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Diabetes in humanitarian crises: The Boston Declaration

Life for a Child General Manager Dr. Graham Ogle and Health Systems Specialist Emma Klatman joined the Harvard Humanitarian Initiative in Boston to sign the declaration: “Diabetes in humanitarian crises: the Boston Declaration” published on June 6, 2019, by the Lancet Diabetes Endocrinology journal.

Chronic health conditions can be difficult to manage, and as type 1 diabetes is fatal without proper treatment, it is of vital importance that governments in under-resourced countries move towards more effective diabetes programs.

For type 1 diabetes ongoing care is so important and in times of crisis the level of care plummets. This can exacerbate life-long conditions and lead to complications both immediate and long-lasting. Hundreds of millions of people are conflict-affected or displaced globally and the economic and human costs of crises in less-resourced countries are staggering.

This poses an overwhelming task for governments and health-care providers in crisis-affected regions as effectively managing type 1 diabetes requires a high level of complex care. Humanitarian responders and local health-care workers are often ill-equipped to provide adequate care which puts people with type 1 at serious risk of long-term complications or death.

To combat this scenario, Harvard University assembled global health and humanitarian specialists in Boston, Massachusetts in April 2019 to outline four key targets to work towards over the next 3 years – these form the Boston Declaration:

1. Unified and strengthened advocacy for medical care in times of crisis.

2. Universal access to insulin and other essential medicines and diagnostics for glycaemic and blood pressure control in humanitarian crises.

3. Establishment of a unified set of clinical and operational guidelines for diabetes in humanitarian crises.

4. Improved data and surveillance of the prevalence of diabetes, access to care, patient burden, and patient-centered outcomes in humanitarian crises.

These targets are achievable and essential for mitigating the vast costs of life-long health problems associated with under-treated type 1 diabetes. Governments, advocates, disaster relief organizations, and other actors in global health must heed the call to action provided by the Boston Declaration. The signatories of the declaration will hold meetings annually to track the progress on each target.

The inalienable human right to a life with dignity is incompatible with barriers to adequate health-care. These four targets provide a roadmap for the delivery of vital care to those with type 1 diabetes in times of crisis.

To see the Boston declaration in full (free with registration) click here.

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