Ideating 21st-Century Diabetes e-Patients in Africa
Start your answers with T1, T2, T3, T4 or CT for transcript purposes.
Answer only after the moderator prompts. Questions will be prompted every 10 minutes, but keep answers coming using the relevant T and number. Both panel experts and public attendees are encouraged to participate.
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T1: What are the current challenges for diabetes patients and providers?
T2: What types of digital technologies do you think could make a difference? How or Why?
T3: Do you think there are other methods that could be used to improve the state of diabetes?
T4: What are the barriers to implementing these solutions? (e.g. Funding, Connectivity, Policy)
CT (Closing Thoughts): Is there anything you feel is important to add to this conversation?
Join us for a 60-minute Twitter chat with our panel experts. All stakeholders locally and globally are welcome.
Our public transcript will be recorded by Symplur.
Video Credit: CCTV news
Diabetes is a serious chronic disease that occurs due to the body’s inability to produce insulin, which regulates sugar levels in the body (Type 1), or when the body cannot effectively use the insulin it produces (Type 2). A recent report by the World Health Organization (WHO) found that the global prevalence of diabetes has nearly doubled since 1980, rising from 4.7 percent to 8.5 percent. This trend is particularly troubling, as diabetes prevalence has risen faster in low and middle-income countries. In many of these countries, diabetes is an added burden to states already struggling to deal with weak economies, weak health systems and significant infectious disease burdens. This is especially true for African countries.
Here are six facts about Diabetes in Africa:
1. The prevalence of diabetes in African adults has more than doubled since the 1980s. The International Diabetes Federation estimates that more than 14 million people in Africa live with the disease and if trends continue this figure could grow to 34 million by 2040.
The increase in diabetes (Type 2) cases in Africa is largely attributed to changing lifestyles. A large percentage of people with diabetes (58 percent) live in cities. Traditional diets are changing to more high-calorie refined carbohydrates and fats which are more readily accessible and affordable than healthier options. Occupational patterns are also changing leading to physical inactivity and a more sedentary lifestyle.
2. Most African countries have healthcare systems already struggling to keep up with other illnesses like HIV, tuberculosis, malaria and diarrheal diseases, all of which seem more pressing than diabetes. As a result, Africa has the highest percentage of undiagnosed people (an estimated two-thirds) who are at a higher risk of developing harmful and costly complications. These complications include heart disease, strokes, damage to eyesight, kidney failure and loss of limbs.
3. Awareness is one of the biggest issues when it comes to diabetes in Africa. Limited awareness about the disease among both healthcare professional and the general public contributes to the high number of neglected cases or misdiagnosis. Better education about the importance of healthy diets and physical activity is necessary.
4. Access to affordable insulin is another challenge faced by many diabetics in African countries. Almost a third of diabetics need insulin to treat their disease. While many African countries have health programs that provide more affordable insulin at public clinics, the supply can be erratic or patients have to travel far to a clinic with supplies. If public healthcare providers do not have insulin, patients are forced to buy more expensive private sector insulin or go without. This is one of the leading causes of the 321,000 diabetes-related deaths every year in Africa.
5. Insulin is not the only expense. Access to blood glucose meters, test strips and syringes are also essential for diabetes treatment. The high cost of these medical devices, coupled with the treatment of complications due to the disease, increases the burden of disease on patients and health systems.
6. While the current facts about diabetes in Africa are dire, efforts are being taken to address this challenging disease. Diabetes awareness and treatment programs are being developed by states, civil society and the private sector. For instance, one of the three main manufacturers of insulin, Novo Nordisk, has programs in several African countries to improve awareness about diabetes and to improve the availability and affordability of treatments. 
The Future of Digital Health and Diabetes
Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions as to what to eat, when to exercise, and determine their insulin dose and timing if required. In addition, patients and providers are generating vast amounts of data from many sources, including electronic medical records, insulin pumps, sensors, glucometers, and other wearables, as well as evolving genomic, proteomic, metabolomics, and microbiomic data. 
It is estimated that $25–$30 billion in new investment will be needed in healthcare assets only, to meet the growing healthcare demands of sub-Saharan Africa. But there is one area of healthcare investments which has been less explored, which is the role digital solutions can have in boosting healthcare access in Africa.
Many countries in sub-Saharan Africa have already achieved a high level of mobile penetration (85%) and internet penetration is also on the rise – mobile devices have become increasingly common and have been adopted in some countries in sub-Saharan Africa as a force for delivering better healthcare. South Africans are already being exposed to the digital health age by the increasing take-up of standalone mobile health (devices via increasing use of smartphones among clinicians and patients). The South African messaging platform MomConnect (a mobile messaging platform) saw 465,703 users adopt the service, demonstrating the increasing maturity of digital participation.
The benefit of mobile technologies lies in access. Barriers like geographical distance and low resources, which have long prevented millions of people from getting the care they need, are much easier to overcome in the digital age. Indeed, there are countless ways in which technology can be deployed to improve healthcare access and delivery. For example, previously, patients would travel to far-off health clinics only to find that the medicines they needed were no longer in stock. Today, around 27,000 government health workers in Uganda use a mobile health system called mTRAC to report on medicine stocks across the country.
Another example is during the 2014-2015 Ebola crisis in West Africa. The WhatsApp system allowed the BBC to use its platform to share lifesaving health information with people in rural and quarantined areas, as well as ask questions, share stories and local solutions. The advent of technology, especially internet and internet-enabled services, has made it much easier for countries in Africa to provide healthcare services to its citizens. However, to effectively leverage technology in the sector, you need adequately trained doctors and nurses. Health care practitioners are in short supply across sub-Saharan Africa and they do not have appropriate training or access to continuing medical education. Upskilling the local healthcare workforce is, therefore, a major prerequisite for tangible private investment in primary health. 
Join this 60-minute Twitter chat session to discuss the opportunities and challenges of diabetes innovation with our panel experts.
Healthcare social media hashtags and communities related to Diabetes:
#diabetes #T1D, #type2diabetes, #type1diabetes
The chat session is open to everyone to participate, however, our panel experts bring a unique set of perspectives relating to the topic:
Isack Gakuru (Rwanda) Semitek Medical Group
Prof. Jamie Saris (Maynooth University)
Dr Egide Haragirimana (Burundi University)
Tim Dasgupta – Eradicate Diabetes – mHealth (USA)
Divya Gopisetty – The diaTribe Foundation (USA)
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