For proper delivery of diabetes care, insulin, medication, test strips and monitoring equipment should be available, accessible and affordable to all people with diabetes who require them.
One of the major breakthroughs in medical sciences of the last century was the discovery of insulin in 1921. This discovery meant that people with diabetes who were insulin-treated survived the acute effects of the disease. More than eighty years after its discovery, people around the world are still dying because they cannot access insulin, which is classified by the World Health Organization (WHO) as an essential drug. Continuous accessibility to insulin is still a major problem in many developing countries especially those in sub-Saharan Africa such that there are reports of premature deaths due to the chronic lack of access to insulin in some of these countries.
This section examines the barriers to access and diabetes care in Mali, Mozambique and Zambia. These countries were chosen due to their geographical, historical and socio-economic differences, and as it was felt that they were representative countries for sub-Saharan Africa. An assessment was carried out in these three countries to see how a sustainable solution could be found to the issues of access to insulin and proper diabetes care under extreme conditions of scarce resources in the health sector.
This section also captures the pattern of use of diabetes therapies, both pharmacological and dietary, in countries where there are data. Describing the use of hypoglycaemic treatments is valuable in gaining an understanding of how therapies are actually used in practice, as against the advice given in various published guidelines.