Global Access to Diabetes Care


WASHINGTON, D.C. — Clinically silent, Type I diabetes dramatically cut the life span of children in the early 20th century. By 1921, however, the introduction of insulin lifted this death sentence. Insulin, a hormone allowing glucose to enter cells, offered unprecedented protection to diabetics living in developed countries.

Africa faces two surmountable but neglected issues related to diabetes. Developing countries in Africa lack the financial resources to manage the disease. Mali, Mozambique and Zambia lack the funds, supplies and medical professionals to manage diabetes. These countries subsequently bear a majority of this burden. Lack of insulin remains the most common cause of death in children with diabetes.

Wealthier African countries also need assistance with diabetes management. Citizens often live with more financial security in these countries. And as a result, relief organizations concentrate funding the more impoverished countries. This neglects the needs of the more developed nations such as South Africa, Kenya and Nigeria.

Those in the field of development assume wealth translates to self-sufficiency. However, these wealthier countries do not have the outlets to properly use supplies. A study in Nigeria surveyed diabetics on the use of insulin — 61.1% scored “below average.” For instance, a majority did not know vomiting could be a sign of ketoacidosis or that heavy exercise stands as the leading cause of an insulin reaction.

Funds severely limit progress in both developing and developed African nations. Josip Car, a clinical lecturer on primary care, offers a cost comparison of living with diabetes in African to that of living with it in Britain. Car notes the rising costs of living with the disease in Britain. The number of prescriptions, including medicines and monitoring, increased by more than 300% from 1991 to 2004.

The total expenditures rose an alarming 650%. Insulin contributes the most to this growing cost.

In affluent nations, these high costs burden patients and the healthcare system. If patients in Britain cannot pay the high cost of treatment, how can diabetics in less developed countries?

The International Diabetes Federation (IDF) strives to alleviate this burden, as it aims to “promote diabetes care, prevention and a cure worldwide.” This federation establishes a network of knowledge by directing international press attention to the disease, as well as lobby national governments for increased funding.

Ann Keeling, CEO of the federation, spoke earnestly in interview with the Diabetes Hands Foundation. In this interview, she spoke on the importance of the upcoming United Nations Summit on Non-Communicable Diseases (NCD.) Limited global recognition means “sleepwalking into a sick future.”

More than 300 million people live with diabetes worldwide, and Keeling estimates this number will rise to 500 million by 2025. To combat this growing epidemic, the IDF and other relief organizations need heads of state to lead more policy changes.

At the Summit on Noncommunicable Diseases, the IDF reported great progress. The 193 member states unanimously voted to adopt the Political Declaration on NCD Prevention and Control. This declaration commits to position diabetes and other noncommunicable diseases at the top of the global health agenda.

Diabetics from Britain to Africa face a range of barriers. Today, the high cost of treatment, the unequal access to insulin and limited understanding of the health risks threaten the lives of diabetics. Enforcement of the declaration helps stem this growing epidemic, promising healthy management of diabetes worldwide.

– Ellery Spahr

Sources: Canadian Medical Association Journal, Journal of Diabetes and Metabolic Disorders, International Diabetes Federation, American Diabetes Association
Photo: Roche


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