Type 1 Diabetes (T1D) is a complex chronic disease that requires consistent access to insulin, syringes, and blood glucose monitors. This can be a challenge anywhere, and one that is particularly acute across many low- and middle-income countries (LMICs), where health systems often lack the resources for comprehensive diabetes care. T1D can be a death sentence for those who cannot afford insulin, while others may not receive proper care until they develop life-threatening complications, such as diabetic ketoacidosis (DKA). Children are at particular risk.

Helmsley recognizes that barriers to care are deeply entrenched. Our goal is to create a sustainable, global movement that improves policies, supply chains, and health systems for the most vulnerable T1D populations in LMICs, where – as elsewhere – type 2 diabetes is far more common.

Internationally, new cases are skyrocketing. From 2009 to 2019, the number of people worldwide diagnosed with diabetes, type 1 and type 2, increased 62 percent, to 463 million, according to Diabetes Research and Clinical Practice. By 2045, the number is projected to be 629 million.

This surge is felt most acutely in LMICs, which often lack the clinics, diagnostic tools, medical specialists, educators, distribution networks, and government support to give people with T1D an opportunity for success. In some countries, T1D carries a stigma – mothers are blamed for their child’s condition and are spurned by their community, while the children themselves become pariahs. Meanwhile, the increase in type 2 cases will lead to greater need for wide distribution and availability of insulin.

Our Global Access program focuses on three main areas:

First, health systems need to be stronger so that they can care for anyone with a chronic illness, including T1D. According to the World Health Organization (WHO), at least half of the world’s population still lacks access to essential health services for non-communicable diseases (NCDs), so we work with partners addressing this need. This includes expanding  PEN-Plus (the Package of Essential NCD Interventions-Plus), an integrated delivery model that provides high-quality care for T1D and other severe chronic NCDs in low-resource countries. We anticipate that more than 20 countries will be part of a network committed to expanded treatment for T1D and other severe chronic diseases, and four of these countries will implement PEN-Plus nationwide.

We are also galvanizing a global movement, through partnerships with groups like the NCD Alliance, to advocate for the needs of the growing number of people living with chronic conditions in LMICs.

Second, we want to improve access to insulin, which is unaffordable for most people living in LMICs. We work on two timelines – addressing the medium-term need of changing multinational pricing and supply chain practices, while also ensuring that children who need insulin today can get it. We have supported Health Action International, a nonprofit, to develop partnerships with the WHO and to support civil society organizations in Peru, Mali, and Tanzania to advocate for better insulin pricing and diabetes policies globally. We also support efforts to distribute insulin and supplies across poor communities in more than 40 countries.

Third, we recognize that health care is but one part of what is needed to be healthy. Food security is essential. In impoverished communities, our approach to supporting the T1D community is holistic, supporting efforts for sustainable livelihoods and economic development.