Finger prick test for blood glucose testing using a gluco-meter

Improving access to continuous glucose monitoring devices in Kenya and South Africa

What is this project?

The Access to CGMs for Equity in Diabetes Management (ACCEDE) project seeks to make continuous glucose monitoring devices (CGMs) more accessible and affordable to people living with diabetes in Kenya and South Africa. The project also aims to improve healthcare providers and people with diabetes’ knowledge and understanding of CGM and how to integrate this technology into effective diabetes management. It will ultimately lay the groundwork for sustainable financing of CGMs.

Why are we working on it?

Low- and middle-income countries (LMICs) are home to majority of the nearly 540 million people living with diabetes. Of these, millions of people with diabetes rely on insulin to effectively manage their blood glucose levels. To maximize the efficacy of insulin and to avoid harmful side effects, accurate and consistent monitoring of blood glucose is essential. CGMs make this possible by continuously collecting glucose data throughout the day and night.

Whereas CGMs have become a standard part of diabetes management in high-income countries, adoption of this technology in LMICs has lagged. FIND market research shows that only 16% of individuals with type 1 diabetes in South Africa have access to CGMs, with the figure dropping to just 3% in Kenya.

In these countries, CGMs are primarily accessible to those who can afford to pay out of pocket (up to US$120 per month). Additionally, the limited availability of CGM products, coupled with low awareness among people with diabetes and healthcare providers, further contribute as significant barriers to access.

What does it involve?

ACCEDE adopts a comprehensive three-pronged approach to enhance CGM accessibility in Kenya and South Africa. The data and evidence gathered through this project will be integrated into an investment case for CGMs in low- and middle-income countries (LMICs), which can serve as a valuable resource for policy makers and funders, assisting them in making informed decisions when seeking ways to expand access to this groundbreaking technology.

What do we expect to achieve?

ACCEDE is designed to improve access to CGMs in LMICs in a sustainable way. By demonstrating the positive clinical and health economic impact of these devices, and by highlighting that there is ample market opportunity, the project aims to encourage suppliers to introduce their technologies at affordable prices in these countries and to engage private and public health insurers to support the sustainable funding of these tools for people who need them.

Lessons and results will also help promote equity in diabetes management beyond Kenya and South Africa, laying the foundation for improving CGM access in the region and in other resource-limited countries.

What is the timescale?

ACCEDE will run from 2023 to 2025, after which CGM users in Kenya and South Africa are projected to double in number.

Partners and funding

The ACCEDE project is being supported by the Leona M. and Harry B. Helmsley Charitable Trust.

FIND will work with CGM manufacturers to bring their products to LMIC markets at affordable costs. On the ground, the project will partner with diabetes centres in Kenya and South Africa to collect pertinent data for clinical and health economic studies.

ACCEDE will also involve regional key opinion leaders in diabetes, government agencies, people with lived experience and civil society organisations, and industry groups to ensure the efficient implementation of the project.