. Dr. Nikkil Sudharsanan.

The project focuses on two implementation strategies: telemedicine with self-monitoring and community medication delivery. Through telemedicine, patients regularly measure their blood pressure or blood glucose at home and transmit the results via mobile phone to healthcare providers. Clinicians can remotely review these data, identify patients requiring additional support, and provide follow-up care through a telemedicine platform that is being co-designed for rural Rwanda and Uganda. According to Prof. Sudharsanan, the platform is deliberately being developed for basic mobile phones rather than smartphones to ensure it can be used in the local context.

The second implementation strategy, community medication delivery, addresses one of the main barriers to continuous care. Community health workers collect prescription refills from primary healthcare facilities and deliver the medication directly within patients' communities. By building on the existing network of community health workers in Rwanda and Uganda, the strategy reduces long travel times and improves access to essential treatment.

A key feature of BEACON-HD is its participatory approach. Patients, community health workers, clinicians, health facility administrators, and government representatives will be involved throughout the project in adapting both implementation strategies. Stakeholder advisory groups and co-design workshops will help tailor the telemedicine platform and implementation procedures to the local context in rural Rwanda and Uganda. 

The effectiveness of the two implementation strategies will be evaluated through a large cluster-randomized trial involving nearly 2,000 patients in each country. Rather than testing the interventions under laboratory conditions, the study will implement them directly within routine primary healthcare services in rural Rwanda and Uganda. Researchers will assess clinical outcomes, such as improvements in blood pressure and blood glucose control, alongside implementation and health system outcomes to evaluate how the interventions perform under real-world conditions.

Beyond evaluating effectiveness, BEACON-HD places a strong emphasis on long-term sustainability and policy uptake. Throughout the project, the consortium will work closely with local stakeholders and national governments to support the adoption of successful approaches. Implementation guides, policy recommendations, digital resources, and training materials will be developed to facilitate the long-term integration of the interventions into public healthcare systems.

“Our goal is not simply to publish scientific papers. We want to develop solutions that are affordable, scalable, and can actually be adopted within health systems,” says Prof. Dr. Sudharsanan. “If the approaches prove successful in Rwanda and Uganda, they could also serve as a model for improving chronic disease care in other countries across Sub-Saharan Africa.”

By combining expertise in behavioral science, implementation science, digital health, health economics, and public health, BEACON-HD aims to generate evidence that contributes to stronger, more equitable healthcare systems and supports progress toward universal health coverage.

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Contact

Prof. Dr. Nikkil Sudharsanan
Rudolf Mößbauer Assistant Professorship of Behavioral Science for Disease Prevention and Health Care
Am Olympiacampus 11
80809 München

phone: 089 289 24990
e-mail: nikkil.sudharsanan(at)tum.de

Text: Bastian Daneyko
Photos: Private/Andreas Heddergott