Expert Meeting : Access to insulin and diabetes care

GHF Expert Meeting


“What are the current challenges and solutions to access to insulin and diabetes care?”

 

Campus Biotech, Geneva - November 11, 2019; 9.00 - 18.00

 

 

Globally it is estimated that one person in three has no guaranteed access to essential medicines.1-3 In the poorest parts of Africa and Asia, this proportion increases to one-half.4 Considerable attention has been paid to the issue of access to medicines for HIV/AIDS, tuberculosis and malaria,5-11 however little attention has been paid to questions of access to essential medicines for Noncommunicable Diseases and diabetes.

Insulin for type 1 diabetes is a rare example where there is an absolute need for a given medicine. Although global disease burden data is lacking in 2015, it is estimated that 542,000 children aged 0-14 have type 1 diabetes and that its prevalence is increasing by 3 percent per year.12 While there are no estimates for the total amount of people living with type 1 diabetes estimates show that they may represent 5 percent of the total diabetes burden, of 514 million, or 20.8 million people.13 In contrast use of insulin in the management of type 2 diabetes is required for better control and its use is dependent on capabilities existing within different health systems and it is estimated that by 2030 close to 80 million people will need insulin with currently 50% of these people lacking access.14 Poor access to insulin translates into life expectancy for a child with Type 1 diabetes in sub-Saharan Africa being as low as one year.15 This is in contrast to recent data by Miller et al.16 showing that people diagnosed with Type 1 diabetes in the 1960s and 1970s in the USA have only a 4-6 year difference in life expectancy from that of the general population.

Previous work by the Addressing the Challenge and Constraints of Insulin Sources and Supply (ACCISS) Study, being co-led by Dr. David Beran of the Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, highlighted the poor availability and affordability of insulin.17,18 The factors leading to this included a variety of barriers at global and national level. Little is known about why the price of insulin has remained consistently high over the years. It is thought, however, to be the result of market domination by three multi-national companies, Eli Lilly, Novo Nordisk and Sanofi.19 This domination has also meant that individuals with diabetes have had to change types of insulin as these companies have the ability to withdraw formulations from the market.20,21

The study of diabetes has been a strong research and clinical focus of Faculty of Medicine at the University of Geneva for more than three decades. The Diabetes Center stresses the importance of a strong network of specialists, with the aim of complementing areas of expertise, of promoting discoveries and of defining innovative preventive and therapeutic strategies against diabetes. The Diabetes Center is interdisciplinary as its initial members are affiliated to various Departments of the Faculty of Medicine. It also collaborates with the University Hospitals of Geneva and with Faculty of Science.

Given the involvement of a researcher from the University of Geneva in a leading study on the issue of access to insulin; the existence of a strong focus on diabetes research at the University of Geneva; and the position of Geneva as the global health capital it is felt that an expert meeting on this issue hosted by the University of Geneva is a unique opportunity to showcase the work being done at the University of Geneva as well increase the visibility of the institution and this global health issue.

 

Agenda

08:30-09:00 Registration and coffee
09:00-09:30 Welcome and introduction of the meeting
o Prof
o Dean, Faculty of Medicine, University of Geneva;
o Prof Valérie Schwitzgebel
Vice-President Diabetes Center of Medical Faculty, University of Geneva;
Head of Pediatric Endocrine and Diabetes Unit, Department of Pediatrics, gynecology and obstetrics, University Hospitals of Geneva
09:30-09:45 Access to insulin global challenges and “homemade” insulin
Presentations
o Dr Margaret Ewen
Health Action International;
Access to insulin : a complex issue
o Alex Kelly
BioFoundry;
Open Insulin : a solution to lowering barriers to access
09:45-10:30 Overall group splits into 4-6 groups around tables with rapporteurs
10:30-11:00 Coffee Break and poster session
11:00-12:00 What role for innovation in changing the landscape of management of Type 1 diabetes?
5-minute pitches
o Prof Pedro Herrera
Genetic Medicine and Development, University of Geneva;
Insulin-secreting alpha cells
o Dr Thomas Zueger
University of Bern;
Open Artificial Pancreas (OpenAPS)
o Prof Domenico Bosco
University of Geneva;
Novelty in the Islet of Langerhans Transplantation
o Dr Thomas Zueger
University of Bern;
Headwind
o Dr Andreas Güntner
Mechanical and Process Engineering, Eidgenössische Technische Hochschule Zürich (ETHZ);
Non-invasive Metabolic Monitoring with Breath Sensor

  • Moderated by Prof Antoine Flahault, Institut of Global Health, University of Geneva
13:00-14:00 Key note presentation – Open to public
o Dr Soumya Swaminathan
Chief Scientist, World Health Organization;
Opening remarks
o Prof Emmanouil Dermitzakis
Department of Genetic Medicine and Development, Faculty of Medicine; University of Geneva;
Swiss Institute of Bioinformatics (SIB);
Health 2030 Genome Center
Precision Diabetes
14:00-14:15 Break and poster session
14:15-14:45 Care for Type 1 diabetes in difficult settings and for marginalised populations
Presentations
o Dr Edna Majaliwa
Muhimbili National Hospital, Tanzania;
Managing Type 1 diabetes in Tanzania: Lessons learnt and ongoing challenges
o Dr Philippa Boulle
Médecins Sans Frontières (MSF);
Delivering Type 1 diabetes care in a humanitarian context
o Dr Mirjam Dirlewanger
University Hospitals of Geneva;
Type 1 diabetes care in Geneva for vulnerable populations
14:45-15:15 Overall group splits into 4-6 groups around tables with rapporteurs
15:15-15:45 Coffee Break and poster session
15:45-16:15 Rethinking delivery of care for Type 1 diabetes: systems, education and empowerment
Presentations
o Dr Valla Tantayotai
Foundation for the Development of Diabetes Care, Thailand;
Education and empowerment for people with diabetes
o Dr David Beran
University of Geneva;
Rethinking delivery of care for Type 1 diabetes

  • Moderated by Prof Alain Golay, University Hospitals of Geneva
16:15-18:00 What is missing for the management of Type 1 diabetes in 2019 and a roadmap for the future
Panel discussion – - Based on discussions from the day the discussants will give their feedback
o Stéphane Besançon
Santé Diabète, Mali;
o Prof Antoine Geissbuhler
University of Geneva, University Hospitals of Geneva;
o Molly Lepeska
Health Action International; The Netherland;
o Dr Gojka Roglic
World Health Organization (WHO);
o Prof Valérie Schwitzgebel
University of Geneva, University Hospitals of Geneva;
o Aigerim Zhaparova
Diabetes Advocate with Type 1 diabetes, Kyrgyzstan;

  • Moderated by The Lancet Diabetes & Endocrinology
18:00-18:30 Concluding remarks
o Prof Antoine Geissbuhler
Vice-Rector University of Geneva;
Director, eHealth & Innovation at University Hospitals of Geneva;
Co-president of the Geneva Health Forum

 

Key note presentation – Open to public - 13:00-14:00

Dr Soumya Swaminathan Chief Scientist, World Health Organization (WHO) Opening remarks
Prof Emmanouil Dermitzakis Department of Genetic Medicine and Development
Faculty of Medicine, University of Geneva;
Swiss Institute of Bioinformatics (SIB);
Health 2030 Genome Center
Precision Diabetes

 

Organized by

Diabetes Center of Medical Faculty Division of Tropical and Humanitarian Medicine
Department of Pediatrics, gynecology and obstetrics
ACCISS Study Geneva Health Forum

 

Organized in collaboration with

Fonds Général de l'Université de Genève Swiss National Science Foundation

Photo credit : David Beran