A recent symposium highlighted the severe challenges faced by underserved communities in India, where a seven-year-old girl undertook a grueling 38-hour journey to obtain life-saving insulin, underscoring the growing diabetes crisis in the region.
At the Arogya World Scientific Symposium held in Menlo Park, California, health leaders underscored the alarming increase of diabetes and cardiovascular diseases, particularly among South Asian populations, as they discussed the barriers preventing access to essential treatment and diagnosis. The case of a seven-year-old girl from a remote district on the border of Jharkhand and West Bengal illustrated the acute challenges faced by families in accessing medical care.
Seema Srivastava, the global advocacy and social impact director at Beyond Type 1, highlighted that India has the world’s largest population of children living with diabetes, with over 300,000 affected by Type 1 diabetes. “Living in privileged communities, it is a daily burden to manage diabetes,” Srivastava remarked, emphasizing the dire need for resources and medication for these vulnerable children.
Srivastava recounted the efforts of a nonprofit organization in a rural district of Jharkhand, which had received support through a health initiative she oversaw while leading the Gavi program for the Gates Foundation. The organization screened more than 17,000 residents, identifying approximately 1,700 individuals with diabetes, including 111 children and adults with Type 1 diabetes. Among them was the seven-year-old girl, who had to travel extensively to reach a healthcare facility.
“They told us that they want to work in a small district because nobody believes that diabetes happens to people in villages,” Srivastava shared, highlighting the prevailing stigma and misconceptions surrounding the disease. The findings also revealed significant structural barriers to care, with approximately 85% of patients lacking national identity cards, which are required to access insulin through government healthcare systems.
“There was not even an auxiliary nurse or midwife going into that district,” Srivastava noted, explaining that the girl had to travel to Malda, West Bengal, to reach a primary healthcare center for her life-saving treatment.
Despite recent national guidelines released by India for pediatric diabetes care and efforts to expand access to free insulin and testing, Srivastava stressed that implementation remains challenging in many rural areas. “The ground reality is difficult, far from the guidelines,” she stated, underlining the disparity between policy and practice.
The Role of Philanthropy
The symposium also addressed the critical role of philanthropy in tackling chronic diseases. Srivastava indicated that while philanthropic organizations have historically filled gaps left by underfunded health systems, there has been a noticeable shift toward long-term investments in healthcare infrastructure and workforce development.
“Traditional philanthropists are now moving away from just filling gaps towards funding more systemic strengthening,” she said, advocating for enhanced training and support for community health workers and primary healthcare professionals to ensure sustainable care delivery.
Dr. Nalini Saligram, founder and CEO of Arogya World, remarked on the historical impact of philanthropy in global health initiatives targeting HIV/AIDS, maternal health, and child mortality. “Philanthropy did step up and tackle all serious challenges,” she stated, reinforcing the importance of sustained efforts in healthcare improvement.
Health Implications of Diabetes
As discussions progressed, the speakers noted that diabetes remains underrecognized despite its significant health and economic impacts. Srivastava pointed out that diabetes is often framed as a manageable condition, which can contribute to a lack of urgency in addressing its prevalence. “The problem is not the lack of resources. It’s more about type 2 diabetes being framed as one size fits all,” she said.
Saligram echoed this sentiment, emphasizing that diabetes can lead to severe complications, including heart disease, stroke, amputations, and vision loss. “Diabetes is not always recognized as a very serious disease,” she said, calling for increased awareness and preventive strategies.
She further noted that lifestyle changes could significantly reduce the risk of Type 2 diabetes and associated cardiovascular diseases, stating, “We know 80% of type 2 diabetes can be prevented if you eat right, exercise, and avoid tobacco.”
Research on South Asian Health Disparities
Dr. Alka Kanaya, a professor at the University of California, San Francisco, presented findings from the long-running Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, which investigates health outcomes among South Asian Americans. “We’ve noticed in studies around the world that South Asians have more diabetes and heart disease than other groups, but we really don’t understand why,” Kanaya explained.
The MASALA study has produced over 150 scientific publications, revealing distinctive patterns of body composition among South Asians that may contribute to their elevated disease risk. “We have the highest rates of diabetes compared to other groups,” she stated, noting that factors such as lifestyle, environment, stress, and physical inactivity are significant contributors to the growing prevalence.
Kanaya highlighted disparities among South Asian subgroups, reporting that Bangladeshis have the highest risk for diabetes, with approximately one in two affected, while Indians have a rate of one in four, and Pakistanis fall in between. Despite these concerning trends, she emphasized that diabetes and cardiovascular disease are not inevitable, asserting that lifestyle changes can make a significant difference.
In conclusion, health experts at the symposium stressed the urgent need for improved healthcare access, earlier diagnosis, and stronger prevention efforts as diabetes continues to expand across the developing world. The experiences of patients, particularly those in remote rural communities like the young girl from Jharkhand, serve as a stark reminder of the work that remains to be done to ensure equitable healthcare for all.
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