#SpareARose and #insulin4all – Highlighting the global healthcare dilemma

I’m one of the lucky people with T1D. 

What does that mean?

It means that by virtue of solely my birth place, I have access to the drugs and treatments I need to keep myself alive at no additional cost to me. And even more so, as any other healthcare issues arise, whether related to Type 1 Diabetes, or otherwise, I have access to those treatments too, on the same “Free at the point of access” basis.

Unlike some people, who were born and live in global locations with no healthcare system, or one where the only access to life saving treatments comes at an inordinate cost, where you can describe life as “Working to pay for treatments to live”, I not only have access to life saving treatment, but also to life enhancing approaches to delivering that treatment, for example, building my own pancreas and getting the majority of supplies for that delivered to me without paying out any form of cash.

That’s simply because I was born and live in the UK.

Therein lies the dilemma of global healthcare, as highlighted by the Spare-A-Rose campaign from the International Diabetes Federation’s “Life for a Child” charity.

We spend a lot of time dreaming about access to new technologies that would make living with our conditions easier, whilst more than half the global population doesn’t even have access to either drugs or education that would just keep them alive.

What would Banting think, given that he gave away the patent for insulin for a paltry sum for the good of man?

More widely, it raises the question as to whether access to healthcare and more importantly, life saving treatments, should be a basic human right. As it stands at the moment, this isn’t the case for the vast majority of people on the planet. Instead it’s a service provided only if you can pay for it.

For a long time, developed countries have contributed to Foreign Aid budgets, where a portion of the tax revenues earned from are earmarked for use in poorer countries for development and humanitarian purposes. In the UK, this is done via bilateral agreements (63%) and international organisations (such as the UN) – 37%. In the UK, this amounts to 0.7% of GDP (an amount encouraged by the UN), which is enshrined in an act of parliament.

The money going to international organisations is typically used in delivering humanitarian aid and support for context specific issues (think earthquakes, ebola, the war in Syria, etc). Bilateral agreements provide cash to a country to improve various aspects of the economy, with guidance from various charities and organisations.

How is this money spent? Digging in to the UK’s Statistics on International Development, it would appear that this money is split as below:

Healthcare receives a reasonable proportion of what is spent as UK overseas aid. Added to that, the broad definition of Health spending is:

Health – including basic health care, communicable disease control, health
education and health personnel development.

Now we could assume that “basic health care” would include access to treatments such as insulin for those who need it, and the appropriate drugs for those with other conditions.

And yet, the IDF Life for a Child charity still has to run the Spare a Rose campaign to provide access to better diabetes care for children and young people in developing countries. Basic healthcare would appear to be very much less than we assume.

There are a number of factors at play here.

1. We could and should share the wealth that we create much more effectively on a global basis. That’s a difficult problem to solve in a world where we are becoming increasingly inward looking.
2. The cost of access to the various resources for dealing with long term diseases should be lower. We know that pharmaceutical companies undertake differential pricing based on different markets. We know that the #insulin4all campaign looks to reduce the costs of insulin. We also know we can’t boycott insulin without “severe” side effects. This raises the question of how can we better support efforts to reduce the costs of treatment on a global basis? What can we, as a population, do to convince the pharma companies to reduce their costs to everyone? Should pharma related to critical lifesaving drugs be profit limited?
3. Is it possible to better advise local country healthcare systems without it needing a charity to support this approach, or is this interfering and ties in with question 1?

In the meantime, while these larger questions remain, we can at least assist.

Work with the likes of the IDF to try and reduce the cost of life critical treatments across the globe. It will take people power lobbying as much as groups like the IDF to do this.

Instead of buying 12 or 24 roses for Valentine’s day, buy one less rose and give money to “Life for a Child” (or any other charities that provide services for the long term diseases you consider close).

It’s not the solution, far from it, but it’s a start, and it will help save lives.