In the DRC, a local NGO fights against diabetes during natural disasters and civil conflicts

Growing up in what is now the Democratic Republic of the Congo, Alfred Kakisingi has seen many of his loved ones experience the effects of diabetes. For those whose condition worsened, the prognosis was grim. “Every time they send someone with diabetes to the hospital, the mindset is that it feels like a death sentence,” he says.

Decades later, despite the increasing prevalence of diabetes in the DRC, the disease is not receiving enough attention from health providers in the region, Kakisingi says. Hospitals and health care providers in the region believe that “diabetes is not a priority for them,” he laments. People in the DRC often learn that they have diabetes only when they begin to experience severe complications from the disease; untreated diabetes puts people at high risk for limb amputation, vision loss and premature death. Globally, about half of all adults with type 2 diabetes go undiagnosed or are unaware of their condition, according to the Lancet.

The World Health Organization has warned of a rapid increase in conditions linked to obesity, diabetes and hypertension in the DRC, in line with a similar trend in low- and middle-income countries around the world. One in four DRC residents suffered from hypertension in 2014, one of the highest rates in Africa, according to the WHO. The prevalence of diabetes fell from 11.9% to 15.6% between 2010 and 2015 among workers at the Tenke Fungurume copper and cobalt mine in the DRC, a longitudinal study to study workers’ health records found.

To take part

Kakisingi co-founded and heads an organization called Association des Diabétiques du Congo, or ADIC, which educates residents of eastern DRC on diabetes prevention, nutrition, personal care and management, and distributes medicines to help people to control the disease. ADIC is based in the city of Goma, along the DRC’s eastern border with Rwanda.

The DRC has experienced decades of unrest, including wars and ethnic conflicts involving around 150 armed groups, sometimes spilling out from Rwanda; the Ebola, cholera and Covid-19 epidemics; and natural disasters, including floods. In May, tens of thousands of people fled their homes when the Mount Nyiragongo volcano erupted just 12 kilometers from Goma. The DRC had 5.2 million internally displaced people in 2020, the largest internally displaced population in Africa, including 2 million newly displaced people, according to UNHCR.

Civil conflict makes travel difficult and dangerous, which is why ADIC is working with partners in towns and villages in eastern Congo to provide training and provide diabetes medication to those in need. She also runs an outpatient clinic in Goma, which treated 3,995 patients last year. When diabetic patients arrive, their blood sugar is controlled and stabilized if necessary. They are offered counseling on diabetes and how to manage it, and given a supply of drugs if available.

Diabetes treatment therapies donated by Merck KGaA via Direct Relief are packaged to the Association des Diabétiques du Congo in Goma for delivery to a diabetes center in South Kivu, a 200 kilometer boat ride followed by 130 kilometers by the road. (Photo courtesy of the Association des Diabétiques du Congo)

Direct Relief has partnered with Merck KGaA to donate and deliver diabetes medication to ADIC for use with its local patients. As of 2019, Direct Relief has provided 3,222 pounds of Merck KGaA drugs to ADIC – over 350,771 defined daily doses of drugs for diabetes and hypertension. The donations to ADIC are part of a larger program in which Merck KGaA has donated 20 million doses of its type 2 diabetes medicine Glucophage, plus more than 10 million doses of its blood pressure medicine Concor . (Merck KGaA, based in Darmstadt, Germany, is entirely separate from US-based Merck & Co., although both companies share historical roots.)

Support for diabetic patients in the DRC by Direct Relief and Merck KGaA is part of a global movement to bring diabetes care to people in countries in crisis. The movement includes the WHO Global Compact on Diabetes, introduced in April 2021, which sets out a vision “to reduce the risk of diabetes and ensure that all people diagnosed with diabetes have access to quality care and treatment that is equitable, comprehensive and affordable”.

“Diabetes is a global epidemic,” according to the WHO Global Diabetes Compact. Before the emergence of COVID-19, more than 420 million people lived with diabetes globally, or 6% of the world’s population, and four times more than in 1980, the report says. “This number is expected to reach 570 million by 2030 and 700 million by 2045, growing fastest in low and middle income countries.”

The WHO Global Compact on Diabetes cited “a chronic lack of investment in diabetes prevention, early diagnosis, treatment and appropriate care,” which “must be corrected without delay to reduce the immense suffering millions of people and mitigate preventable long-term social and economic consequences. costs to society.

In partnership with Life for a Child, Direct Relief has been donating supplies to ADIC to support its patients with type 1 diabetes since 2011. As of 2019, ADIC has been receiving donations of insulin and type 2 diabetes medications and cardiovascular disease, as part of Direct Relief. with the International Diabetes Federation to support people with diabetes in countries in crisis.

“The work of Direct Relief is part of a very large initiative by advocacy organizations, political organizations, WHO and others to bring diabetes and noncommunicable diseases to the fore in humanitarian and crisis situations. , to provide care and access to medicines for people all over the world. the world who live in these situations, ”said Kelsey Grodzovsky, program manager for global programs at Direct Relief.

Improve access to quality medicines

The limited supply of diabetes drugs available in the DRC is often of poor quality, Kakisingi said. Direct Relief supplies ADIC with premium brand name generic medicines from Merck KGaA, including Glucophage and Glucovance (oral medicines to control type 2 diabetes) and the high blood pressure medicine Concor. These are drugs originally developed by Merck KGaA which are now out of patent.

“The benefits are huge,” Kakisingi said. “Direct Relief sends us top quality drugs. Some doctors, when they see these products, say they have never seen them before. Second, the product is sent so quickly. DR takes care of the freight and customs clearance costs, and that’s a very big plus.

Andre Musto, Senior Vice President, Head of Cardiovascular Metabolism and Endocrinology Franchise at Merck KGaA, Darmstadt, Germany, said: “Given the current situation of undertreatment and limited access to medicines, we are taking very seriously seriously our responsibility to develop and support diabetes treatment and education to face the current scenario and help future generations in better health. We are honored to continue our collaboration with Direct Relief and support their efforts and ultimately help patients in need. ”

Merck KGaA’s drugs have gone to countries in crisis around the world, including the Central African Republic, DRC, Republic of Congo, Ethiopia, Haiti, Syria and Zimbabwe, among others.

In 2020, Direct Relief provided diabetes products valued at hundreds of millions of dollars to underserved people with diabetes who have been affected by disasters and emergencies in more than 60 countries around the world. Working closely with the three global manufacturers of insulin, Direct Relief is now one of the largest suppliers of humanitarian insulin in the world. Direct Relief’s distribution center dramatically expands its refrigeration capacity to store cold chain drugs (with space for up to 677 product pallets), allowing for increased support for people in need of cold chain therapy. the cold chain for diabetes, cancer, hemophilia, rare diseases and other conditions.

Rita Tshimanga of Direct Relief provided translation support for this story.

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