Co-managing the double burden: strategies for simultaneously tackling infectious and non-communicable diseases

Evidence increasingly shows close, bidirectional links between infectious diseases (IDs) and non-communicable diseases (NCDs). However, research, health policy, and prevention practices still largely address them in separate frameworks. This scoping review summarises the current evidence on the interconnections between IDs and NCDs and explores integrated strategies for their prevention and management.

This scoping review systematically searched PubMed, Web of Science, and Scopus for English-language systematic reviews and meta-analyses published between Jan 1, 2000, and April 20, 2026. Two reviewers independently screened eligible studies and extracted effect estimates for associations between IDs and NCDs. Evidence was grouped into two themes: associations between infectious agents and cancer, and the effects of NCDs on susceptibility to or severity of IDs.

From 5799 records identified, 41 meta-analyses or systematic reviews met the inclusion criteria. The included reviews showed associations between pathogen infections and specific cancers, including hepatitis B and C virus infections with liver cancer, human papillomavirus infection with cervical cancer, and Helicobacter pylori infection with gastric cancer. IDs were also associated with an increased risk or burden of NCDs, as illustrated by the association between tuberculosis and chronic obstructive pulmonary disease. Conversely, NCDs could affect susceptibility to and outcomes of IDs; patients with diabetes or cardiovascular disease had higher risks of severe disease or adverse outcomes following tuberculosis, influenza, or COVID-19 infection.

IDs and NCDs can interact through shared mechanisms, overlapping risk factors, and bidirectional pathways, underscoring the need for integrated strategies that combine prevention, early detection, treatment, and long-term management. At the public health level, this calls for health policies and financing mechanisms to move beyond disease-specific silos towards systemic frameworks that support integrated prevention and control, coordinated management, and cross-sectoral action.