When children with type 1 diabetes arrive for the first time to the Rwanda Diabetes Association clinic, in Kigali, Rwanda, many believe their lives are over. Dr. Manzi understands that fear – he has lived it himself. Diagnosed at 11 years old, he spent years struggling with diabetes. Through incredible strength, he not only learned how to manage it, but he also found meaning in helping others do the same.

“Someone who has come in with no hope can leave with hope,” he said.

Some of his young patients have been misdiagnosed, sometimes repeatedly. Others have faced rejection. Some have overheard their parents question whether it is worth paying for medication or schooling for a child who will never be cured.

These are all experiences Dr. Manzi knows, he confronted them during his own childhood.

Now 27, he works for the Rwanda Diabetes Association, the very organization that once supported him. They provided him with free insulin and monitoring supplies, taught him the ins and outs of managing his glucose levels, and showed him that his own life was just beginning. It’s also where he grew into a dedicated educator and advocate for others living with diabetes.

“Trust me”

In 2008, at age 11, Aime Manzi became suddenly unwell. Within a few weeks, he lost more than 30 pounds. He needed to use the bathroom so frequently that his brother complained about sharing a room with him. His teachers assumed he was looking for excuses to leave the classroom. He often fell asleep during class, compounding their frustration.

A local hospital thought he might have malaria or tuberculosis – both common and highly visible infectious diseases in Rwanda. “I think they didn’t think a young person could have diabetes,” Aime recalled.

Eventually, doctors decided he was dehydrated, and instructed him to leave school temporarily, and try to eat and drink more.

That didn’t work, so his parents took him to a traditional healer, who said he had been poisoned and provided a medicine that made him vomit uncontrollably. Then, thinking his illness might be spiritual, they took him to a Catholic priest, hoping for a miracle.

“I started to believe this was a punishment from God.” Aime said.

When he collapsed, nonresponsive, in the middle of doing chores around the house, his uncle carried him in his arms for three hours to a hospital in Kigali, where he was diagnosed with type 1 diabetes. Doctors explained that the disease was lifelong and would require daily injections. Aime’s parents were skeptical.

Aime had trouble managing his injections. No one had properly explained the protocols, and his parents assumed he’d probably been cured and no longer needed to buy insulin.

But, of course, that wasn’t possible.

Eventually, Aime was referred to Life for a Child’s local partner, the Rwanda Diabetes Association where doctors showed him how to manage his blood sugar and provided him with a blood glucose meter, strips, and insulin, all free of cost. Without the support they provided, he said, his parents would not have been able to manage the expense: “It was a lot.”

Aime’s parents were upset to learn that their son would always have diabetes. The expense and difficulty of providing separate, appropriate meals disturbed them, and they assumed he’d contracted the disease by eating too much sugar – “If you eat too much sugar, you’re going to be like Manzi,” Aime recalled other parents telling their kids.

School in Rwanda requires tuition fees, and Aime’s parents didn’t want to pay them. Dr. Manzi said they felt that “instead of spending money on this one, we can just spend money on the other kids who are healthy.”

“There aren’t many old pictures of me because during that time my family had really given up on me.”

At a time of heightened concern about AIDS and tuberculosis, two diseases that spread through person-to-person transmission, other parents didn’t want their kids to spend time with him assuming he might transmit his diabetes to them.

“I was left with no friends to play with.” Aime said.

It was around this time that the Rwanda Diabetes Association invited him to an overnight camp session – an invitation that marked a turning point in his life.

The other kids at the camp “…were young kids, very joyful, doing well at school,” he explained. “They were OK with insulin, they could inject themselves well. I was like, ‘How did you do it?’”

Equally important were the staff members focused on teaching the campers that their diabetes was completely manageable – that they could live great lives and achieve long-term dreams.
When Aime arrived home from camp, he told his parents, “You don’t believe in me, you think I’m going to die, but trust me: Let me go back to school.’”

This marked a pivotal shift for him. He was so inspired that he began volunteering with the Rwanda Diabetes Association, encouraging other kids with new diagnoses to see their diabetes as manageable and their future as bright.

“Change the Whole Narrative”

The last piece fell into place when Aime asked a science teacher what he knew about diabetes. “I was testing him a little bit,” Aime cheekily admits. The teacher’s answer was full of misinformation. He claimed diabetes could only be passed on genetically, and those who had it were always “one step from death.”

A natural advocate, Aime corrected his teacher, who then invited him to speak to his whole class about diabetes – a daunting prospect for a child “But I wanted to play with my friends again,” he said.

That experience taught him to love science and to seek out chemistry and biology classes, where he frequently asked teachers what they knew about diabetes. “Teachers didn’t really know how diabetes worked, they had a negative image,” he recalled. “I liked to challenge them and change their minds.”

Against all odds, and everything he had been told about the limitations of living with diabetes, Aime went onto medical school. He continued volunteering with Rwanda Diabetes Association (RDA), leading camps and peer support groups.

Being a doctor makes it possible for him to “change the whole narrative” surrounding diabetes in Rwanda.

Advocate. Camp leader. Researcher. Dr. Manzi is someone young people with type 1 diabetes in Rwanda can count on.

Today, Dr. Manzi is a general physician who works with children with diabetes at the RDA’s clinic in Kigali. One day he hopes to specialize in endocrinology. He’s also a committed advocate for his patients, working with their families so they can offer effective support and educating larger communities about how diabetes actually works.

The Kigali clinic cares for about 500 young patients, he said, and the RDA serves approximately 1,300 across Rwanda.

Rwanda has strengthened its health system for type 1 diabetes over the past few decades. While some children with diabetes have access to private clinics, some still choose to receive care through the RDA, Dr. Manzi observed. It may not be as fancy, he said, but it offers something more important, “a family of people with the same condition.” It brings Dr. Manzi the greatest joy, telling his young patients that he, too, has type 1 diabetes. It’s often the first step of teaching them how much they have to look forward to.

For many of them, managing diabetes would be financially impossible without support from the RDA. Their family incomes are simply too low to pay for insulin, testing strips, a blood glucose meter and strips, and regular blood panels, as Dr. Manzi’s was during his childhood.

“A Happy Man”

Just recently, Dr. Manzi began treating a 14-year-old boy diagnosed with diabetes. The teenager, a bright student, reminded Dr. Manzi of himself – “I think I wasn’t as bright,” he said drily – and this boy, too, was in danger of going without an education.

The boy’s mother was distressed that he was having difficulty managing his blood sugar levels at school, where the food provided wasn’t enough to counter the level of insulin he needed to take. Fearing the painful symptoms of low blood sugar, he was even refusing to administer insulin while at school – and beginning to develop complications. His mother had begun to wonder whether keeping him in school was worth the money.

“I’m still working to make his glycemia [a medical term for blood sugar levels] fall in the right range,” Dr. Manzi said. “If it all works out, I’ll be a happy man.”

You can make a donation to help a young person like Aime look after their health and plan for the future. Thank you so much for whatever you can contribute.

The post Dr. Manzi gets it, he’s lived it appeared first on Life for a Child.

A deep dive into DALY estimates and the 2025 funding gap

Life for a Child is an international non-profit organization that supports children with diabetes by providing insulin, test strips, and essential diabetes care to over 60,000 children in low-income countries who would otherwise have little to no access to treatment.

Without access to supplies and skilled medical care, children with type 1 diabetes (T1D) often die quickly, and with only intermittent access may die within a few years of diagnosis. In some countries,  limited amounts and types of older insulins may be provided by the health systems. In these ‘luckier’ countries, test strips are still not usually provided. Without regular blood glucose testing, children may survive into early adulthood, yet still experience early mortality due to long-term complications such as blindness, kidney failure, or amputations.

Life for a Child (LFAC) offers a lifeline, extending life expectancy and improving the quality of life for children at a remarkably low cost. Life for a Child also does incredibly critical work in improving care delivery infrastructures in each of these countries that they support. They work directly with local healthcare providers to co-develop critical education materials for young people living with diabetes. Further, they provide a support network to local healthcare providers and some governments. This is all to help improve sustainability of access to services, medications, and support for people with diabetes in the long run.

Scott and I have been supporting Life for a Child as our charity of choice for many years. As we wrote in our analysis here in 2017:

“Life for a Child seems like a fairly effective charity, spending about $200-$300/yr for each person they serve (thanks in part to in-kind donations from pharmaceutical firms). If we assume that providing insulin and other diabetes supplies to one individual (and hopefully keeping them alive) for 40 years is approximately the equivalent of preventing a death from malaria, that would mean that Life for a Child might be about half as effective as AMF, which is quite good compared to the far lower effectiveness of most charities, especially those that work in first world countries.”

We used some of GiveWell’s analyses to assess effective giving, especially comparing options like GiveDirectly or more specific charity options like AMF:

“​For example, the Against Malaria Foundation, the recommended charity with the most transparent and straightforward impact on people’s lives, can buy and distribute an insecticide-treated bed net for about $5.  Distributing about 600-1000 such nets results in one child living who otherwise would have died, and prevents dozens of cases of malaria.  As such, donating 10% of a typical American household’s income to AMF will save the lives of 1-2 African kids *every year*.”

(Note: In addition to donations, I also have supported Life for a  Child with my time at both the US level, serving on the US-based Life for a Child US board, as well as the US representative on the international advisory committee for Life for a Child.)

However, in 2025, Life for a Child faces an immediate and unexpected $300,000 funding shortfall, due to a previously committed donor no longer being able to provide this donation. This funding was for test strips, which will reduce the number of strips provided per child from three to two test strips per day.

Further, Life for a Child has additional funding needs to continue expanding to support more children who are otherwise unsupported and going without critical supplies. (The room for funding is several orders of magnitude above this year’s funding gap.)

In order to assess the need for how we (in a general sense, speaking of all of us) fill this funding gap and understanding if this is still a cost-effective way to support people with diabetes, we wanted to revisit our analysis for how cost-effective Life For a Child is.

For background, I asked Graham Ogle, head of LFAC, for some numbers. These include:

• Life for a Child currently supports 60,000 children in 2025
• The original expansion plan is a goal to support 150,000 children by 2030
• Estimates for how much is spent per child is about $150 USD (slightly less than what Scott and I had estimated in 2017), or $160 USD if you incorporate indirect costs.

We used these numbers below to estimate the cost-effectiveness of Life for a Child’s interventions.

Estimating Life for a Child’s Cost per Disability-Adjusted Life Year (DALY)

The Disability-Adjusted Life Year (DALY) is the most commonly used metric in global health to capture both the years of life lost (YLL) due to premature death and the years lived with disability (YLD) due to a health condition, such as type 1 diabetes.

The goal of Life for a Child’s work is to reduce both of these by providing insulin and glucose monitoring as well as improved care necessary for improved health outcomes.

1. Life for a Child support reduces Years of Life Lost (YLL) 

To estimate YLL reduction, we calculate the difference between the expected age at death for a child with T1D who receives no care versus a child receiving LFAC support:

• Without Life for a Child :
  • In the worst-case scenario, children with T1D may die within 1-2 years due to lack of insulin, meaning an early death by age 10 instead of the typical life expectancy of 60 years in some of these countries. . This results in 50 YLLs (60 – 10 = 50).
  • In countries where insulin is available but costly and/or glucose monitoring is not affordable and readily available, children may survive into their late 20s or 30s, but still experience significant complications, reducing life expectancy. In this scenario (minimal access to insulin, glucose monitoring, etc), we make a rough assumption that children with diabetes may survive into their mid to late 30s, therefore 25 YLLs is a reasonable estimate (60 – 35 = 25).
• With Life for a Child :
  • Life for a Child’s program significantly improves both short-term and long-term survival. We assume that children supported by Life for a Child have the potential to live to an average life expectancy of 50-60 years (instead of dying prematurely due to untreated T1D), even when considering that LFAC only supports children into early adulthood (e.g. 25-30 years of age).

If we assume the average life expectancy for children newly diagnosed with T1D increases from 15-35 years to 50-60 years with standard Life for a Child support, that gives a savings of 25-35 YLLs (DALYs) per child, accounting for most of the uncertainty in our lifespan estimates above.

2. Years Lived with Disability (YLD) Reduction

T1D also causes significant disability when people with T1D don’t have access to insulin and/or sufficient glucose monitoring and monitoring for early signs of complications, especially due to complications like blindness, kidney failure, and amputations. Each of these conditions brings about substantial life impairment.

• Without Life for a Child:
  • Children with poorly supported T1D face a high likelihood of severe complications as they age. We estimate the disability weight (DW) for this scenario at 0.20, reflecting significant disability as a result of some of those complications.
• With Life for a Child:
  • Access to insulin and glucose monitoring and healthcare monitoring drastically reduces the risk of complications. We estimate a DW of 0.05, which represents a much lower level of disability, especially in terms of future complications.

With such DWs, the reduction in YLD before premature death (20%-5%=15% over 5-30 years = 1-4 DALYs), and the 5% reduction in the YLL benefit (5% * 25-35 = 1-2 DALYs) partially cancel out, and don’t change the end result much. The net gain of 1-2 DALYs due to YLD reduction is smaller than the uncertainty range on the YLL benefit.

So for purposes of cost-effectiveness calculations, we’ll ignore YLD in the rest of this post and continue using the 25-35 DALYs per child figure.

3. Total DALYs and Cost per DALY

For this section, we’ll assume the total impact of Life for a Child’s intervention per child from the calculations above is 25-35 DALYs.

Life for a Child’s cost per child in 2025 is approximately $150 per year (or $160 including indirect costs), and if we estimate that most children receive treatment for about 15 years, meaning the total cost per child is roughly $1,500–$2,250 over that period (or $1,600-$2,400 total with indirect costs).

Thus, the cost per DALY for Life for a Child can be estimated as:

(Cost per child) / (DALYs saved per child)

Here are a variety of estimates for varying cost levels using the lower bound of 25 DALYs saved per child supported:

• With $1,500 per lifetime per child ($150/year for 10 years) and 25 DALYs saved, that estimates $60 per DALY ($64 with indirect costs)
• With $2,250 per lifetime per child ($150/year for 15 years) and 25 DALYs saved, that estimates $90 per DALY ($96 with indirect costs)
• With slightly higher costs to assume the cost will rise over time of $175/year for 15 years, this is a higher estimated $2,625 per lifetime per child and 25 DALYs saved, estimating $105 per DALY.
• With slightly higher costs to assume the cost will rise over time of $175/year for 20 years, this is a higher estimated $3,500 per lifetime per child and 25 DALYs saved, estimating $140 per DALY.

This places Life for a Child’s cost per DALY in the range of $60–$90, for conservative estimates a remarkably cost-effective intervention, and even the higher estimates of $105-$140 assuming an increase in costs and increase in years of support compares favorably to the most effective global health programs, including those recommended by GiveWell.

How did we come to this conclusion?

• GiveWell estimates cash transfers through GiveDirectly result in $1000/DALY, based on welfare gains rather than direct health outcomes (so apples and oranges), but even apples to oranges we can estimate Life for a Child is more cost-effective by at least single digit (eg 1-9x) factors than cash giving elsewhere.
• We know GiveWell’s top charities are around $50-$100/DALY. Given we were estimating $60-$140 with a wide swathe of estimates, we can see that Life for a Child aligns with some of GiveWell’s top charities in terms of cost per DALY and thus “compares favorably” in our analysis. 

Why You Should Donate to Life for a Child

The point of this post was for Scott and I to reassess our statement that we have been making since ~2017 or so, which is the fact that Life for a Child is a remarkably cost-effective charity overall, and likely one of the most cost-effective charities to support people living with diabetes around the world who otherwise won’t have access (or regular access) to insulin and blood glucose testing.

Life for a Child has a DALY cost in the range of $60-$140 (reflecting current versus future cost increases), depending on which input variables you use, which makes it one of the best uses of global health funding available today.

Because of this reassessment, we also hope if you’ve read this far that you, too, will consider making a life-saving and life-changing donation for people with diabetes by donating to Life for a Child.

If you’re feeling overwhelmed with world events and want to make a tangible difference in people’s lives in a measurable way, consider donating to Life for a Child.

If you want to support people with diabetes in the most cost-effective way, so that your donation dollars make the biggest impact? Donate to Life for a Child.

Your donation saves – and changes – lives.

(Thank you).

PS – feel free to reach out to me (Dana@OpenAPS.org) and/or Scott (Scott@OpenAPS.org) if you want to chat through any of the estimates or numbers in more detail and how we consider donations.

The post The cost-effectiveness of Life for a Child appeared first on Life for a Child.

In 2020, we launched Vision 2030, our ten-year plan to expand support for more young people and drive sustainable improvements in diabetes care. In this update, we highlight our progress toward these ambitious goals, showcasing key achievements to date and addressing the challenges we continue to navigate.

Goal 1: Increase the number of children and young people supported to 150,000

When Vision 2030 was launched in 2020, Life for a Child was delivering essential diabetes care to 23,000 young people across 43 countries. By 2024, we have expanded our reach to 57,741 children and young people in 48 countries—a 150% increase in just four years. This means that since 2020, an additional 34,741 children and young people are now better equipped to manage diabetes, attend school or work, and lead healthier lives.

We’ve also welcomed new partners in Chad, Guinea-Bissau, Zambia, India, Sudan, Nepal, and Somaliland, each facing unique challenges shaped by their specific contexts. Despite this progress, reaching our target of supporting 150,000 children and young people by 2030 remains an ambitious challenge.

Goal 2: Improving health outcomes for young people with type 1 diabetes

We’ve implemented several initiatives to improve health outcomes for young people with type 1 diabetes:

• Extend30: We extended support to age 30 for young adults in low-income countries, providing continued care during this critical period.
• Blood glucose monitoring: We increased the daily provision of blood glucose monitoring strips from three to four per young person, improving their ability to manage diabetes effectively.
• Move the Needle: We transitioned from syringes and vials to more convenient pens and cartridges, enhancing treatment access and usability.
• Basal analog insulin: We expanded the number of centers receiving basal analog insulin. Currently, 54% of our partners are using analogues, and we are documenting the impact of this transition in several ongoing studies.

Goal 3: Encouraging local provision of type 1 diabetes care

These initiatives are helping build local expertise, empowering healthcare professionals to deliver improved care for young people with type 1 diabetes.

• Professional Development: Our mentoring program has connected 42 healthcare professionals from our local partner centers with mentors to support the achievement of their individual professional goals. We have enabled partners to attend international diabetes conferences, encouraging them to share insights and apply them in their own settings, while also promoting horizontal peer learning to exchange experiences and best practices.
• Research and Publications: Over the past four years, we’ve published 27 studies to address knowledge gaps in diabetes care within low-income settings. Profiles of recent research and a full publication list are available for review.
• Diabetes Education: We’ve co-developed carb-counting books to enhance educational opportunities and improve self-management for young people with diabetes and their families.
• World Health Organization Essential Diagnostics List (WHO EDL): Through our advocacy efforts, diabetes supplies were successfully added to the WHO Essential Diagnostics List, improving global access.
• Changemaker Projects: Guided by the principles of meaningful engagement, we are supporting emerging advocates at every stage of their journey. This approach is empowering young leaders in seven Life for a Child-supported countries—Tanzania, Ghana, Burundi, Mexico, Dominican

Challenges and opportunities

As the number of children and young people we support increases, so does our need for resources.

The goals outlined in Vision 2030 are ambitious, but they are essential. We can’t accept a world where young people with type 1 diabetes are left without the supplies and care they need to survive and thrive.

Though our progress is encouraging, significant challenges persist. You can make a difference by donating to help support young people living with diabetes.

Meet the young people driving our vision.

Meet the inspiring young people we support, whose resilience and strength are at the heart of Vision 2030. Click the names below to learn more about each young person featured in the Vision 2030 graphic.

Joe, Guatemala	Kasun, Sri Lanka	Doumbia, Mali
John, Ecuador	Manuel, Bolivia	Sanjida, Bangladesh
Laura, Panama	Jina, Kenya	Kumari, Sri Lanka
Mireille, Rwanda	Betty, Ethiopia	Sebastián, Ecuador
Vishalini, Sri Lanka	Gayathri, India	Maria Isabel, Panama
Brandon, Bolivia	Sadia, Bangladesh	Ineza, Rwanda

 

The post The road to Vision 2030 appeared first on Life for a Child.

To better understand the high incidence of T1D in Yemen, Life for a Child partnered with Sana’a University, the International Organization for Migration, and the Sana’a Diabetes Centre to conduct a study. This research focuses on the clinical characteristics, biomarkers, T1D subtypes, and diabetic ketoacidosis (DKA) risk factors at diagnosis among children and adolescents.

The findings are concerning. Children in Yemen experience significant delays in T1D diagnosis and treatment, leading to a high incidence of DKA at diagnosis. DKA can rapidly become fatal, and even when not fatal, delayed diagnosis for T1D results in severe health complications, affects growth and development, compromises quality of life, and worsens long-term health outcomes. T1D is challenging to manage even under the best circumstances, and the importance of an early start cannot be overstated. With 79% of the study population under 19 years old presenting with DKA at diagnosis, immediate and urgent intervention is essential to protect the lives and futures of young people living with T1D in Yemen.

In a timely alignment with our research, Life for a Child has entered into a Collaboration Agreement with the Yemeni Diabetes Association. This partnership aims to implement targeted interventions to reduce adverse outcomes from misdiagnosis and to improve access to at least an ‘intermediate care’ level. Our specific recommendations include:

1. Enhancing Early Diagnosis: Through comprehensive training programs for healthcare professionals.
2. Increasing Community Awareness: Focusing on the recognition of T1D symptoms.
3. Ensuring Timely Access: To essential diabetes care services, including vital insulin and supplies.

We are positioned to advocate effectively for these recommendations. Through our new collaboration with the Yemeni Diabetes Center, we strive to empower healthcare professionals through education and capacity building, while directly supporting young people with diabetes by providing crucial insulin and supplies. These interventions are critical to reducing life years lost to T1D and improving health outcomes for children in Yemen. Through these efforts, we aspire to ensure that every child with T1D in Yemen receives timely and effective care, thereby significantly improving their quality of life and health outcomes. This collaboration underscores our commitment to translating research findings into impactful, on-the-ground initiatives.

You can view the study here.

Emma Klatman Global Policy and Advocacy Manager

The post Action-focused research in Yemen appeared first on Life for a Child.

The post Love in Sri Lanka appeared first on Life for a Child.

In October 2023, the World Health Organization (WHO) officially recognized the crucial importance of Self-Monitoring of Blood Glucose (SMBG) for people with insulin-treated diabetes, marking a milestone achievement. This recognition was the result of collaborative efforts by Life for a Child and FIND, advocating for SMBG inclusion on the Essential Diagnostics List. This news is opportune, aligning with WHO’s Global Diabetes coverage target of ensuring 100% access to affordable insulin and SMBG for people with type 1 diabetes by 2030.

This month, we published a commentary in Lancet Diabetes and Endocrinology, outlining this milestone and proposing strategies to ensure policy advancements translate into tangible improvements in under-resourced settings, where SMBG remains unaffordable for many.

A milestone achievement, but more work is needed

While the inclusion of SMBG in the EDL represents a significant advancement in addressing disparities, it serves as only the initial phase of a larger journey aimed at ensuring equitable and sustainable access for all individuals in need. To realize this objective, we propose the following actions to support tangible improvements in SMBG access for T1D communities in low- and middle-income countries:

• The WHO should provide guidance and support to national health systems and organisations working in diabetes care.
• Policymakers, organizations and individuals must embrace collaboration and advocate for the adoption of essential diagnostics lists at the national level.
• Health systems must establish robust monitoring mechanisms.

What steps are Life for a Child taking to bolster these achievements?

Capacity Building and Education: At Life for a Child, we recognize the pivotal role of education in empowering individuals to effectively utilize SMBG in type 1 diabetes (T1D) care. We provide continuous education and support to our local partners on SMBG and have an extensive range of educational resources for children, parents, and healthcare professionals, available in 24 languages.

Benchmarking: We believe in establishing robust monitoring mechanisms to track the adoption and impact of SMBG. Regular evaluation enables us to pinpoint areas for improvement and furnishes advocates with data to champion increased access to essential diabetes management tools and treatments. Through our support to local partners in data compilation, research endeavors, and participation in initiatives such as SWEET, we facilitate data collection, benchmarking, and evaluation.

Communication: We believe in the importance of disseminating high-level developments to a variety of stakeholders. Regarding the updated Essential Diagnostics List (EDL), we are encouraging our NGO partners an all diabetes centers and associations with connections to Ministries of Health to relay the WHO’s acknowledgment of the importance of meters and strips to decision-makers.

We see the addition of SMBG to the WHO’s Essential Diagnostics List as a significant milestone in global health for type 1 diabetes. While ensuring access to affordable SMBG won’t happen overnight, by uniting as a global community, each of us can contribute to realizing this shared vision together.

View our recent article published in The Lancet Diabetes & Endocrinology.

View the WHO news release detailing the addition of blood glucose monitoring tools.

Herbert from Bolivia underlines the importance of blood glucose monitoring in the artwork he submitted to the Life for a Child art competition.

Emma Klatman Global Policy and Advocacy Manager
Rachel Clayton Marketing and Communications Manager

The post An achievement for global access to self-monitoring, but what comes next? appeared first on Life for a Child.

In 2013 there were only 22 known children and young adults with T1D under 25 years old in Burkina Faso. We knew from experience that there should be many more, and it was highly likely that many young people would be dying from misdiagnosis or lack of access to supplies and education. Today, after ten years working in the country, our suspicions have been confirmed. Between 2013 and 2022, 312 new cases of T1D were diagnosed, five cases of T2D and two suspected cases of maturity-onset diabetes of the young.

In the graph below, you can see sharply rising T1D incidence over the last ten years since Life for a Child commenced support in 2013, which is actually good news. This rise means far fewer young people are dying without a diagnosis.

Dr. Yempabou Sagna is an endocrinologist at our local partner center in Burkina Faso and one of the authors of the study. He said, “I think the most positive finding is that there is sharply rising T1D incidence, mainly due to increased detection rate with the support of Life for a Child. Many of these patients would likely have died unrecognized from non-diagnosis. This study will make it possible for decision-makers to understand that this type of diabetes also exists in Burkina Faso, and we hope that this will help to facilitate the subsidy of insulin.”

Due to the limited access to insulin and high prices, almost all children and youth with T1D in Burkina Faso are referred to Life for a Child.

Although there is no pediatric endocrinologist in the country, there are many skilled and dedicated healthcare professionals, and Life for a Child is very well known across the medical community. Indeed, all adult endocrinologists and internal medicine specialists in the country were involved in this study.

Dr. Yempabou Sagna said, “It was firstly the lack of specialists that motivated me to work in pediatric diabetes. In Burkina Faso, the management of childhood diabetes is integrated into adult services. In the long run, I would like to create pediatric endocrinology and diabetology department in my country.”

As of today, Life for a Child supports 315 children and young individuals across Burkina Faso.

We expect this number to continue to rise for some time, as long as access to supplies, education, and awareness improves. We are committed to providing ongoing support in these areas.

Dr. Sagna and his team are working hard to improve care and provide new opportunities for diabetes education and peer support. In 2022 they organised the country’s first ever T1D camp. This second camp in 2023 saw 58 young people attend for four days of games, peer support and diabetes education.

Despite this encouraging progress, the study shows that there is much work to be done.

The number of young people dying from diabetes and complications in Burkina Faso remains substantial. Non-diagnosis is thought to be the commonest cause. At the end of this study follow-up period, 271 of the 312 young people were known to be alive and were still followed up in hospitals. Among the 40 others, 23 had died, four had emigrated, and 14 were lost-to-follow-up.

We are determined to continue providing young people with insulin and blood glucose monitoring supplies, diabetes education resources and healthcare professional support. Burkina Faso will benefit from our recent program extension to provide support to young people up to the age of 30, and we are helping to provide equipment for regional health centres. In addition, we will continue to collect data, research and advocate for young people living with diabetes in the region.

Dr. Yempabou Sagna said “I think it is necessary that programs like Life for a Child should continue their action in developing countries like Burkina Faso because in view of this study, hundreds of lives have already been saved by early diagnosis.”

Explore the comprehensive study here.

In 2013, Life for a Child forged a groundbreaking partnership with Yalgado Ouedraogo University Hospital and the NGO Santé Diabète. This collaboration aimed to provide diabetes management supplies and reliable support to children and young people living with diabetes. We also started collecting data, to capture the health outcomes and experiences of young people we support.

Emma Klatman Global Policy and Advocacy Manager
Rachel Clayton Marketing and Communications Manager

The post A remarkable increase in survival appeared first on Life for a Child.

This is one of the core messages of a new paper titled, ‘Meaningful Engagement of People Living with Noncommunicable Diseases: Empowering Participation in Health Decision-Making’, authored by one of Life for a Child’s advisory committee members, Mark Barone and Global Advocacy and Policy Manager, Emma Klatman.

Mark and Emma advocate for a sincere integration of the expertise of people living with noncommunicable diseases (PLWNCDs), emphasizing the need to move beyond symbolic gestures. They stress that decision-making processes must include PLWNCDs with diverse perspectives, varying socioeconomic backgrounds, and representation from different geographic locations. Mark and Emma assert unequivocally that the voices of PLWNCDs should be accorded equal weight alongside industry leaders and influential figures in global health.

“It is high time to move from identifying people living with NCDs merely as ‘patients’ towards recognizing their worth rather as ‘impatients’ who are indispensable and irreplaceable contributors in all phases of decision-making processes.”

The paper explains the importance of destigmatizing, empowering and empathetic language practices when addressing and referring to PLWNCDs. Despite the availability of guidelines promoting such language, adoption remains low, and stigmatizing or disrespectful wording is still common. Increasing the adoption of respectful language and associated behavior can help to reduce hierarchies and power imbalances.

In essence, Mark and Emma establish the advantages of meaningful engagement of PLWNCDs in health decision-making. They provide a roadmap for not only empowering their participation but also advocating for the indispensable role PLWNCDs play in shaping healthcare policies and practices.

You can view the full paper here.

Rachel Clayton Marketing and Communications Manager

The post Lived experience is indispensable in health decision-making appeared first on Life for a Child.

A doctor from our local partner centre in Gaza told us: “The health and humanitarian situation of Gazan children with diabetes is devastating due to non-stop bombardment. Young people are exposed to frequent admission to hospitals with diabetes coma resulting from the lack of insulin and food. There is malnutrition and a very soon expected starvation that people will be facing in the upcoming days.” He also informed us that many health workers have been killed and health centres destroyed.

In addition to loss of life, the ongoing violence hampers access to vital healthcare services for everyone in Gaza. The healthcare system has been decimated by the bombing. Many children and young people living with diabetes face obstacles in obtaining life-sustaining supplies, including insulin. Internal displacement, food insecurity, emotional trauma, injuries, disease, and fear further exacerbate life-threatening fluctuations in blood glucose levels.

Amidst this deeply painful and distressing period, Life for a Child has been unable to provide immediate life-saving emergency assistance. Our typical supply channels have been disrupted since the transportation of insulin necessitates a cessation of violence due to the cold chain requirement. While we acknowledge and support the determined efforts of UN agencies in delivering insulin into Gaza, we know that more substantial support is required, and are frustrated to be unable to provide supplies where they are so urgently needed. The Life for a Child team, in collaboration with our key logistics partner, is earnestly exploring alternative solutions to ensure that essential care reaches Gazan children with diabetes in need.

Access to healthcare is a human right. We advocate for unobstructed access to essential diabetes care that is critical for the survival and well-being of children and young adults. Life for a Child’s vision statement is No child should die of diabetes, and we urgently demand full, unimpeded humanitarian access to deliver life-saving supplies to the Gazan population in need.

The post Life for a Child statement on Gaza appeared first on Life for a Child.

Two pivotal studies conducted by Life for a Child in India and Sudan were discussed in this review. These studies, conducted as part of ongoing Life for a Child advocacy since 2015, aimed to provide new information on thermostability of human and analog insulin in a real-world hot climate setting, as well as the efficacy of traditional evaporative cooling devices in reducing storage temperature and loss of insulin potency.

The Review has profound implications, particularly for individuals living with insulin-requiring diabetes in resource-limited settings. Access to refrigeration is not always available for those living with diabetes in these circumstances and these findings could potentially reduce wastage of insulin vials and alleviate the anxiety associated with the efficacy of their medication, thereby offering tangible improvements to their daily lives. For those who rely on insulin and may live vial-to-vial, and their health professionals, this knowledge could alleviate some of the burden of worry about the efficacy of their medication in the absence of refrigeration.

Life for a Child views the Review as a significant win in global diabetes advocacy. It stands as a testament to the influence of research and collaborative endeavors in shaping evidence-based guidelines. Our research partnerships with esteemed organizations like the DREAM Trust in India, University of Florida, and University of Gothenburg, and the Sudanese Childhood Diabetes Association have been instrumental in shaping these guidelines.

Moving forward, our aspiration is that this groundbreaking review will catalyze a reassessment of human insulin package inserts. The potential revision of these inserts holds promise for providing more precise and accessible information to individuals managing diabetes and their healthcare providers. This evolution could further empower people in effectively navigating their diabetes management.

Emma Klatman Global Policy and Advocacy Manager
Rachel Clayton Marketing and Communications Manager
Dr. Graham Ogle General Manager

The post A win for advocacy on insulin thermostability appeared first on Life for a Child.