Expert Meeting : Access to insulin and diabetes care

GHF Expert Meeting

“What are the current challenges and solutions to access to insulin and diabetes care?”

 

Campus Biotech, Geneva - November 11, 2019; 9.00 - 18.30

 

 

Globally it is estimated that one person in three has no guaranteed access to essential medicines. In the poorest parts of Africa and Asia, this proportion increases to one-half. Considerable attention has been paid to the issue of access to medicines for HIV/AIDS, tuberculosis and malaria, however little attention has been paid to questions of access to essential medicines for Non communicable Diseases and diabetes

Insulin for type 1 diabetes is a rare example where there is an absolute need for a given medicine. Although global disease burden data is lacking in 2015, it is estimated that 542,000 children aged 0-14 have type 1 diabetes and that its prevalence is increasing by 3 percent per year. While there are no estimates for the total amount of people living with type 1 diabetes estimates show that they may represent 5 percent of the total diabetes burden, of 514 million, or 20.8 million people. In contrast use of insulin in the management of type 2 diabetes is required for better control and its use is dependent on capabilities existing within different health systems and it is estimated that by 2030 close to 80 million people will need insulin with currently 50% of these people lacking access. Poor access to insulin translates into life expectancy for a child with Type 1 diabetes in sub-Saharan Africa being as low as one year. This is in contrast to recent data by Miller et al. showing that people diagnosed with Type 1 diabetes in the 1960s and 1970s in the USA have only a 4-6 year difference in life expectancy from that of the general population.

revious work by the “Addressing the Challenge and Constraints of Insulin Sources and Supply” (ACCISS) Study, being co-led by Dr. David Beran of the Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, highlighted the poor availability and affordability of insulin. The factors leading to this included a variety of barriers at global and national level. Little is known about why the price of insulin has remained consistently high over the years. It is thought, however, to be the result of market domination by few multinational companies. The lack of training of staff, the lack of diagnostic tools in health centers, the lack of information from patients, the lack of reliable distribution channels also explain the difficulties encountered.

In this perspective, the development of new tools and the recent discoveries on diabetes open the door to new strategies

In view of this, the development of new tools and recent discoveries about diabetes open the door to new strategies.

It therefore appears important to develop action research programs to define new strategies to improve diabetes management in resource-con-strained settings.

Given the involvement of a researcher from the University of Geneva in a leading study on the issue of access to insulin; the existence of a strong focus on diabetes research at the University of Geneva; and the position of Geneva as the global health capital it is felt that an expert meeting will be a good tool to build a roadmap for action.

At first, the Expert Meeting will aim to

• Share different perspectives around the complex issue of managing type 1 diabetes.
• Identify barriers and opportunities for managing type 1 diabetes in resource-limited settings.
• Identify potential actions to improve the management of type 1 diabetes in resource-limited settings.

The outcome of the expert meeting will be a “roadmap” to addressing certain bottlenecks in diabnetes management. This document will feed into a workshop at the Geneva Health Forum (March 2020) which will aim to build a research program based on the propositions identified by the Expert meeting. This research can then be implemented by the participating organizations. This work will also foster networking among those involved in the management of type 1 diabetes in resource-limited settings. These meetings should facilitate the development of future collaborations.

 

Agenda

08:30-09:00	Registration and coffee
09:00-09:30	Welcome and introduction of the meeting o Prof Cem Gabay o Dean, Faculty of Medicine, University of Geneva; o Prof Valérie Schwitzgebel Vice-President Diabetes Center of Medical Faculty, University of Geneva; Head of Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, gynecology and obstetrics, Geneva University Hospitals
09:30-09:45	Access to insulin global challenges and “homemade” insulin Presentations o Dr Margaret Ewen Health Action International; The Netherland Access to insulin : a complex issue o Alex Kelly BioFoundry; Australia Open Insulin : a solution to lowering barriers to access
09:45-10:30	Overall group splits into 4-6 groups around tables with rapporteurs
10:30-11:00	Coffee Break and poster session
11:00-12:00	What role for innovation in changing the landscape of management of Type 1 diabetes? 5-minute pitches o Prof Fabrizio Thorel Genetic Medicine and Development, University of Geneva; Insulin-secreting alpha cells o Dr Thomas Zueger University of Bern; Open Artificial Pancreas (OpenAPS) o Prof Domenico Bosco University of Geneva; Pancreatic islet transplantation o Dr Thomas Zueger University of Bern; Headwind o Dr Andreas Güntner Mechanical and Process Engineering, Eidgenössische Technische Hochschule Zürich (ETHZ); Non-invasive Metabolic Monitoring with Breath Sensor o Dr Giacomo Gataldi and Montserrat Castellsague Perolini University of Geneva; MOOCs and MOORE Moderated by Prof Antoine Flahault, Institut of Global Health, University of Geneva and Dr Catharina Boheme, Chief Executive Officer, FIND
13:00-14:00	Key note presentation – Open to public o Dr Soumya Swaminathan Chief Scientist, World Health Organization; Opening remarks o Prof Emmanouil Dermitzakis Department of Genetic Medicine and Development, Faculty of Medicine; University of Geneva; Swiss Institute of Bioinformatics (SIB); Health 2030 Genome Center Precision Diabetes
14:00-14:15	Break and poster session
14:15-14:45	Care for Type 1 diabetes in difficult settings and for marginalised populations Presentations o Dr Edna Majaliwa Muhimbili National Hospital, Tanzania; Managing Type 1 diabetes in Tanzania: Lessons learnt and ongoing challenges o Dr Philippa Boulle Médecins Sans Frontières (MSF); Delivering Type 1 diabetes care in a humanitarian context o Dr Mirjam Dirlewanger Geneva University Hospitals; Type 1 diabetes care in Geneva for vulnerable populations
14:45-15:15	Overall group splits into 4-6 groups around tables with rapporteurs
15:15-15:45	Coffee Break and poster session
15:45-16:15	Rethinking delivery of care for Type 1 diabetes: systems, education and empowerment Presentations o Dr Valla Tantayotai Foundation for the Development of Diabetes Care, Thailand; Education and empowerment for people with diabetes o Dr Philippe Klee Geneva University Hospitals; Implementation of innovation in daily management of type 1 diabete Moderated by Prof Alain Golay, Geneva University Hospitals
16:15-18:00	What is missing for the management of Type 1 diabetes in 2019 and a roadmap for the future Panel discussion – - Based on discussions from the day the discussants will give their feedback o Stéphane Besançon Santé Diabète, Mali; o Prof Antoine Geissbuhler University of Geneva, Geneva University Hospitals; o Molly Lepeska Health Action International; The Netherland; o Dr Gojka Roglic World Health Organization (WHO); o Prof Valérie Schwitzgebel University of Geneva, Geneva University Hospitals; o Maria-Claudia Berghusen Diabetes Association, Peru; Moderated by Neil Bennet, The Lancet Diabetes & Endocrinology
18:00-18:30	Concluding remarks o Prof Antoine Geissbuhler Vice-Rector University of Geneva; Director, eHealth & Innovation at Geneva University Hospitals; Co-president of the Geneva Health Forum

 

Key note presentation – Open to public - 13:00-14:00

Dr Soumya Swaminathan	Chief Scientist, World Health Organization (WHO)	Opening remarks
Prof Emmanouil Dermitzakis	Department of Genetic Medicine and Development Faculty of Medicine, University of Geneva; Swiss Institute of Bioinformatics (SIB); Health 2030 Genome Center	Precision Diabetes

 

Download the PDF presentation

Organized by

Diabetes Center of Medical Faculty	Department of Pediatrics, gynecology and obstetrics	Division of Tropical and Humanitarian Medicine	ACCISS Study	Geneva Health Forum

Photo credit : David Beran

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