Ongoing and planned activities to improve the management of patients with Type 1 diabetes across Africa; implications for the future

ABSTRACT

Background

Currently about 19 million people in Africa are known to be living with diabetes, mainly Type 2 diabetes (T2DM) (95%), estimated to grow to 47 million people by 2045. However, there are concerns with early diagnosis of patients with Type 1 diabetes (T1DM) as often patients present late with complications. There are also challenges with access and affordability of insulin, monitoring equipment and test strips with typically high patient co-payments, which can be catastrophic for families. These challenges negatively impact on the quality of care of patients with T1DM increasing morbidity and mortality. There are also issues of patient education and psychosocial support adversely affecting patients’ quality of life. These challenges need to be debated and potential future activities discussed to improve the future care of patients with T1DM across Africa.

Methodology

Documentation of the current situation across Africa for patients with T1DM including the epidemiology, economics, and available treatments within public healthcare systems as well as ongoing activities to improve their future care. Subsequently, provide guidance to all key stakeholder groups going forward utilizing input from senior-level government, academic and other professionals from across Africa.

Results

Whilst prevalence rates for T1DM are considerably lower than T2DM, there are concerns with late diagnosis as well as the routine provision of insulin and monitoring equipment across Africa. High patient co-payments exacerbate the situation. However, there are ongoing developments to address the multiple challenges including the instigation of universal health care and partnerships with non-governmental organizations, patient organizations, and pharmaceutical companies. Their impact though remains to be seen. In the meantime, a range of activities has been documented for all key stakeholder groups to improve future care.

Conclusion

There are concerns with the management of patients with T1DM across Africa. A number of activities has been suggested to address this and will be monitored.

KEYWORDS:

• Type 1 diabetes
• healthcare policies
• insulin
• primary healthcare
• glucose monitoring
• patient co-payments
• Africa

Declaration of interest

The co-authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. However, a number of co-authors are employed by national or regional governments in Ministries of Health or are advisers to them. These include:

• Yogan Pillay – National Department of Health, Pretoria, South Africa

• Bene D Anand Paramadhas and Celda Tiroyakgosi – Ministry of Health and Welfare, Gaborone, Botswana

• Enos Rampamba – Department of Health, Limpopo Province, South Africa

• Abubakr Alfadl – Federal Ministry of Health, Sudan

• Angela Timoney – NHS Scotland, Edinburgh, UK

Otherwise no other conflicts of interest to declare

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.