Category Archives: News

Drug Revolving Fund (DRF) BY PHARM BUKOLA FABIYI

I was engaging my followers on the need for constructive methods of essential medicine financing when Pharmacist Bukola Fabiyi mentioned “Drug Revolving Funds” as a potent and strategic means of ensuring people do not die due to live saving medications like insulin.

So i pleaded with her to submit an article about this which she did and i hope our readers can begin to task the government at local, state and federal level into making sure the right things are done towards ensuring essential medicines are made available, affordable and accessible to everyone irrespective of the social status.

Drug Revolving Fund (DRF)

The Bamako Initiative (BI) was introduced by WHO/UNICEF in the late 1980’s to improve access to essential drugs for the most vulnerable in the society and thus improve the health outcomes (Chukwuani et al., 2006).

Essential medicines, as defined by the World Health Organization (WHO), are the medicines that “satisfy the priority health care needs of the population”. These are the medications to which people should have access at all times in sufficient amounts.

Essential medicines selected for diabetes are “Insulins and analogues” and “Oral blood glucose lowering medicines”

The DRF is a method of financing medicine in which, after an initial capital investment, drug supplies are replenished with monies collected from the sales of drugs according to the world health organization. It is an effective strategy for ensuring regular drug supply in the healthcare delivery system.

This scheme according to the research conducted by ogbonna however has not been successful due to the following reasons:

  • Poor management
  • Mis-application of the Fund
  • Purchasing of drugs at exorbitant prices
  • Lumping of the proceeds of the fund into a general account
  • Non-reimbursement of the cost of drugs for exempted patients.

According to Gazelle News, May 14, 2013, it stated that 17 states went to understudy and adopt Ekiti’s unified DRF.

A case study was also carried out and evaluated on the efficiency in the drug supply system in Kano state in 2013. Kano state was able to increase their procurement significantly from N133 million in 2008 to N1 billion in 2013 without additional financial support. This was managed and supported by key institutions.

To ensure the success of DRF, quality medicines must be identified, the medicine must be affordable and the monitoring and evaluation of the DRF facility must be achieved in accordance to the set performance targets (Ogbonna and Nwako, 2016).

The Central medical stores in Lagos was renovated in 2013 through funding from Non-Governmental Organisation and Federal Ministry of Health (NGO/FMOH). The Lagos state ministry of health has gone into collaboration with PATHS (Partnership for Transforming Health Systems) and private suppliers of medicines to enhance the operation of sustainable DRF system.

References:

Ogbonna, B. O., and Nwako, C. N. (2016) Essential Drug Revolving Fund Scheme in Nigeria, from the Edge of a Precipice towards Sustainability. Journal of Advances in medical and Pharmaceutical Sciences. Vol 8(2), Pp1-8.

WHO (2009) How to establish a successful revolving drug fund: the experience of Khartoum state in the Sudan. Available [online] from here

A WONDERFUL TRIP TO GHANA FOR DIABETES ADVOCACY TRAINING – Omolade Onafowokan

I had the opportunity of attending an advocacy program on the 22nd – 26th of August 2018. I went as a representative of my country Nigeria (The Nigeria Diabetes Online Community). The venue of the program was at the University of Ghana, Yiri lodge, Accra.

The advocacy program was organized by the SONIA NABETA FOUNDATION, DIABETES YOUTH CARE and Sponsored by T1 INTERNATIONAL, there were also many invited advocates from different country.

At exactly 9am on the 23rd of august the founder of T1 INTERNATIONAL, Elizabeth , open with the following contents. “The meaning of diabetes advocacy, T1 diabetes aim, Importance of diabetes awareness, advocacy plan, advocacy goal.”

After this inspiring step and perfect explanation of what she meant, she gave every advocate an assignment to do in his/her country. It was the most orderly and systematic arrangement I have experienced.

I learnt about ways of improving public awareness through diabetes education, because not all people that are diagnosed of diabetes accept the condition and the fact that they don’t accept means they are not willing to learn about diabetes.

Also, I also learnt about diabetes advocacy aim which helps to raise public awareness round the world in terms of access to insulin, test strip, supporting people with diabetes, organizing diabetes resources and campaigning for world diabetes day.  I learnt about the means of taking action to achieve a specific change in policy practice that could benefit people with diabetes based on good advocacy.

I learnt about speaking on what is important to us, by ensuring that voices of people living with diabetes are heard and by making a difference, standing up for our health right. It is a way of fighting for long term change so more people can have a better life with diabetes.

In numerous ways, I benefited from the experience. First, it paved way for me to know how my goal could be achieved based on advocacy’s key message. Second, the lecture enables me find a remedy to any advocacy issue I may encounter.  Finally, the experience I had was that I was able to gather a first – hand information on how my goal could be easily achieved.

My action plan is to organize a diabetes education program at school in November period, giving them information on what diabetes entails, because misconception about diabetes is one of the health challenges we face in our community and this brings about mismanagement of diabetes. “EDUCATION IS KEY”.

My goal is to make sure students are able to understand the facts and initiative about diabetes.

A Bad Case- An Original Comedy Series Surrounding Diabetes

A Bad Case is an original comedy series about four friends and what happens when diabetes shows up at the worst possible moment. It is  a message of hope to the world. It’s comedy about when diabetes goes all wrong and easily relatable.

According to Erin Spinento who also directed the movie:

Hollywood has consistently gotten our story wrong. They have used diabetes as a handy plot tool to raise the stakes for a story. From minor mistakes to huge blunders, they are sharing an inaccurate story of what it means to live with diabetes.

It is time to change that narrative. It is time to have our stories told accurately and in depth. A Bad Case is the story of four friends who handle their diabetes very differently. There is a good chance you will see yourself in at least one of the characters on screen. For the first time, a viewer might be able to relate to someone just like her, who has the same outlook or quirks, who has developed the same strategies for dealing.

Knowing how crucial a positive outlook is on doing a good job of taking care of diabetes, a series that focuses on diabetes and humor could have an incredible impact on those who are struggling with the difficulty of this condition.

Personally, the only way I can deal with such a long-term and difficult situation is to find the humor, even if it is a sort of gallows humor. When we can come to a point of laughing at the absurd difficulty, we gain perspective and a renewed sense of strength to keep on fighting.  

I want to produce this series to explore a new medium for pursuing the same mission I have always had when it comes to interacting with the diabetes community; to empower people to take amazing care of their diabetes.

You can watch, follow the series and support the project here

For interviews or more info, please contact:

Erin Spineto, Sea Peptide Productions. erin@seapeptide.com

Free foot checks for people with diabetes

As Rainbow Specialist Medical Centre celebrates her  anniversary, they’ve organized a training for health workers on skills in diabetes care as well as free foot checks for patients living with diabetes.

 

This would be during the 5th Annual Diabetes Foot and Podiatry Workshop organized at Dover Hotel, Lekki.

 

Medical Director of the centre and coordinator of the Diabetes Podiatry Initiative Nigeria (DPIN), Dr. Afoke Isiavwe, in a statement, said the workshop, the 5th edition, is being organised to address the high rate of amputation among Nigerians living with diabetes, which has been reported to be as high as 53.2 per cent of the number of people with foot ulcer in some centres. This makes diabetes foot the most common cause of non-traumatic amputation in the lower extremities in Nigeria and elsewhere in the world.

International training faculty from the World Walk Foundation, Jamaican Chapter, will conduct the 2018 edition of the workshop, according to the release.

The focus of the training would be on primary health care workers as they are the first point of call in diabetes care.

“It is important to equip these group of healthcare workers with necessary skills in these two common conditions to detect initiate correct treatment and also know when to refer patients for further care,” the release further said.

 

BBC presenter apologises for ‘confused start’ due to hypoglycemia on air.

A BBC World service presenter, Alex Ritson was presenting at about 5 am in the Newsroom on Friday when his listeners heard him stumble on some of his words.

The presenter ,who has Type 1 diabetes has apologized for a “confused start”  saying he had a “low sugar attack” just as he went on air.

He was discussing about the Pope’s visit to Bangladesh when he suddenly was speaking slowly and difficult to understand

“I have Type 1 diabetes and I had a low sugar attack, a ‘hypo’, just as we came on air which caused me a little confusion in my opening sequences , so many apologies for that.”

A BBC spokeswoman said

“One of our presenters was a little unwell while on air this morning.”

”The presenter came back on air later in the programme and explained to listeners that they had Type 1 diabetes and were feeling better ”

So many listeners have commended him for that.

While so many of us think diabetes is just a problem of high blood sugar, it really is a struggle between high sugar levels and low sugar levels that result from insulin use. The patient is basically struggling to find a balance.

Hypoglycemia (low blood sugar) occurs in people with diabetes when their blood sugar goes beneath 4mmol/l (70mg/dl) but the value varies for most people.

Early signs and symptoms of diabetic hypoglycemia include:

Shakiness, Dizziness, Sweating, Hunger, Irritability or moodiness, Anxiety or nervousness, Headache

In more severe cases, there can be confusion, unconsciousness and even death.

To know more about hypoglycemia, you can check this

 Hypoglycemia training programme

Woman Living With Diabetes No Longer Needs Insulin After Bioengineered Pancreas Transplant

The major problem with type 1 diabetes is that the body produces antibodies that attack the body’s healthy islet cells in the pancreas which produces insulin. This limits insulin production making the body the body unable to make use of glucose gotten from diet leading to high blood sugar. The patient then has to makes rely on insulin injections or pumps to survive.

Before now, several research works have being aimed at transplanting islet cells from deceased donors into the liver but this has not been ideal The liver can only take few islet cells and with risk of bleeding.
Recently, researchers at the University of Miami Diabetes Research Institute have tried another location – the omentum, a fatty membrane in the belly.

A 43 year old single mother with a 25 year history of type 1 diabetes has been off insulin for over a year following islet cell transplant in the omentum. Before the transplant, she was said to have been on about 33 units of insulin per day. No surgical complications were observed during the procedure.

The researchers said

“The cells began producing insulin faster than expected, and after one year she is doing well and doesn’t need insulin injections”.

“We’re exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach,”

Dr. David Baidal, assistant professor in the University of Miami Research Institute who led the study said. The research is the first step towards developing a mini organ called BioHub.

The BioHub would be like a home to the islet cells providing it with blood supply and nutrition, making it easier to remove in cases of complications. The researchers plan to test the use of omentum as a site in 5 new patients.

IMPROVED LIFESTYLE
Baidal explained that

“Her quality of life was severely impacted. She had to move in with her parents. And, if she traveled, she had to travel with her father”.

This is indeed good news.
This is a step in the positive direction for about 422 million people worldwide living diabetes. It would also markedly save cost for insulin in the long term.
More information of this ground breaking research headed by Dr David A. Baidal can be seen in the New England Journal of Medicine.

Meanwhile, you can win an all expense paid trip to a Diabetes youth camp in Ghana. Click here for details

Diabetes Advocates Protest Against High Insulin Prices

When Frederick Banting discovered Insulin in 1922, he never thought it’s prices would be as high as what is obtainable today.

Source: T1International

Insulin is a vital drug that is needed for people living with diabetes to survive but the increasing prices have caused people to ration insulin doses and skip injections causing poor control of their blood sugar.
On Saturday, 9th of September, 2017, T1International, an advocacy group for people living with type 1 diabetes around the world and People of Faith for Access to Medicines (PFAM) along with other stakeholders led a demonstration in front of Eli Lilly and Company International corporate headquarters in downtown Indianapolis. The day for online action was September 8th, 2017.

“We spend more money on diabetes than on our house payments,” Indiana resident Erin Roberts said.
Mike Hoskins who was at the protest said on his blog that he was spending $700 per month to get 3 vials of insulin in 2015 and that was more than half of housing cost per month and he had to borrow from a friend.

Consumers of these products are frustrated and have come out in mass to express their feelings. Parents of children living with diabetes and other concerned persons participated in the protest. Some people lamented that they have to pick between buying their groceries and buying insulin.

Some protesters at the demonstration.
Source: T1International

The 3 main pharmaceutical companies producing insulin are Eli Lilly, Novo Nordisk, and Sanofi and they’ve continually increased the prices of insulin.
March 2017 saw another increase of Eli Lilly’s insulin product ; Humalog and Humilin by 7.8 percent.

Lilly is said to have raised the price of its version of insulin by over 300% over the past seven years. A U.S. patient’s out-of-pocket cost for a month’s supply of Eli Lilly’s Humalog can be over $400 (About 144,000 Naira).

In July 2017 it was reported that Lilly had a 35% increase in quarterly profits: $1+ billion, on $5.82 billion revenue. Though Eli Lilly recently started a patients assistance program when people complained about the costs, it is still grossly inadequate as only a small number of people would benefit.

Humalog has seen a 1123 percent increase in price since June 1996.
The insulin makers have also argued that its costs a great deal for advancements to produce new and better insulin.

Photo credit : Business insider

An Eli Lilly spokesperson responded in an email saying, “We are pleased that people in the diabetes community are engaged in this issue, and demonstrations are one way to do so. It will take continued effort across the healthcare system to affect real change, and Lilly is committed to working with others to make it happen.”

People with diabetes are asking Eli Lilly for three things:
• Be transparent about how much it costs to make one vial of Humalog insulin
• Be transparent about your profits from each vial
• Lower the price of insulin

So many people are dying from diabetic ketoacidosis because they can’t afford insulin.
For a long time, Africa was thought to be safe from diseases called “diseases of affluence,” like diabetes which plague the Western world but this is now known to be false as there is an increasing statistic of people living with diabetes and this includes both rich and poor.

As at 2013, the Nigerian government was reportedly spending $500 million (78.5 million Naira at that time) on importation of insulin annually. Insulin access is still a major problem in developing countries too.

On the pages of Indystar on Saturday

You can still lend a voice to the cause via social media.
Hashtag is #Insulin4all . You can get more information on Facebook and other social media sites.

Hashtag

SPONSORING ORGANIZATIONS OF THE DEMONSTRATION:

T1International

People of Faith for Access to Medicines

Public Citizen 

Patients for Affordable Drugs

Merck Diabetes and Hypertension Awards

Merck Diabetes Award

All medical undergraduates and postgraduates are invited to apply for the

Merck Diabetes Award 2017
Theme: Every Day is a Diabetes Day

Please submit a concept paper about:

  • How to improve the awareness about Diabetes Early Detection and Prevention in your country.
  • How to encourage your society, scientific community, local authorities, media and relevant stakeholders to Think and Act on Diabetes Every Day.
  • Your ideas of developing new policies, strategies, social media campaigns and more.

 

Merck Diabetes Award 2017

is:

“Postgraduate Diabetes Diploma with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October, 2017 in Cairo, Egypt to receive the award”.

Merck Diabetes Award is being rolled out in many of the African and Asian universities as part of our commitment to building diabetes capacity and improving access to quality and sustainable healthcare solutions in developing countries.

The aim of Merck Diabetes Award is to create a Diabetes Experts Platform across the globe.

Please submit your one page concept paper to:
submit@merckdiabetesaward.com

Submission deadline is 31st July 2017

Entry requirements:

Postgraduate Diploma

Health professionals, both UK and overseas, with an honors degree or equivalent (including international qualifications) are eligible to apply for the PG Diploma Diabetes course online.

Non graduates are also encouraged to apply (applicants will be asked to submit a piece of work for assessment to confirm that they are able to work comfortably at degree level).

Applicants should submit copies of the following with their application:

  • qualification certificates
  • one written reference
  • English language qualification (IELTS 6.5 or equivalent) please see University of South Wales for further details

Merck Hypertension Award

All medical undergraduates and postgraduates are invited to apply for the

Merck Hypertension Award 2017

Theme: What the Healthy Heart needs

Merck Hypertension Award is being rolled out in many of the African and Asian universities as part of our commitment to building healthcare capacity and improving access to quality and sustainable healthcare solutions in developing countries.

The aim of Merck Hypertension Award is to create a Hypertension Experts Platform across the globe.

To raise the required awareness to control and prevent hypertension, countries need systems, policies and services in place to promote universal health coverage and support healthy lifestyles: eating a balanced diet, reducing salt intake, avoiding harmful use of alcohol, getting regular exercise and stopping the use of tobacco.

Please submit a concept paper about:

  • How to improve the awareness about hypertension control and prevention in your country.
  • How to encourage your society, scientific community, local authorities, media and relevant stakeholders to think and act on Hypertension Every Day
  • Your ideas of developing new policies, strategies, social media campaigns and more.

Merck Hypertension Award 2017
is:

“Postgraduate Diploma in Preventive Cardiovascular Medicine with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October 2017 in Cairo, Egypt to receive the award”.

Please submit your one page concept paper to:
submit@MerckHypertensionAward.com

Submission deadline is 31st July 2017

Entry requirements:

Postgraduate Diploma

Health professionals, both UK and overseas, with an honors degree or equivalent (including international qualifications) are eligible to apply for the PG Diploma Diabetes course online.

Non graduates are also encouraged to apply (applicants will be asked to submit a piece of work for assessment to confirm that they are able to work comfortably at degree level).

Applicants should submit copies of the following with their application:

  • qualification certificates
  • one written reference
  • English language qualification (IELTS 6.5 or equivalent) please see University of South Wales for further details

For more information visit Merk’s Official website

NGDOC D-Meetup 2017

The Nigeria Diabetes Online Community is organizing a D-Meetup for Children living with diabetes in Nigeria.
The aim of the D-Meetup aims to create an amazing experience for children living with diabetes in a medically safe environment and will run over a weekend.

The activities will centre around children living with diabetes between the ages of 12 – 21 years to meet and share their experiences with one another as they learn to take responsibility for their health status and also to create in them a “I can do it” attitude as they improve on their self-esteem.

wpid-aviary_1448913080416.jpg

This meetup will include meeting with People living with Diabetes Globally, Nutritionist, Paediatric endocrinologist; Tourism; Games; Dinner amongst others.

It also will foster their physical activities and more controlled access to food relative to their experience at home while monitoring a good glycemic control.


Interested in partnering with us contact us on ngdoc@gmail.com or ngdocdmeetup@gmail.com

Do you know any child living with diabetes within the age of 12 – 21 years kindly encourage them to fill the form to participate.

Are you interested in sponsoring this event or volunteering your time and talent to make this event a success? Kindly fill this form.

POLITICS OF DIABETES IN NIGERIA

The recent series of tweets by the USA senator and presidential aspirant, Senator Bernie Sanders, ‘attacking’ insulin makers, that followed a letter sent by him and his counterpart in the House of Representatives to the Department of Justice and Federal Trade Commission on the need for investigating insulin makers for price collusion was a result of his identification with diabetes (which runs in his family) especially during his campaign for Democrats nomination.

Bernie is not the only USA politician advocating on behalf of the People Living with Diabetes (PWD) , Senator Jenne Shaheen who is the leader of the US Senate Diabetes Caucus was quoted to be committed to ensuring that diabetes is a ” priority for legislation no matter what happens in the election” of 2012.  Her commitment could also be linked to her identification with her diabetic granddaughter.

Moreover, the revelation by the UK Prime Minister, Theresa May, on her Type 1 diabetes status in addition to the functional relationship between the UK Parliament and several diabetes groups in the UK points to the fact that fight for the people with diabetes is a major cause for UK politicians. The act of identifying with diabetes and other non communicable diseases by politicians is a common trend across the developed countries, and this has propelled them to advocating, legislating and making policies for the education, prevention, diagnosing and management of diabetes mellitus in their respective countries.

One of the tweets by Bernie Sanders on his twitter handle @sensanders reads “in the richest nation in the world diabetes patients are being forced to decide between eating and paying for the drugs they need”.

I was prompted to respond by comparing the condition of the people with diabetes (PWD) in poor and unstable nations with those in rich countries that are being sympathised with.

Also, my reaction to the letter by Bernie and his colleague on insulin price is by asking for who are to be the defenders for the “weak and helpless” people living with type 1 diabetes (PWT1D) in poor countries like Nigeria.

My last response was inspired by the attitude of politicians across Africa especially Nigeria where disclosure of true health status of politicians seems abominable whether they are being affected by common diseases or not.

Their practice is to embark on medical tourism to developed countries for treatment and management of such diseases secretly  while people only engage in speculation about their health status . For instance, former President Olusegun Obasanjo was forced to disclose his battle with diabetes over several number of years by his need to get votes for his successor who later died in government due to a then undisclosed ailment. This was at the tail end of his (Obasanjo) eight year tenure.

The failure of Nigerian politicians to identify with non-communicable diseases especially diabetes, by which many of them are believed to be affected, and their ability to travel abroad for treatment make them not to have any inspiration or encouragement to make any specific serious legislation, policy or advocacy that is needed to support the common people on the care and management of diabetes, as many are being afflicted and killed by the disease due to their helplessness.

This is evident in the absence of any specific health policy or program on diabetes, lack of appropriate medical facilities for diagnosis and care, inadequate funding for non-communicable diseases, shortage of diabetes specialists and caregivers, inadequate education on prevention and management of diabetes, absence of any parliamentary resolution on diabetes and absence of any regulation on access to and price of diabetic drugs, (especially insulin) among others.

However, according to International Diabetes Federation (IDF), as at year 2015 out of 415 million people living with diabetes in the world, 75 percent are in the poor and middle income countries with Sub-Sahara Africa accounting for 14.2 million . It is shown that prevalence rate of diabetes in Nigeria is 1.9 percent for adults and 3 out of 100,000 children while around 949, 900 persons are undiagnosed. Among 5 million people that die due to diabetes annually across the world Nigeria accounts for more than 40,000. Relatively, Nigeria leads in the number of incidence of and mortality rate from the disease in Africa.

Meanwhile, the current economic condition, a result of economic recession, in the country is making self management of diabetes unaffordable for the people living with diabetes.

The reliance on importation of all the much needed diabetic supplies,  continuous fall in the exchange rate of Naira to foreign currencies, galloping inflation and dwindling real income have all contributed to unaffordability and inaccessibility of the supplies most especially insulin.

The price of each of the items has skyrocketed to about 150 percent increase within a short period of eight months. Choosing myself as a typical sample of an average  person living with diabetes in the country , my monthly costs of supplies currently within Lagos metropolis could be broken down as follows :

Insulin ( Mixtard of 100 IU)              N5500 per vial

Syringes                                                       N2500 per pack of 100 units

Glucometer (Accu-chek Active)    N8000

Meter test strips                                    N4600 per pack

Diabetic multivitamin                        N3400

All these prices are only obtainable within Lagos which is the major commercial city in the country, but in other cities and towns most of the supplies are either much more costlier or not totally available. Meanwhile , my monthly income stands at around N25000 out of which I spend around N16000 on the supplies (64 percent) . The cost of transportation and other implicit costs are yet to be included.

Despite all the available statistics on diabetes, though actually underestimated because of absence of credible medical data gathering in the country, and the plight of the people living with diabetes in managing the condition there is no any serious political will on the part of policy makers, and in spite of signing up with Global Action on Non-communicable diseases, to help the people with diabetes out of the challenges being faced in the need to lead fulfilled lives, and reduce the level prevalence of the disease.

Nigeria is only chosen in this article as a reflective sample for all the poor and politically unstable countries of the world, which means that the conditions of the people living with diabetes in these countries, especially in Africa, need urgent and serious actions on the part of their politicians on supports for adequate management as well as on the need for measures for prevention to reduce the rate of prevalence.

So, the question still remains as who will fight for the ‘weak and helpless’ people living with diabetes in the poor countries?

Olafimihan Nasiru Titilope is living with diabetes can be reached on nasoola77@yahoo.com

 

The article posted is strictly the responsibility of the author. NGdoc  will not be liable for any errors, omissions, or any losses, injuries, or damages arising from its display or use. This article is featured on an as-is basis.