WHY DOES THIS CHALLENGE MATTER?
People living with diabetes (PLD), especially those with Type 1, are particularly vulnerable in conflict zones where access to food, healthcare, and treatment continuity is severely disrupted. Managing diabetes in these settings is a complex challenge requiring context-specific solutions, as traditional care models fail to account for displacement, food insecurity, and breakdowns in health infrastructure. Without targeted interventions, the risks of complications and preventable deaths rise sharply.
Irregular access to food:
KEY ISSUES
In conflict-affected areas, PLD often rely on one daily meal typically food aid or traditional staples like injera and wat—that is not suited for insulin regimens. This unpredictability in meal timing and nutritional content makes blood glucose control extremely difficult.
Irregular access to healthcare centers:
Health facilities are often damaged, destroyed, or inaccessible due to insecurity. This limits access to essential services such as blood glucose testing, insulin, and diabetes care. Medicine supply chains, including cold chain systems, are frequently interrupted, and many PLD lose their medication during displacement without knowing where to seek replacement.
Quality services: Challenges in adaptation of insulin use & patient follow-up: PLD may need to adapt to new insulin regimens/switch insulins, including fixed dose combinations (eg 30/70), which may be the only available insulin and without possibility of self-monitoring. They may face challenges in reaching health facilities for follow-up, being several times displaced. The staff at the health facilities may not be trained in management of diabetes. In addition, the health information on previous management of diabetes may be lost.
EXPECTATIONS
Capture more information and initiate a dialogue to test possible solutions to uncover practical, contextsensitive solutions that not only address the unique challenges in Ethiopia but can also be translated to other countries affected by armed conflict.
Laboratory
Endocrinologists
Anthropologists
Developers/Programmers (e.g.interoperablemHealth)
Nutritionists
Diabeticpatients/Diabetesassociations
LocalCommunityexperts
StudentsinGlobalHealth/GraduateInstitute/ SDCInnovation&Others.
CHALLENGE OWNED BY
WHY DOES THIS CHALLENGE MATTER?
Diabetes affects an estimated 828 million [1] people worldwide, with a rapid increase in low- and middle-income countries. For those living with Type 1 diabetes, and some with Type 2, access to insulin, blood glucose monitoring equipment, professional care, and the empowerment to manage their condition is critical. However, these essentials are often out of reach for those in rural, remote, conflict, or displaced settings. Despite advancements in diabetes management technologies, such as automated glucose detection systems, many of these innovations remain inaccessible in these contexts due to high costs, complex requirements, and environmental challenges. MSF works in regions where these barriers prevent people from benefiting from life-changing technologies.
[1] https://wwwthelancet.com/journals/lancet/article/PIIS0140-6736(24)02317-1/fulltext
High Cost of Technologies:
KEY ISSUES
While open source solutions emerge in some areas, the price of complete diabetes management devices remains prohibitively expensive, limiting access in lowerresource settings
Technology complexity and Lack of sufficient Training:
Many of the available technologies require specialized training and health care workers often lack sufficient training for these technological devices.
Harsh Environmental Conditions:
Extreme heat, dust, power outages, and unreliable internet connectivity make it difficult for many devices to function effectively in the field
Device Adaptability:
Current devices often do not meet the environmental, infrastructural, or socioeconomic needs of the target populations
EXPECTATIONS
Ideally, define a prototype for a new diabetes management device that meets all specifications.
Another positive outcome would be identifying key elements from existing tools that could be adapted to meet these needs. And exploring the feasibility of creating a new device and determining the most practical tool to focus on for adaptation can also be considered as key outcome.
Biomedical engineering
IT - Developing / Programming
Sustainable financing
User-Centered design (UI/UX expertise)
Person living with diabetes / Member of diabetes association
CHALLENGE OWNED BY
