Insulin for the world's poorest countries

Abstract

I hope that John Yudkin's well argued appeal (March 11, p 919)1Yudkin JS Insulin for the world's poorest countries.Lancet. 2000; 355: 919-921Summary Full Text Full Text PDF PubMed Scopus (44) Google Scholar for the provision of free insulin for those with diabetes in Africa will be heeded.During a visit to the Kilimanjaro Christian Medical Centre, Moshi, Tanzania, I saw a man aged 20 years, a known diabetic, admitted to hospital in diabetic coma. He had been unable to get the insulin that he needed. The policy in Tanzania (as I was told) is to provide free insulin to those who need it. However, economic constraints are such that this policy cannot be realised. A diabetic has to find the money and transport to get to the nearest hospital, and when he gets there insulin may not be available. He is then given a prescription to buy his supply privately at an inflated price well beyond the means of most subsistent farmers. The young man I saw is likely to be dead within a few years.Yudkin analyses the amount and cost of insulin needed for type-1 diabetics in Africa. He estimates that the provision of free insulin to these patients would be around 0·5% of current world insulin costs, Medicines for tuberculosis are provided free (although diagnosis can be expensive for the patient) and I hope that life-saving insulin may also be provided free. I hope that John Yudkin's well argued appeal (March 11, p 919)1Yudkin JS Insulin for the world's poorest countries.Lancet. 2000; 355: 919-921Summary Full Text Full Text PDF PubMed Scopus (44) Google Scholar for the provision of free insulin for those with diabetes in Africa will be heeded. During a visit to the Kilimanjaro Christian Medical Centre, Moshi, Tanzania, I saw a man aged 20 years, a known diabetic, admitted to hospital in diabetic coma. He had been unable to get the insulin that he needed. The policy in Tanzania (as I was told) is to provide free insulin to those who need it. However, economic constraints are such that this policy cannot be realised. A diabetic has to find the money and transport to get to the nearest hospital, and when he gets there insulin may not be available. He is then given a prescription to buy his supply privately at an inflated price well beyond the means of most subsistent farmers. The young man I saw is likely to be dead within a few years. Yudkin analyses the amount and cost of insulin needed for type-1 diabetics in Africa. He estimates that the provision of free insulin to these patients would be around 0·5% of current world insulin costs, Medicines for tuberculosis are provided free (although diagnosis can be expensive for the patient) and I hope that life-saving insulin may also be provided free. Insulin for the world's poorest countriesAuthor's reply Full-Text PDF