IADA Workstreams
THE BOSTON DECLARATION
The geography and nature of humanitarian crises today put people with diabetes at greater risk than ever
Forced migration is at record high levels with 79.5 million people displaced from their homes in 2019. 85% of those affected are being hosted in low-income or middle-income countries and 77% are living in protracted refugee situations with the average duration of displacement now being over 20 years. In addition, there are >100 million conflict-affected non-displaced people and 175 million people affected by natural disasters annually. Despite projections of increases in both diabetes and humanitarian crises, the provision of diabetes care in humanitarian settings remains scarce and poorly coordinated. Thus, diabetes is a crisis within a crisis that represents an urgent need for advocacy, approaches to ensure delivery of essential care and medications, and surveillance systems to monitor and drive progress.
This was highlighted at a symposium at Harvard University in April 2019, which led to the Boston Declaration which was signed by 64 signatories from over 40 international organizations and published in The Lancet Diabetes & Endocrinology in August 2019. It set four major targets for the group to work towards over the next years:
- Unified and strengthened advocacy
- Universal access to insulin and other essential medicines and diagnostics for glycemic and blood pressure control in humanitarian crises
- Establishment of a unified set of clinical and operational guidelines for diabetes in humanitarian crises
- Improved and coordinated data and surveillance
In order to achieve these goals successfully, sustained collaborative commitment of a diverse network of partners is required. The International Alliance for Diabetes Action (IADA) was therefore established with the goal of ensuring availability and affordability of diabetes treatments and diagnostics and radically improving care for every person with diabetes affected by humanitarian crises.
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The geography and nature of humanitarian crises today put people with diabetes at greater risk than ever
As of the end of 2025, forced displacement remains at historically high levels: almost 118 million people are forcibly displaced from their homes. Around 68% of refugees are hosted in low- and middle-income countries, and displacement is increasingly prolonged: approximately seven in ten refugees are living in protracted situations that have lasted five years or more. Beyond those who are displaced, conflict affects millions more people who remain in their communities but face disrupted access to health care, medicines, and essential services. In total, an estimated 239 million people are in need of humanitarian assistance and protection globally.
Both diabetes and humanitarian crises are projected to increase, yet diabetes care in humanitarian settings remains scarce and poorly coordinated. Closing this gap will require sustained advocacy, reliable delivery of essential care and medicines, and surveillance systems that can monitor and drive progress.
In April 2019, a symposium at Harvard University highlighted this gap and led to the Boston Declaration, which was published in The Lancet Diabetes & Endocrinology in August 2019 with 64 signatories from more than 40 international organizations. The declaration set four goals:
- Unified and strengthened advocacy
- Universal access to insulin and other essential medicines and diagnostics for glycemic and blood pressure control in humanitarian crises
- Establishment of a unified set of clinical and operational guidelines for diabetes in humanitarian crises
- Improved and coordinated data and surveillance
Achieving these goals requires sustained collaboration across organizations, disciplines, and communities. IADA was established to enable this collective effort, so that everyone living with diabetes in humanitarian settings has access to affordable treatments, diagnostics, and high-quality care.
LEADERSHIP
Forced migration is at record high levels with 79.5 million people displaced from their homes in 2019. 85% of those affected are being hosted in low-income or middle-income countries and 77% are living in protracted refugee situations with the average duration of displacement now being over 20 years. In addition, there are >100 million conflict-affected non-displaced people and 175 million people affected by natural disasters annually. Despite projections of increases in both diabetes and humanitarian crises, the provision of diabetes care in humanitarian settings remains scarce and poorly coordinated. Thus, diabetes is a crisis within a crisis that represents an urgent need for advocacy, approaches to ensure delivery of essential care and medications, and surveillance systems to monitor and drive progress.
PARTNERS
This was highlighted at a symposium at Harvard University in April 2019, which led to the Boston Declaration which was signed by 64 signatories from over 40 international organizations and published in The Lancet Diabetes & Endocrinology in August 2019. It set four major targets for the group to work towards over the next years:
- Unified and strengthened advocacy
- Universal access to insulin and other essential medicines and diagnostics for glycemic and blood pressure control in humanitarian crises
- Establishment of a unified set of clinical and operational guidelines for diabetes in humanitarian crises
- Improved and coordinated data and surveillance
In order to achieve these goals successfully, sustained collaborative commitment of a diverse network of partners is required. The International Alliance for Diabetes Action (IADA) was therefore established with the goal of ensuring availability and affordability of diabetes treatments and diagnostics and radically improving care for every person with diabetes affected by humanitarian crises.
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