World Diabetes Day is celebrated each year to draw attention to issues of utmost importance to the diabetes world. This year's focus is a topic close to the heart of anyone active in the diabetes community, regardless of where they live: ‘Access to Diabetes Care’.
World Diabetes Day takes place every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1921. A hundred years after the discovery of insulin, ‘Access to Diabetes Care’ is one of the biggest challenges in managing this chronic condition around the globe.
While people with diabetes need ongoing care, millions of them do not have access to fundamental components required for proper treatment to reduce the risk of serious complications. But what does access to diabetes care mean? “Access to diabetes care can mean so many different things depending on people's personal situation and the region they live in. It can quickly become a life-threatening situation when a person with diabetes doesn't have what they need and that is unfortunately still the case for many, around the world” says Kyle Jacques Rose, Vice President at the International Diabetes Federation (IDF) that initiates World Diabetes Day each year.
If not now, when?
World Diabetes Day is a unique opportunity to raise awareness and drive change for the more than 460 million people living with diabetes1 and the millions more at risk1. Change is much needed, as the following statistics show:
Over 700 million people are expected to be living with diabetes by 20452
3 in 4 people with diabetes live in low and middle-income countries2
50% of all people living with diabetes are undiagnosed2
1 in 2 people who need insulin cannot access or afford it2
“Facts & Figures.” World Diabetes Day, International Diabetes Federation, https://worlddiabetesday.org/about/facts-figures/.
“Infographics.” World Diabetes Day, International Diabetes Federation, https://worlddiabetesday.org/resources/wdd-2021/infographics/.
Need for a holistic approach
The availability of medication and the opportunity to consult healthcare professionals are perhaps the most obvious aspects. But access also includes devices to manage therapy, like blood glucose monitoring systems with all the necessary equipment and supplies, as well as ongoing education and psychological support for people with diabetes. Last but not least, people need access to healthy food and a place for physical activity.
While not everything may be perfect in Europe or North America, people in low- and middle-income countries face very different challenges. In India, for example, 80 % of the population, more than one billion people, do not have access to modern health care1. Out-of-pocket medical expenses are 63 %2 versus a world average of 18 %3. This situation is by no means unique to India but occurs across other countries in South Asia, sub-Saharan Africa, and some parts of Latin America as well.
Big, complicated and diverse
Lack of infrastructure and financial struggles only represent the tip of the iceberg. Or as Dr. Sana Ajmal, Executive Director of Meehti Zindagi, a non-profit organisation providing insulin, test strips and peer support for people living with diabetes in Pakistan, brings it to the point: “The problem of access is big, complicated and diverse.” Sana Ajmal was one of the speakers at the #DiabetesMeetUp hosted by Roche Diabetes Care and mySugr to enable the exchange among influencers from the international diabetes community. Leading up to World Diabetes Day this year´s influencer event focussed on the topic of access to diabetes care in all parts of the world. The stories Sana Ajmal shared about children living with type 1 diabetes in Pakistan highlighted only some of the challenges they face in managing their condition. These range from limited public support and lines at dispensaries that cost a full day's work, to availability issues and being unable to attend school due to their condition.
Mihai Irimescu, Cluster Head Asia Emerging Markets at Roche Diabetes Care, knows first-hand that the reasons for poor access to diabetes care in this region are many. Prevention of diabetes and related complications, diagnosis, and self-monitoring of blood glucose are often not considered essential parts of the healthcare systems. There is a lack of awareness and education, as well as stigmatisation associated with chronic diseases and a bias towards traditional medicine. “But there is hope. Especially when stakeholders come together, things can happen.”
The power of partnerships
“We at Roche believe in the power of partnerships”, states Mihai Irimescu at the #DiabetesMeetUp. “We work in various capacities with many different partners to reduce barriers that prevent people from being diagnosed and to make our devices and support available. Our approach is to develop local solutions, in partnership with local stakeholders, tailored to local needs, to provide sustainable improvements in health and in healthcare. Our aim is for every person living with diabetes who needs our solutions to be able to access and benefit from them in their daily therapy management. Ultimately, I am convinced that if we can share best practices from one country to another, access to diabetes care will improve.”
Roche supports a number of programs aimed at making lasting improvements in local capabilities and helping in developing sustainable healthcare systems. One example of a signature project is ‘Changing Diabetes in Children’, a public-private partnership for improving the lives of children with type 1 diabetes in low-resource settings. Established in 2009 by Novo Nordisk, it is supported by the World Diabetes Foundation (WDF), the International Society for Pediatric and Adolescent Diabetes (ISPAD) and Roche.
Changing Diabetes in Children has now passed a historic milestone reaching 30,000 children across 18 countries and will continue to push forward to even higher aims. “The program's vision and ambition are straightforward”, says Vinay Ransiwal, General Manager and Vice President for Novo Nordisk Middle Africa at the #DiabetesMeetUp: “No child should die from diabetes. Our journey has only just begun. We want to take this program to more than 100.000 vulnerable children and adolescents across the globe by 2030.”
Roche will continue to be part of this journey. Pedro Goncalves, Head of Global Commercial Organisation Roche Diabetes Care, highlights the company's role in this context: “As a global leader in integrated personalised diabetes management, we see it as our responsibility to ensure the development and the implementation of sustainable care providing access to therapy solutions as well as extensive diabetes awareness and education. And we do this in low- and middle-income countries equally as well as in mature countries. People can count on us as a partner.”
Key Indicators of Social Consumption in India: Health, Government of India: Ministry of Statistics and Programme Implementation: National Statistical Office, Nov. 2019, http://mospi.nic.in/sites/default/files/publication_reports/KI_Education_75th_Final.pdf.
Published by Statista Research Department, and Jul 29. “India: Share of out-of-Pocket Health Expenditure 2018.” Statista, 29 July 2021, https://www.statista.com/statistics/1080141/india-out-of-pocket-expenditure-share-in-total-healthcare-expenditure/.
“Out-of-Pocket Expenditure (% of Current Health Expenditure).” Oct 2021, https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS.