UCL Institute for Global Health
Health services for people with chronic disease
Health services in many resource-poor countries are poorly equipped to manage patients with chronic disease. The prevalence of insulin-requiring diabetes in much of sub-Saharan Africa is an order of magnitude lower than in industrialised countries, in large part because the life expectancy of people who develop this condition is as low as a year.
While the cost of insulin contributes to this problem, diabetes is a condition where drug availability at affordable cost is only one of several components of an effective health care system needed to ensure survival – educated healthcare staff, monitoring equipment, and a referral system for complex cases are also vital.
While non-communicable disease is accorded low priority in countries with a high prevalence of HIV and other communicable diseases, attention to improving health systems is important both for reasons of disease burden and equity, and because even management of infectious diseases such as AIDS and TB raise parallel problems.
The International Insulin Foundation was established as a charitable foundation to tackle the issues of diabetes management in resource-poor countries.
As well as acting as an advocacy group, the IIF has supported the work of David Beran in conducting rapid assessment protocols in 3 countries in Africa (Mozambique, Zambia and Mali) and one in Latin America (Nicaragua), producing reports which have become the basis of national diabetes programs, or even of programs for non-communicable disease as a whole.
With support from Diabetes UK, David Beran is working with the Ministry of Health and the Diabetes Association in Mozambique to take forward the development of services for patients with diabetes and other non-communicable diseases in Mozambique. David Beran has also recently completed and launched a major report on Implementing Diabetes Programs in sub-Saharan Africa.