This September’s High-Level Meeting on Universal Health Coverage (UHC) at the UN General Assembly is an opportunity to assess progress towards health for all, including those living with type 1 diabetes (T1D) and other severe noncommunicable diseases (NCDs).

The film “A Holistic Approach to Healthcare,” produced by Helmsley in partnership with BBC Storyworks, shows that integrated NCD care can move the world closer to realizing UHC for people living with severe, chronic conditions in limited-resource health settings.

Here, T1D Program Director Gina Agiostratidou, reflects on the messages that she hopes global health advocates will take from this film on the eve of the UN General Assembly.

What inspired the film, A Holistic Approach to Healthcare? Why did you feel BBC Storyworks was the right partner to tell this powerful story?

Through my work I encounter people of all ages living with T1D. Each time I have one of these interactions, especially with children, I become more committed to my work. Instead of seeing “access to care” as a matter of statistics and policies, I witness the human side of the issue — the emotions, obstacles, and triumphs that add up to a life with T1D. As we work to improve access to T1D care in low- and middle-income countries (LMIC) like Malawi, the experiences of people living with the condition always shape our efforts.

We had worked with BBC Storyworks in the past — on a short film featuring Helmsley grantee Life for a Child — and won the best NCD short film at the 2020 World Health Organization Health for All Film Festival. With their storytelling expertise, we knew they’d be a great partner to bring this story to a global audience.

The story follows Manuel and Yamakani, two boys living with T1D in rural Malawi. With the support of their mother, Masalina Eliasi, their quest for care leads them to a nearby PEN-Plus clinic. What is PEN-Plus, and how is Helmsley involved?

As many people know, T1D is a lifelong condition that requires specialized care and daily management. But in resource-limited settings, these services are only available in major cities, putting lifesaving support out of reach for thousands living in rural areas — including families like Masalina’s. The PEN-Plus model fills this gap, bringing care for T1D to district hospitals and training nurses to help diagnose and treat severe NCDs.

Recognizing the complexity of T1D care, Helmsley has been investing for nearly a decade to pilot models of care that can be implemented and led by governments in the most resource-limited settings. In 2020, this work culminated in The Lancet NCDI Poverty Commission and support to Brigham and Women’s Hospital and Partners in Health for initial implementation in sub-Saharan Africa and South Asia. In 2022, African health ministers endorsed PEN-Plus as their regional strategy to boost access to the diagnosis, treatment, and care of severe NCDs — they see its value as they strive for UHC. In addition to supporting NCDI Poverty Network to begin initial implementation in 12 countries, the WHO Regional Office for Africa has funding from us as it works with country health leaders to scale the PEN-Plus model and bring T1D care to people across 20 African countries.

What will it take to ensure that everyone — everywhere — has access to high-quality NCD services like those offered through PEN-Plus?

Ensuring universal health coverage for every person with a chronic condition can seem like an enormous task — and in many ways it is. However, Helmsley has seen that we can move quickly to national scale by engaging Ministries of Health, people living with NCDs, industry leaders, global supporters, and country partners. As I mentioned, Helmsley is supporting the NCDI Poverty Network and WHO Africa to spread the PEN-Plus model and integrate care into national health systems. We have also been supporting UNICEF to develop global technical tools for better diagnosis and treatment of childhood NCDs and to strengthen national strategies in Malawi and Mozambique. By working with a diverse group of collaborators — and reaching across disease silos — Helmsley’s Type 1 Diabetes Program and partners are strengthening systems of care and moving closer to a world of UHC, where children like Manuel and Yamakani can thrive.

Zooming out, so many issues compete for global attention and resources. How is Helmsley encouraging partners to think in new ways about healthcare solutions — especially for the T1D community?

Our approach is pragmatic. We know that to achieve improved outcomes for T1D, we need to consider the whole person, rather than the disease. Over the course of their life, a person will experience a wide range of intersecting challenges and diagnoses. Similarly, as governments and providers seek to allocate their limited resources and time, they do not have the luxury of thinking about any disease in isolation. So while we are urgently working to address the needs of people living with T1D, we want to make investments that can lift the whole health system.

For example, as PEN-Plus scales to a growing number of clinics it has a broader impact on training and mentorship, monitoring and evaluation, supply chains, and attention for a much broader range of NCDs and co-morbidities. As we work to make T1D supplies more affordable and accessible through ongoing initiatives (like developing standardized demand forecasting tool with WHO), we know it’s critical that this be applicable to all essential NCD health products. As we seek to drive policy reform and increased global attention for T1D, we know it’s critical to join with other funders and technical experts through the NCD Alliance. We are grateful that a growing, diverse network of partners is stepping up to emphasize inventive, holistic approaches that prioritize community involvement as a key component of the solution. By honing people-centered services and , we will be one step closer to reaching the global targets outlined in the Global Diabetes Compact and Sustainable Development Goal 3.4 and realizing person-centered UHC.

The BBC story is one of progress. What’s next for Helmsley’s work on global access to T1D care, and what gives you hope for the road ahead?

We know there’s more to be done. Looking ahead, Helmsley remains committed to advancing global access to T1D care: we’re working toward a world where no one is left behind due to limited resources or geographical barriers. What gives me hope is the potential for collective action to address a multitude of NCDs. By expanding integrated care models, shaping more sustainable markets for needed medicines, and amplifying the voices of affected communities, we can catalyze a global movement to treat chronic non-communicable diseases. My hope is that partners from around the world will continue joining us on this journey, as we strive to create a future where UHC — including 21^st-century T1D care — is a reality for everyone. Until then, we will keep pushing!