In 2021, the International Diabetic Federation (IDF) recorded more than 32 million adults living with diabetes in Pakistan, accounting for 26.7% of the population. However, this number has since risen. 

Due to Pakistan’s unaffordable and lacking health care system, the country has the highest proportion of diabetes-related deaths among under 60-year-olds globally at 35.5%, particularly in areas suffering from poverty. Despite this, Pakistan spends less than 1% of its GDP on its health care system. Several organizations are working to address the diabetes crisis in Pakistan. 

The Cause

As of April this year, the World Bank predicted Pakistan’s poverty rate would reach 37.2% of the population. The rate has decreased since 2018. However, due to the extensive population growth in Pakistan, the number of Pakistanis living below the poverty line has increased by 3 million.

Poverty primarily occurs among women and children, with malnourishment a vital factor in the diabetes surge in Pakistan. The influx of malnourished expectant mothers has led to an increase in the risk of and number of children born with Type 1 diabetes, an issue that has risen in line with Pakistan’s population increase. 

As a result of Pakistan’s high poverty rates, there are high levels of illiteracy in rural areas. Many areas are not educated about the dangers of diseases like diabetes and its treatment and, therefore, are not able to recognize the issue until the severity has reached amputation or worse. 

The lack of access to sporting facilities and public spaces for exercise, particularly in schools, has further progressed obesity across the population and, therefore, those at risk of diabetes. This progression has been worsened by Pakistan’s recent surge in consumption of fast and ultra-processed foods. 

Although diabetes remains a preventable and manageable disease, the severe lack and unequal dispersion of health care and medication has heightened the impact and outcome of diabetes across Pakistan. As a result, health care and medicine often cost significantly more than the $3 average most earn in a day.

Pakistan’s Medical System

Pakistan spends less than 1% of its GDP on the health care system. The country runs a health care system comprising both public and private sectors; however, as much of the country is still developing and lives in poverty, the private sector is largely inaccessible. 

The public sector is suffering under surging population growth, which has led to inadequate health infrastructure, including accessible hospitals and doctors. The sector is inadequately equipped due to shortages of medicine within the country and an uneven distribution of doctors – with many traveling overseas once qualified or into the private sector. 

Pakistan imports more than 95% of its active pharmaceutical ingredients; however, the rupee’s highest inflation in decades has made purchasing and importing such products nearly impossible, and a massive decline in medicine production and availability has been seen since January. 

As the diabetes crisis in Pakistan continues to grow, 30% of health care facilities have run out of life-saving insulin, and many of Pakistan’s pharmaceutical manufacturers have closed and left the country. 

The availability of insulin is now inconsistent and unreliable, and the price has tripled for both hospitals and individuals. 

Many Pakistanis have simply stayed at home, stuck living in poverty and unable to afford medicine or transport to hospitals that are inaccessible and inadequately stocked. As a result, death rates from diabetes have surged.

The Diabetes Association of Pakistan (DAP)

Since 1966, the Diabetes Association of Pakistan (DAP) has served Pakistan and prioritized and addressed the nationwide diabetes crisis. As a member of the International Diabetes Federation, it “strives to raise the quality of life in Pakistan through raising awareness of healthy lifestyles, management and prevention of diabetes.”

It provides education and support for all Pakistan residents at risk of or suffering from diabetes, as well as health professionals and children, to improve and reduce diabetes’ future impact. Its cost-free services include these efforts to address the diabetes crisis in Pakistan:

• Diabetes Awareness Programs at schools and workplaces.
• Supporting families directly to improve surroundings.
• Training for medical professionals to support and improve diabetes treatment.
• Insulin pump support and education.
• Diabetes Prevention Camps and Diabetes Support Camps.

The World Diabetes Foundation

The World Diabetes Foundation ran another project addressing the issue of diabetes in Pakistan from 2015 to 2018. The project set out to improve accessibility to Diabetes Clinics and treatment across the country, including rural areas with mass poverty. Within the project, it was able to open up three clinics across Islamabad and Rawalpindi and offer training on diabetes to:

• three hundred and fifteen nurses
• six doctors
• five paramedic staff

The project conducted 110 awareness and screening camps, and screened 12,699 across these areas with a mere budget of $134,739.

Although both were able to improve health care accessibility and diabetes education in Pakistan, resources and access are limited. With the Pakistani government’s support and funding, true change and improvement can be most impactful and widespread, especially in rural areas with high poverty levels.

By prioritizing education, affordability and accessibility to diabetes support and medication across Pakistan, the country’s health and economy have the potential to improve significantly in the future.

– Lucy Blake
Photo: Flickr