Diabetes treatment > Access and supply

Kyrgyzstan is a small mountainous country with a predominantly agricultural economy; it gained independence with the break-up of the Soviet Union in 1991. For a significant sector of the Kyrgyzstani population, economic difficulties at national level translate into high unemployment and widespread impoverishment. Kyrgyzstan inherited an extensive but basic health-care system, with a functioning – albeit fragmented – structure for managing chronic diseases.

Insulin is a life-sustaining medication and as such has been designated an ‘essential drug’ by the World Health Organization (WHO). Insulin therefore should be universally available to everyone who requires it for survival. However, accessibility to the drug is often not secure. This results in life-threatening complications for people who depend on insulin for survival. The authors of this article, in reporting on the results of the International Diabetes Federation (IDF) survey, 2002-2003, make a call for improvements to the pricing and availability

Editor-in-Chief's editorial

President's editorial

For the West, the availability of animal insulin is a question of freedom of choice. However, it is the only way of survival for a number of people with diabetes in the developing world. Will the plea for help from the people with diabetes in the developing countries, in search of life, go unnoticed, unheard?

The growing diabetes crisis in the United States is a well reported fact. Nevertheless, diabetes-affected families are often being left out in the cold. Many are forced to dig deeply into their own pockets because, in many cases, even if insurance is available, insulin, syringes and blood glucose testing equipment as well as medical services such as outpatient education, so essential for diabetes care, are not covered.

People with diabetes in Hungary have access to free insulin, subsidized medication and diabetes equipment within a healthcare system whereby diabetes care is provided mainly by General Practitioners (GPs). Only a small number of people with diabetes - those with type 1 and difficult type 2 cases - are treated at national diabetes centres. These diabetes centres however provide a guarantee for better healthcare for all by consulting with and organizing postgraduate training for family doctors.

The world has received shocking news on earthquakes and flooding in many countries in recent months. Not long ago, the war in Kosovo and the earthquakes in Venezuela were the main topics in the news in which thousands of deaths and injuries, lost homes and destroyed villages and cities were reported. What are the worst problems for people with diabetes in these catastrophic situations? What can be done on a local and international basis to help them survive and continue their lives under such difficult circumstances?

Diabetes affects an estimated 3.3% of the adult population in Argentina. For many of these people, insulin is a life-sustaining drug. Without uninterrupted access to insulin, people dependent on this drug for survival face the real possibility of death, some within days. The collapse of the reimbursement system and speculation have caused grave interruptions in the supply of medicines such as insulin and now an emergency response is expected from the Argentinean authorities.

For many people with diabetes insulin is essential to health. Indeed, there are few other conditions where the replacement of a hormone that the body has ceased producing can make an acute difference between life and death. Nevertheless, a recent data-gathering project in Central and Eastern Europe illustrated that, almost 80 years after its discovery, access to insulin supplies is still problematic.