The Frightening Reality of Skyrocketing T1D Diagnoses in Mali
Life for a Child supports young people living with diabetes in some of the world’s most vulnerable communities. In addition to the story shared below, read more about their work supporting young people like Rwandan sisters Ineza and Rebeka at ToClimbAThousandHills.org.
Until 2022, there have been wide gaps in the data about the incidence and impact of type 1 diabetes across the world. According to estimates from the T1D Index, almost one thousand people live with type 1 diabetes in Mali, but 1,500 more people would still be alive today if everyone had access to a timely diagnosis, vital diabetes supplies and management education. An average young person diagnosed at age 10 in Mali will lose an estimated almost 50 years of healthy life. Type 1 diabetes diagnoses have been increasing eight times faster than the population growth of Mali. Globally, there are an estimated total of 3.86 million people that would be alive today if everyone had equitable access to diabetes healthcare and tools. Learn more at T1DIndex.org.
In 2007 there were only 28 people in Mali under the age of 25 living with diabetes.
28 young people alive.
Out of a population of over 13 million at the time.
From 2007 to 2016, 460 more people under the age of 25 would be diagnosed with type 1 diabetes. The data alone seem to suggest that type 1 diabetes (T1D) was extremely rare in the land-locked West-African country until suddenly, in the year 2007, there was an outbreak of type 1 among the youth in the country. The reality is far more grim.
It wasn’t that T1D didn’t exist in Mali. The disease just wasn’t being diagnosed or treated sufficiently, and countless lives were lost. Through the intervention of Life for a Child, and the French non-government organization (NGO) Santé Diabète, hundreds of Malian lives have been saved. Today the total number of young people supported by Life for a Child and Santé Diabète across Mali is over 700.
Life for a Child believes that no child should die of diabetes. What began as a pilot program in 2000 to help children living with T1D in under-resourced countries has since grown to support more than 22,000 young people in 43 countries across the globe. The organization first expanded into Africa in 2004, and Mali was an early target for diabetes intervention.
Santé Diabète was founded in 2001 by Stephane Besançon to help Malians with diabetes gain access to diabetes supplies and critical care for their disease. They began working in Mali in 2003, and faced a large uphill battle from the start.
Besançon, the current CEO of the organization told Beyond Type 1 “Back then [in 2004] there were only 10 children alive with type 1 diabetes and only one specialist practicing in the capital Bamako. Treatments like insulin were available only in the private sector, they were very expensive and nearly inaccessible to the majority of patients. Significant work was needed to build a structure to guarantee diabetes care in Mali.”
Life for a Child specializes in working with local institutions like Santé Diabète, and the pairing has been nothing short of groundbreaking. Life for a Child’s general manager Graham Ogle says of Santé Diabète “it’s the local champions in these countries who are critical to the success. Things can really turn around, and they have in Mali.”
While Santé Diabète works in close partnership with the Malian government to ensure that medical care and diabetes education is provided, Life for a Child has supported this work with supplies such as: insulin, syringes, test strips, HbA1c testing, education resources and other assistance.
Increase in T1D Prevalence and Incidence
Since 2007, when Life for a Child and Santé Diabète began their intervention to provide care for all young people under 26 with diabetes in Mali, the population of people living with the disease has skyrocketed. A study published earlier this year demonstrated that during the first 10 years of the program, prevalence of T1D increased substantially every single year, from 0.43 (per 100,000) to 2.90 in 2016.1 That’s nearly a 600 percent increase in the percentage of young people living with T1D in the country.
The incidence of T1D diagnoses also steadily increased from 2007 to 2016 over the course of the study. Notably, incidence rates peaked in 2014 following a poster campaign from Life for a Child in 2013. The organization placed 1,600 posters in health facilities across the country, raising awareness of the warning signs of T1D that are often misdiagnosed and lead to death.
Diabetes care in Mali is much more advanced than it was 20 years ago.
“The partnership between Santé Diabète, Life for A Child and the Malian authorities has helped change the lives of children and young adults with type 1 diabetes,” Besançon explained. “The situation today is radically different in Mali, with a reinforced endocrinology and diabetology service in the National Hospital of Mali which includes a children’s diabetes sub-unit … the opening of 32 diabetes clinics in the different regions of Mali and the district of Bamako taking care of more than 20,000 patients with type 2 diabetes… and a specialist T1D specialist at the hospital in Mali and 10 type 1 diabetes clinics in the regions of Mali caring for 950 children and young adults with T1D”
More than just numbers
Daba Doumbia is a 21-year-old young man (and excellent soccer player!) living in Mali, who recently submitted the video below to Life for a Child. Were it not for the intervention of Santé Diabète and Life for a Child, he may not be alive today. According to Besançon, “Access to healthcare allowed Doumbia to grow up to be a dynamic young man who will soon excel in his studies.”
In his own words, Doumbia says, “I was shocked when I found out I had diabetes. I watched my life fall apart and my dreams fly away in a second like a house of cards. I believed my life was over and I no longer had a right to happiness. Thanks to the help of a big brother and doctor, I was able to … meet young people with diabetes like me and also to facilitate access to quality care, including the acquisition of devices and insulin. [With] the support of my family, doctor and friends, I was managing my life well with diabetes and got back to playing football.”
More help needed
One thing is clear. Intervention saves lives. Diabetes care in Mali has come a long way over the past two decades, but there is still so much to be done. The number of lives lost to missed diagnosis and under-treated diabetes around the world is unacceptable, and a little bit of help can go a long way. If you would like to find out how to get involved and potentially save lives, consider donating to Life for a Child.
1. Sandy JL, Besançon S, Sidibé AT, Minkailou M, Togo A, Ogle GD. Rapid increases in observed incidence and prevalence of type 1 diabetes in children and youth in Mali, 2007–2016. Pediatr Diabetes. 2021;1–7. https://doi.org/10.1111/pedi.13191
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