In alignment with the priority agenda for addressing diabetes in humanitarian crises that was outlined in the Boston Declaration, the main collaborative activities of the Alliance have been grouped into four workstreams, each of which has appointed a working group lead (see Leadership page). The workstreams are complementary and interdependent, such that the tools and approaches developed through one workstream will facilitate achievement of the objectives of other workstreams. Ultimately, the goal is to develop a robust framework and core capacity for an international coordinating and surveillance center for diabetes in humanitarian settings.
Access to Medicines and Diagnostics
WE STRIVE to improve access to insulin and other essential medicines and diagnostics for glycemic control and cardiovascular risk reduction in humanitarian crises.
The goal of this workstream is to develop, pilot and implement approaches to ensure the continuation of essential medicines and services for glycemic control and cardiovascular risk reduction across humanitarian sites.
- The Clinton Health Access Initiative (CHAI) working on bundling commodities for insulin-requiring patients in LMICs and humanitarian settings
- The Foundation for Innovative New Diagnostics (FIND) has launched an initiative to negotiate with diagnostic companies on preferential pricing for glucometers and supplies. Expressions of Interest for country buyers in LICs are being collated, hopefully driving down prices.
- The World Health Organization has been convening expert groups to discuss diabetes care and access challenges and to further discussions on biosimilar insulin pre-qualification.
- IADA members have worked with various stakeholders on evaluating the thermostability of insulin which led to a recent positive scientific review by the European Medicines Agency recommending expanding the storage conditions of insulin.
Clinical Care and Operational Guidance
OUR GOAL is to establish a unified set of evidence-based clinical and operational guidelines for diabetes in humanitarian crises.
This workstream seeks to develop, implement and evaluate evidence-based clinical guidance, educational materials, and cost-effective models of care for diabetes in humanitarian settings and create new tools to facilitate care and coordination between organizations.
- We are creating Open Access Diabetes: Diabetes Education for All (DEFA), an open access education portal to improve access to diabetes education and clinical guidance for healthcare providers and create a portal for support and educational material for individuals living with diabetes in low-resource and humanitarian settings.
- In collaboration with the World Health Organization we are developing insulin treatment algorithms for type 1 diabetes in low-resource and humanitarian settings.
- We launched a sub-group on Nutrition and Diabetes in Humanitarian Settings to discuss current challenges, understand the appropriateness of food systems and supply to people with diabetes in emergencies, consider related policy issues and innovative approaches to support nutritional needs of people with diabetes in these contexts.
Data and Surveillance
WE SEEK to strengthen data availability, accuracy and quality to make decisions, manage programs, formulate policy.
The aim of this workstream is to develop, evaluate and implement standardized indicators and a prototype surveillance system to track, analyze, interpret, and disseminate these metrics for the prevalence of diabetes, access to care and essential medications, patient burden and patient-centered outcomes in humanitarian crises for program monitoring and evaluation.
- We are conducting the UNITED Study, a retrospective, cross-sectional analysis of fundamental practice elements and barriers to diabetes care across four humanitarian organizations in five global regions.
- In collaboration with the Informal Inter-Agency Group on NCDs in Humanitarian Settings, convened by UNHCR, we are developing standardized indicators to monitor diabetes prevalence, access to care and outcomes in humanitarian settings.
- We are developing, piloting, and administering assessments to support ongoing and future consortium efforts, facilitate collaboration, and describe the capacity, barriers and processes around data collection in humanitarian settings to inform the implementation of the NCD indicators.
WE ARE COMMITTED to ensuring access to insulin as a humanitarian priority, reducing stigma and mobilizing increased resources to scale-up the response.
This workstream aims to develop and implement approaches to increase the global health profile of diabetes, raise awareness of access to insulin as a humanitarian priority via high-level advocacy, and develop action plans to increase the ability of IADA to ensure sustained impact, strengthen partnerships, and inform policy by dissemination of findings.
- As a priority for the centenary of insulin discovery in 2021, we are working towards a World Health Assembly resolution on universal access to insulin.
- We are developing a communications package to carry us through the centenary of the discovery of insulin. We would love to hear about any diabetes and insulin centenary activities that we could link with and/or any new ideas for communication and advocacy – do get in touch!
- We are developing a systematic approach to support the other three workstreams, disseminate and raise the profile of their findings, and cultivate strong relationships between Alliance members.