3 – Insulin isn’t always available
In remote and rural places, or regions with limited access to resources, a medical centre itself may not have a reliable supply of insulin, meaning some patients end up rationing their supply or even going without, risking consequences for their health or even death.
4 – Big Pharma prices
Just three companies – Novo Nordisk, Eli Lilly and Sanofi – control 90 percent of the entire insulin market. These pharmaceutical corporations set prices high which significantly impact patients and healthcare organisations all over the world. However, there are several companies working with the World Health Organisation to produce generic versions of insulin that could be much cheaper and so much more widely available.
5 – Food insecurity
A fundamental part of managing diabetes is also managing diet and therefore blood sugar. However, when food may be scarce, or events such as conflict have caused the cost of everyday staples to rise – for example in Yemen – then maintaining regular meal times and reliable portions can become incredibly difficult.
6 – Needles, syringes and waste
Along with access to insulin itself, the problem of finding and affording the bundle of tools required – like needles, syringes and monitoring devices – can be challenging. Even with a reliable supply, keeping these vital items clean, and disposing of them safely, is also difficult – especially for patients who have been forced from their homes or now live in camps.
7 – The fridge myth
In many places, daily temperatures can far exceed the recommended storage range for insulin. Normally, insulin is stored in a fridge, but this is an issue when a person doesn’t have one – either due to poverty, limited power or because they have been forced from home. Instead, patients will often make multiple journeys a day to reach a healthcare clinic, costing time, money and potentially their safety.
However, from experience, we know simple alternative storage solutions (such as basic clay pots) can provide a way of maintaining cool and stable temperatures to store insulin for some time.
8 – The cycle of complications
When a person living through a humanitarian crisis is unable to manage their diabetes, the long-term risk of serious complications – including kidney failure, heart disease and vision loss – rise significantly.
And, when such conditions reach the point of needing urgent medical attention, the availability of specialised and emergency care may not be easy to access. Leaving diabetes untreated becomes a vicious cycle, resulting in more complicated conditions that need more advanced treatments, but are even less likely to be available in the middle of a humanitarian crisis.
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