East African Region Faces Critical Challenges in Type 1 Diabetes Care for Children and Young People
A new report by the Access to Medicine Foundation has shed light on the urgent need to improve access to care for children and young people (CYP) with type 1 diabetes (T1D) in East Africa. The report, which analyzes 11 initiatives supported by major pharmaceutical companies, reveals the stark inequities in access to diagnosis, treatment, and care for T1D across low- and middle-income countries (LMICs), with Sub-Saharan Africa bearing a disproportionately high burden.
The report highlights alarming statistics for the region. In 2024, an estimated 30,113 preventable deaths occurred in people under 19 years old due to T1D, with nearly 40% of these deaths occurring in Sub-Saharan Africa – the highest burden of any region. In some Sub-Saharan African countries, a 10-year-old with T1D may only live until age 19, while in high-income countries, life expectancy can exceed 75 years. Additionally, 63% of all T1D deaths in individuals under the age of 25 in Sub-Saharan Africa were attributed to non-diagnosis. These figures underscore the urgent crisis facing children with T1D in East Africa.
The initiatives analyzed in the report, supported by companies like Lilly, Novo Nordisk, Sanofi, and Biocon, include product donations, capacity building, and awareness programs. While these initiatives have made some progress, they reach only a fraction of the CYP in need, and access to essential medicines and monitoring devices remains a significant challenge. For example, across the 71 LMICs covered in the report, only about 8% of the estimated 825,000 CYP in need of T1D care were reached by the initiatives in 2023.
A significant disparity exists in access to insulin. In LMICs, even basic human insulin is difficult to access, while insulin analogues, which offer better management and quality of life, can cost up to seven times more. This contrasts sharply with high-income countries, where insulin analogues are the standard of care. The report also highlights the importance of continuous glucose monitoring (CGM) devices, which are becoming standard in wealthier nations but remain largely unavailable in LMICs.
The Access to Medicine Foundation’s report calls for urgent and concerted action to address these challenges. Recommendations include scaling up existing initiatives, ensuring access to a broader range of products (including insulin analogues and monitoring devices), improving the sustainability of care, addressing affordability, and strengthening data collection. The report emphasizes that a fundamental shift is needed to move beyond donation-based models and ensure long-term, sustainable access to care for children with T1D in the East African region