Type-1 diabetes is among the most expensive chronic autoimmune diseases. It is also known as juvenile diabetes, affecting children younger than 18. The disease costs a huge burden on the pockets of the families of the patients, especially in low or middle-income countries like Pakistan, where health insurance is merely a dream.
The Rising Incidence of Type-1 Diabetes in Pakistan
The incidence of T1D is increasing drastically globally as well as in Pakistan. Research data indicates that the disease ratio has increased yearly and is currently at 1.02 per 100,000 children.
Healthcare challenges due to Type-1 Diabetes in Pakistan
Pakistan, a middle-income country, suffers the most due to the expensive disease management involving in-house medical expenses, prescription medicines, regular lab tests, insulin, and other medical supplies. Data indicates that approximately 48-64% of the lifetime medical cost is spent just on preventing the complications associated with juvenile diabetes, including stroke and neuropathy.
Some of the major healthcare challenges faced by Pakistan due to Type1 diabetes mellitus include;
Insufficient Access to Healthcare
The infrastructure of basic health units and rural health centers is inefficiently designed, lacking basic diabetes diagnostic tests such as HbA1C or glucose tolerance tests. This leads to severe complications associated with the disease due to a lack of access to proper medical check-ups, emergency services, and insulin. Insufficient access to these resources leads to insufficient disease management, increased risk of severity, and negatively impacts the quality of life for children with T1D.
Affordability of diabetes treatment
The cost of diabetes management is huge and is unaffordable for many Pakistanis due to the increasing inflation and unemployment in the country. This includes the cost of insulin, glucose monitoring supplies, regular doctor visits, and related treatments or hospitalizations.
Lack of Awareness and Education
The low literacy rate in Pakistan makes it challenging for people to comprehend the importance of early diagnosis and proper management of T1D. Many individuals and communities in the country are unaware of the symptoms, risks, and management strategies of Type-1 Diabetes. This lack of awareness can delay diagnosis and treatment, worsening health outcomes.
Shortage of Medical Staff
Pakistan has quite a low doctor-to-patient ratio, i.e., 1:1300. The existing doctors, particularly those in public hospitals, are overburdened due to the high patient load. This leaves little time for personalized care and comprehensive patient education, critical for effectively managing chronic conditions like T1D.
The lack of trained diabetes educators, endocrinologists, and paramedical staff, particularly in rural, remote areas, increases the burden of the chronic disease.
Inadequate Supply of Insulin and Related Supplies
Pakistan has a GDP allocation of less than 3% for the health sector. This results in shortages or irregularities in the supply of insulin, insulin pumps/pens, and diabetes management supplies, making it difficult for patients to maintain consistent control over their blood glucose levels in this resource-constrained environment.
Poor Regulation and Monitoring
Transparency International states Pakistan’s health sector is considered the most corrupt. There are little to no government relief programs or health insurance policies available for families to get the expensive treatment of T1D for their diseased child. Insufficient regulation and monitoring of the healthcare sector can also lead to medication overpricing, poor quality of care, and medical errors.
Policies and Measures to Improve Healthcare Affordability in Pakistan
Current healthcare policies in Pakistan do not adequately address the financial burdens of managing Type-1 Diabetes. Potential policy improvements can include;
Subsidising Diabetes-Related Healthcare: Establishing a national fund or integrating subsidies into existing health insurance to cover costs associated with Type-1 Diabetes care. This includes costs for medications, tests, doctor visits, and support services, making them accessible to even low-income groups.
Development of Public-Private Partnerships (PPPs): PPPs can supplement government efforts by improving service delivery and extending healthcare services’ reach. They can establish specialized diabetes clinics, especially in rural areas, and encourage technological innovations like telemedicine services.
Reducing the Cost of Diabetes Management Supplies: Government policies can lower the cost of supplies by negotiating prices with pharmaceutical companies, removing taxes on medical supplies, promoting local manufacturing, and bulk purchasing.
While challenging to implement, these changes can greatly improve healthcare affordability for those with Type-1 Diabetes.
Role of Non-Governmental Organizations (NGOs) and International Community
Organizations like the World Health Organization (WHO) and several NGOs should play on the front foot to launch programs to support people with Type-1 Diabetes in Pakistan. It must be a priority for the global health community to initiate global coverage for the costly and chronic diseases
These organizations can advocate for policy changes, fund local research, and create community-level programs to assist individuals and families managing Type-1 Diabetes.
Conclusion
The financial impacts of managing Type-1 Diabetes in Pakistan are substantial due to the compromised healthcare system. However, through improved policies, the involvement of NGOs and international bodies, and increased awareness and education, it is possible to make diabetes care more affordable without any social discrimination.