Tackling the challenge of diabetes

EDITOR—Diabetes is one of Africa's emerging challenges.1 This foundation has tackled the problems that patients in three countries in Africa face in accessing care and insulin. It used a rapid assessment protocol, which enabled data to be collected at all levels of the system, from health ministries to individual patients. The results from Mozambique and Zambia highlight the high cost of insulin to the system and patients.2

Although the average price per 10 ml vial of U100 insulin in the public sector in Mozambique and Zambia was around $2-3, supplies were intermittent—and insulin cost over $15.00 per vial (about a month's need) in the private sector. Problems also affected access to syringes and diagnostic tools. Only 6% of health facilities surveyed in Mozambique had facilities for blood glucose measurement, compared with 25% in Zambia.

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