MSF teams care for people living with diabetes in many countries where we work, in Lebanon, Iraq, South Sudan, DRC, and others. Many projects are set-up to respond to patients presenting with ketoacidosis, due to a lack of insulin treatment - and insulin access.
The way in which the big 3 insulin makers monopolize the insulin market is unbelievable, really. It's a racket. They've raised their prices in lockstep with each other for years, to the point that people are dying because they can't afford them anymore. nytimes.com/2016/02/21/opi…
Companies are further monopolizing the insulin market by layering patents on new delivery devices (insulin pens) that make it difficult for lower-cost generics to come on the market. Device patents add >9 years' additional patent protection on some pens: journals.plos.org/plosone/articl…
There are great advocates pushing to improve access to affordable insulin and comprehensive diabetes care (it's not just insulin, it's also supplies: glucometers, strips, syringes, needles, pumps). Shout out to @t1international & the many #insulinforall advocates out there.
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My PhD thesis research focused on analyzing disrupted health systems, and I've spent most of the last decade working in humanitarian response. Here's a thread with some thoughts on what's happening in Ontario:
Health systems are not just the delivery of health services, though that's the point at which most of us interact with the health system (receiving health care). To be able to effectively deliver health services, you need a lot of other things to be in place and functioning.
That picture 👇 is the WHO's health systems framework. The things on the left are generally-agreed upon blocks that need to be in place to be able to run a health system. It's not perfect, but it's a helpful organizing framework that can guide planning and analysis fairly well.