We get updated on the great strides The South African Non-Communicable Diseases Alliance and Diabetes South Africa are making in advocacy.

Fact:  Diabetes is the leading cause of death of SA women – and COVID-19 won’t change that.

Diabetes and COVID-19

Diabetes South Africa (DSA) is a founding member of The South African Non-Communicable Diseases Alliance (SANCDA) but our association stretches back to 2006 to an umbrella health NGO advocacy forum. Through all of the COVID-19 lockdown, SANCDA and DSA continues an essential partnership. Why do we carry on regardless?

We, the people living with diabetes, want access to quality prevention and care. Diabetes, along with many other non-communicable diseases (NCDs), must be prioritised in South Africa. Now more than ever.

What does priority look like? People with diabetes get the needed care without a run-around. Treatment and prevention are taken seriously just as HIV, TB and other communicable conditions are. It means that government takes diabetes and NCD care seriously and puts it at the top of the political hit list without platitudes.

The positive spin-off of the COVID-19 pandemic, if possible, is that, at last, there is recognition of the global neglect of diabetes and other NCDs.

The SANCDA and DSA didn’t just wake up during COVID-19 to these existing problems. Our partnership goes back to 2013, and right from the start, we have demanded fairer and better health services for diabetes and NCDs.

Health and related services must be at the same level (equitable) when benchmarked against those provided for HIV and TB, etc. In all ways.

Diabetes and NCDs policy activism

Our policy demands focus on public sector services where the majority of South Africans receive care. Or not, as the case may be. We engage with relevant and willing stakeholders who are open about their interests and ready to roll up their sleeves to work. Not only is there little or no money for NCDs in the public sector, but the policies that allow for spending are poor and unimplemented.

Unceasingly we hold government at all levels to account for equitable NCDs policy and service delivery. It is not just about “fighting” for rights but also about collaboration and co-production.

Without a doubt, the longest-running example of policy advocacy is the national government’s NCDs National Strategic Plan. After eight long years, its approval is imminent.

During those lonely years, we were often on the outside looking in. In the final phase, the SANCDA was the sole representative of the “people” and civil society giving hundreds of hours of work to get a more equitable deal for NCDs and diabetes. The difference now is that 100 of our “besties” are on the same page, like-minded individuals and organisations.

NCDs – a human rights case

The neglect of diabetes and other NCDs didn’t start with the pandemic. What changed is that, at last, there is recognition for the vulnerability of people living with NCDs. And it is no different from the status afforded people living with HIV.

We followed the steps taken by the HIV activists, holding the government accountable for our constitutional rights. In December 2020, the South African Human Rights Commission officially accepted our complaint against the SA government for “policy” neglect. Our complaint is that The National Development Plan does not consider NCDs a priority, unlike HIV, and this is an inequity to people living with NCDs, including diabetes.

Diabetes helpline during COVID-19

COVID-19 made it clear that people with NCDs, including obesity, are at significant risk of severe complications and death. Hard lockdowns created additional challenges of getting medication, travel and even food.

Early in the pandemic, together with DSA and the National Department of Health, we started a telephone and message service. Its only purpose was to assist people with diabetes to stay healthy. We reconned that simple interventions could do that.

The service is simple, allowing for low levels of technology and encouraging those with limited data access. So, this is how it works: A person sends a message, often as simple as “Hi”. And so, a conversation starts, allowing for information to be shared. The individual’s needs are often clarified over several texts and days, all the while sending information about COVID-19, vaccinations, nutrition, and medicines.

Approximately 10% of the more complex clinical cases are referred on to a diabetes nurse specialist for in-depth interviews and more extended discussion. It could involve changes to meds (including insulin) and perhaps referral to health facilities. The person’s consent is needed for any referral.

Our interventions and solutions uses our vast network of partners, including DSA, all levels of government, other NGOs and caring individuals in society. It takes a community of caring people to run this service. Of course, all of this was backed by years of experience and tested relationships. That is what it is all about.