On 14 November, the international community commemorates World Diabetes Day to raise awareness of the growing burden of this disease, and strategies to prevent and treat it.

The theme this year, and until 2023, is “Access to diabetes care” because too many people still do not have access to diagnostics, medicines and monitoring devices that can help with diabetes management.

This year also marks the centenary of the discovery of insulin in 1921, a scientific achievement which changed the lives of people living with diabetes. But one hundred years on from this hugely important innovation, premature death among people with diabetes is still high in many African countries, because of late diagnosis and a lack of access to insulin.

In the African Region, more than 19 million people are living with diabetes and this number is expected to grow to 47 million by 2025.

Sadly, about two-thirds of people living with diabetes in African countries are unaware of their condition. The known risk factors for diabetes include family history, age, being overweight, having a sedentary lifestyle, unhealthy diet, or use of alcohol or tobacco.

Left unchecked, without management and lifestyle changes, diabetes can lead to heart attack, stroke, kidney failure, lower limb amputation, visual impairment, blindness and nerve damage, including erectile dysfunction. People with diabetes are also at higher risk of developing severe COVID-19 symptoms.

Even when patients are diagnosed, insulin stockouts in public health facilities and the costs of insulin, result in individuals not getting the treatment they need. For example, in Ghana, it would take the average worker more than five days of earnings to save up for a monthly supply of insulin. In most African countries, the cost of insulin and monitoring products for diabetes and other noncommunicable diseases, are paid for out of pocket by individuals and their families.

In addition, surveys by WHO on access to essential services during the COVID-19 pandemic, show that access to diabetes care has been severely disrupted in the African Region. 

To improve equitable access to quality diabetes care, WHO launched the Global Diabetes Compact in April 2021. This builds on work in recent years to rollout the WHO Package of Essential Noncommunicable Disease (WHO PEN) interventions for primary health care in low-resource settings. So far 21 African countries have started using this package. Benin, Eritrea, Eswatini, Lesotho and Togo have achieved national expansion covering all primary health care facilities.

Ultimately, services to prevent and manage diabetes care are essential components in realizing Universal Health Coverage, so that all people can access the care they need.

So today, I ask governments to invest in making essential products like insulin, blood glucometers and test strips available to all communities. This should be backed by training of health workers in noncommunicable disease prevention and management at the district and community level towards improving service availability. I also urge all people living with diabetes to protect yourself from severe COVID-19 illness and death, by getting vaccinated against COVID-19 as soon as you can.

Learn more:

International Diabetes Federation (IDF) Diabetes Atlas Ninth edition 2019

Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic: January - March 2021

The WHO Global Diabetes Compact

WHO prioritizes access to diabetes and cancer treatments in new Essential Medicines Lists

Mbanya, JC. Mba, CM. Centenary of the discovery of insulin: People with diabetes in Africa still have poor access to insulin, E Clinical Medicine, The Lancet, 1 April 2021

WHO prioritizes access to diabetes and cancer treatments in new Essential Medicines Lists