Public HealthInsulin for the world's poorest countries
Section snippets
Prevalence of type 1 diabetes in highly indebted poor countries
Amos et al15 reported the prevalence of diabetes in all countries in 1997. Because there are few studies of prevalence in the developing world, and those for all 40 HIPCs are based on but seven studies, these date are subject to substantial guesswork.
African type 1 diabetic patients under 15 years of age can expect to live for just 1 year;5, 6 and this figure has been applied to estimates for all countries where life expectancy for non-diabetics is under 50 years. Proportionately better
Logistics, education, and monitoring
Besides the supply of insulin, secure distribution networks and educational support will also be needed. Nevertheless, the experience of the Internatinal Diabetes Federation (IDF) insulin task force suggests that grass-roots health workers in these countries know how to use insulin when it is available. Clearly it would be invidious to prescribed single approaches to insulin delivery and patient education and care in countries with very different health care systems. Attempts to install
Costs of a programme of insulin supply
If manufacturers supply the insulin needs of type 1 diabetic patients in the 40 HIPCs free of charge, would the cost be proportionate to that of requirement—in other words around 0.5% of current world insulin costs? At present, animal insulin is sold at a substantially lower price than human insulin, so that, even at market prices, supplying 0.45% of the world's insulin supply because animal insulin should cost US$3–4 million.3, 19 Costs might be reduced by use of insulin that is being
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