A theme issue by, for, and about Africa: Tackling the challenge of diabetes

doi:10.1136/bmj.331.7519.779-b

BMJ 2005;331:779-780 (1 October), doi:10.1136/bmj.331.7519.779-b

Letter

A theme issue by, for, and about Africa

Tackling the challenge of diabetes

EDITOR—Diabetes is one of Africa's emerging challenges.¹This foundation has tackled the problems that patients in threecountries in Africa face in accessing care and insulin. It useda rapid assessment protocol, which enabled data to be collectedat all levels of the system, from health ministries to individualpatients. The results from Mozambique and Zambia highlight thehigh cost of insulin to the system and patients.²

Although the average price per 10 ml vial of U100 insulin inthe public sector in Mozambique and Zambia was around $2-3,supplies were intermittent—and insulin cost over $15.00per vial (about a month's need) in the private sector. Problemsalso affected access to syringes and diagnostic tools. Only6% of health facilities surveyed in Mozambique had facilitiesfor blood glucose measurement, compared with 25% in Zambia.

These hurdles in accessing supplies were compounded by a paucityof trained healthcare workers. Consequently, the life expectancyof a child with newly diagnosed type 1 diabetes is only 0.6years in rural Mozambique.²

David Beran, project coordinator

david.beran{at}access2insulin.org
International Insulin Foundation, London N19 5LW

John S Yudkin, chairman

International Insulin Foundation, London N19 5LW

Competing interests: None declared.

References

Volmink J, Dare L, Clark J. A theme issue "by, for, and about" Africa. BMJ 2005;330: 684-5.[Free Full Text]
Beran D, Yudkin J, de Courten M. Access to care for patients with insulin-requiring diabetes in developing countries: case studies of Mozambique and Zambia. Diabet Care 2005;28: 2136-40.[Abstract/Free Full Text]
Kessner DM, Carolyn EK, Singer J. Assessing health quality: the case for tracers. N Engl J Med 1973;288: 189-94.