Aligning with World Health Organization and Kenyan guidelines is key to improving care for people living with diabetes in Kenya
Today, in response to the Benefits Package and Tariffs Advisory Panel’s invitation for proposals for how to continue strengthening healthcare systems in Kenya, Médecins Sans Frontières (MSF) calls for Kenya’s Social Health Authority (SHA) benefits package to include analogue insulin pens to improve care for people living with diabetes.
By introducing analogue insulin pens to its Social Health Authority benefits package, Kenya would be leading the charge towards upending the global double standard in diabetes care and ensuring that people with diabetes have more equitable access to care.
The number of people living with diabetes worldwide rose from 200 million in 1990 to 830 million in 2022, and yet, globally, only half of those in need were estimated to have access to treatment – with treatment coverage lowest in low- and middle-income countries. In fact, a global double standard of care exists whereby newer analogue insulin pens – which can simplify treatment and reduce complications for people with diabetes – are widely available in high-income countries, while access in low- and middle-income countries and humanitarian settings remains extremely limited.
In Kenya, an estimated 813,300 adults – 3.1 per cent of the country’s adult population – were living with diabetes in 2021. However, this number could be much higher, as it's estimated that over 50 per cent of people with diabetes in Kenya remain undiagnosed.
“The prevalence of diabetes is rapidly increasing around the world, but access to treatment is not improving at the same rate, especially in low- and middle-income countries where modern, more efficacious, and person-preferred treatments like analogue insulin pens are unaffordable or unavailable,” said Dr Elizabeth Jarman, noncommunicable disease technical advisor, MSF Access. “By introducing analogue insulin pens to its Social Health Authority benefits package, Kenya would be leading the charge towards upending the global double standard in diabetes care and ensuring that people with diabetes have more equitable access to care.”
- Insulin pens are the standard of care in many high-income countries and are often preferred by people living with diabetes over insulin delivered from vials and syringes. This is because insulin pens improve accuracy of dosing, are easier to use, and are more robust and compact – overall, they can improve the quality of life for people with diabetes.
- Insulin analogues can decrease complications and improve blood sugar management for people living with diabetes as shown by multiple studies around the world. In Mali, switching children from insulin in vials and syringes to a more physiological (basal-bolus) regime delivered by analogue insulin pens showed a marked improvement in HbA1c levels – which are used to show how well blood sugar levels are managed – and a reduction for diabetic ketoacidosis – a potentially life-threatening acute complication of diabetes.
- In a decisive acknowledgment that analogue insulin pens are a vital treatment for diabetes and should be made available for all, they were recently included in the World Health Organization’s (WHO) Model List of Essential Medicines, in Kenya’s Essential Medicines List and in Kenya’s National Clinical Guidelines on the Management of Diabetes.
In Kenya, ensuring a sustainable supply of affordable analogue insulin pens is especially critical: around 8,000 children are currently receiving analogue insulin pens through the Changing Diabetes in Children programme but, unless analogue insulin pens are universally available in-country, these children will struggle to access the same standard of care once they age out of the programme.
Now is the time to go the last mile and ensure analogue insulin pens are available as part of the Social Health Authority benefits package so that more people in Kenya have access to the insulin delivery device that is most effective for their own clinical needs
“Over the past few years, Kenya has taken important steps in the right direction by including analogue insulin pens in its Essential Medicines List and the National Clinical Guidelines for Diabetes Management,” said Dr Narine Danielyan, MSF Medical Coordinator in Kenya. “Now is the time to go the last mile and ensure these devices are available as part of the Social Health Authority benefits package so that more people in Kenya have access to the insulin delivery device that is most effective for their own clinical needs, in alignment with national guidelines.”
MSF is committed to improving the quality of care for people living with diabetes across its programmes globally and is supporting their transition from using human insulin in vials to analogue insulin pens. In Kenya, this includes programmes in Homa Bay County and Dagahaley refugee camp. An MSF research study is underway to document patient and healthcare worker experiences with the transition and to generate Kenya-based evidence on the feasibility, acceptability and impact of analogue insulin pens in humanitarian settings.
MSF’s full proposal for Kenya’s Social Health Authority benefits package to include analogue insulin pens to improve care for people living with diabetes can be accessed here.
