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Diabetes care in humanitarian settings | Collections | MSF Science Portal

Diabetes affect hundreds of millions of people worldwide, a large majority of them living in low- and middle-income countries. Yet finding effective strategies, tools and policies for effectively managing this chronic illness—especially amid war, displacement or exclusion from care—is a neglected area of humanitarian medicine.

Here we present a cross-section of work on this front by MSF and collaborators. Several studies assess the shift towards community-based, nurse-led models of care in rural settings. Others explore obstacles to diabetes care for war refugees living in camps in Jordan or Lebanon, highlighting how health programs can adapt to their needs. The demonstration that insulin retains potency for 30 days if cooled without refrigeration is opening doors to more patient self-management, as a case study in remote South Sudan shows.

At the same time, MSF and others call for regulatory and financing policies that make diabetes medications and supplies cheaper, better adapted to humanitarian settings, and far more available to patients whose lives depend on them.

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Healthcare needs of older people in humanitarian settings
Healthcare needs of older people in humanitarian settings

Globally, the number of older people is rapidly increasing, with those aged 60+ expected to more than double by 2050—yet in humanitarian crises, they remain one of the most neglected groups. Older adults often face higher risks due to chronic illnesses, mobility issues, and limited access to appropriate care, especially in low-resource or emergency settings. Despite these needs, humanitarian responses rarely prioritize them, and data on their health and mortality are often lacking.


This collection reflects MSF’s ongoing examination of its own data and practices to identify pathways toward more age-inclusive services in humanitarian crises. It includes analysis of data from MSF-supported mental health services, inpatient departments, and sexual violence services, and further offers several calls to action and reflections on why older people remain overlooked in humanitarian crises. However, MSF also acknowledges major challenges remain, including inadequate age-inclusive services, data gaps, and the need for more geriatric expertise.


Watch this space for more publications from a Lancet Healthy Longevity series on healthcare rights and needs of older people.


Combatting antimicrobial resistance
Combatting antimicrobial resistance

Antimicrobial resistance is a growing public health crisis, especially in countries with fragile health systems, population displacement or ongoing conflict. In 2019 antibiotic-resistant bacteria directly caused an estimated 1.27 million deaths, and contributed to 4.95 million deaths, tolls that will continue to increase if no effective action is taken.


MSF’s approach to combatting antimicrobial resistance combines three pillars: infection prevention and control, microbiology and surveillance, and rational use of antibiotics via antibiotic stewardship. Several studies characterize patterns and prevalence of antibiotic resistance among MSF patients, from civilians wounded in Middle East conflicts to hospitalized neonates in Central African Republic and Haiti. New technologies developed by MSF and partners are expanding local capacity for rapid, accurate laboratory diagnosis of infections, so that clinicians can prescribe the right antibiotic for each patient. Other work assesses the practices and challenges related to optimizing rational antibiotic use within health facilities and communities.

If you're interested in learning more about MSF's work in antimicrobial resistance, view the full list of MSF's publications on the topic.

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Sudan/Chad Disaster
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Journal Article
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Research

Estimated sustainable cost-based prices for diabetes medicines

Barber MJ, Gotham D, Bygrave H, Cepuch C
2024-03-27 • JAMA Network Open
2024-03-27 • JAMA Network Open
IMPORTANCE
The burden of diabetes is growing worldwide. The costs associated with diabetes put substantial pressure on patients and health budgets, especially in low- and middle-inco...
Conference Material
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Poster

Evaluating task-sharing for non-communicable disease management in humanitarian settings: lessons learned from MSF’s model of care in Lebanon

Doumit M, Masri S, Beltran I, Incerti A, Ciglenecki I,  et al.
2023-06-07 • MSF Scientific Day International 2023
2023-06-07 • MSF Scientific Day International 2023
Diabetes care in humanitarian settings

Diabetes care in humanitarian settings

Journal Article
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Commentary

A framework for improving diabetes care in humanitarian emergencies

Kehlenbrink S, Jobanputra K, International Alliance for Diabetes Action
2023-03-01 • Lancet Diabetes and Endocrinology
2023-03-01 • Lancet Diabetes and Endocrinology
Conference Material
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Poster

Recurrent DKA reduced by home glucose monitoring and clay pot insulin storage in a low resource setting - a case report

Simon M, Seignoux J, Fadumiyo A, Muderhwa Y
2022-11-30 • MSF Paediatric Days 2022
2022-11-30 • MSF Paediatric Days 2022
Conference Material
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Poster

Decentralization of insulin treatment through nurses and clinical officers in nine health centres in a rural county, Kenya: descriptive study

Borum Mølskov Bech M, Otieno Khisa A, Ndoca K, Ayuaya T, Kajuju P,  et al.
2022-05-09 • MSF Scientific Days International 2022
2022-05-09 • MSF Scientific Days International 2022
Journal Article
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Letter

Diabetes and the WHO model list of essential medicines

Reddy A
2022-01-01 • Lancet Diabetes and Endocrinology
2022-01-01 • Lancet Diabetes and Endocrinology
Journal Article
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Research

MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework

Ansbro É, Homan T, Qasem J, Bil K, Tarawneh M,  et al.
2021-04-26 • BMC Health Services Research
2021-04-26 • BMC Health Services Research
BACKGROUND
In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM i...
Journal Article
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Review

Operational considerations for the management of non-communicable diseases in humanitarian emergencies

Bausch FJ, Beran D, Hering H, Boulle P, Chappuis F,  et al.
2021-02-25 • Conflict and Health
2021-02-25 • Conflict and Health
Non-communicable diseases (NCD) represent an increasing global challenge with the majority of mortality occurring in low- and middle-income countries (LMICs). Concurrently, many humanita...
Journal Article
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Research

Heat-stability study of various insulin types in tropical temperature conditions: new insights towards improving diabetes care

Kaufmann B, Boulle P, Berthou F, Fournier M, Beran D,  et al.
2021-02-03 • PLOS One
2021-02-03 • PLOS One
Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burd...
Journal Article
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Research

Setting up a nurse-led model of care for management of hypertension and diabetes mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

Frieden M, Zamba B, Mukumbi N, Mafaune PT, Makumbe B,  et al.
2020-06-01 • BMC Health Services Research
2020-06-01 • BMC Health Services Research
BACKGROUND
In the light of the increasing burden of non-communicable diseases (NCDs) on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, contex...