Eli Lilly and Company announced that it will begin testing its ideas about diabetes management in what might seem an unlikely place-Ghana, Africa.
The project, which will be conducted in partnership with three medical schools, will begin by determining how many Ghanaians have diabetes, what kind of treatment they receive, and how the disease debilitates them. The project team will instruct healthcare workers how to recognize diabetes and treat it properly. Training will take place at the University of Virginia School of Medicine, one of Lilly’s partners in the project.
“The need for a project like this becomes clear when you look at the staggering global statistics on diabetes,” says Robert M. Carey, dean of the medical school. “The disease affects more than 100 million people worldwide, and that number is expected to grow to 200 million by the turn of the century.”
Says Bill Robinson, Lilly’s general manager for Africa, the Middle East, and Greece, “Diabetes usually goes unrecognized in Ghana, with devastating consequences. In the population of 17.23 million we estimate there are about 300,000 diabetics. And we think about 10,000 are being treated today. The International Diabetes Federation estimates that 50% of all diabetics in Africa die within five years of diagnosis.”
In Ghana, people with diabetes are treated almost exclusively at two major teaching hospitals. One of the goals of the Lilly project is to increase awareness of diabetes on the community level so that local clinics can correctly diagnose and treat patients.
Lilly has pledged nearly $1 million for the Ghana project in the form of educational materials, insulin, and staff time. The company’s long-term hope is that will become involved in all phases of diabetes treatment in Ghana.
The project is the first of this scope for both Lilly and Africa. Lilly sells very little insulin in Ghana, and the company’s agreement with the Ghanaian Ministry of Health does not insure that Lilly will sell more. But Lilly feels that any increase in sales will be better than current levels.
It is not certain whether Ghana will be able to afford up-to-date diabetes care. It costs about $60 a year to treat a person with diabetes in Ghana, which has a per capita average annual income of only $410. The government pays most of the cost of treatment, but the introduction of 290,000 previously undiagnosed diabetes cases, at a total cost of $17.4 million, will be no small matter.
“Clearly one of the things we expect to happen here is increased use of medicine, which is going to cost money,” says Robinson. “The Ghanaian government understands this.”
The cost of not treating diabetes properly is probably higher than $60 per patient per year.
Robinson is troubled by the current state of people with diabetes in Ghana. “Today, people die, they go blind, they have to have their feet amputated and nobody keeps track of it,” he says. “I would be pretty surprised if we don’t demonstrate that $60 per patient is pretty cost effective.”
It’s going to take several months to get the program started and begin the study. In the meantime, healthcare workers from Ghana will begin training at the University of Virginia. Later this year they will return to Africa and begin passing on what they’ve learned to their colleagues, who will then train healthcare workers in local clinics throughout Ghana.