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 email@example.com
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