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Special effort towards chronic disease in East African city

When COVID-19 struck, chronic disease patients in Tanzania’s largest city Dar Es Salaam were exposed to risk of contagion and serious illness. Through support from Novo Nordisk Foundation, the World Diabetes Foundation has been able to contribute to strengthen patient information and the local health care system in its approach to managing chronic disease patients.

Due to the initial public anxiety and fear, many people with chronic diseases stayed home and were reluctant to access health services or even to move around in the neighborhoods.

“The outbreak caused growing concern among people with chronic diseases – posing the question what to do in a situation when you are afraid to travel to the local hospital or health clinic to receive care and medication”, says Bent Lautrup-Nielsen.

He is heading the Global Development and Advocacy department at World Diabetes Foundation, which over the past almost 20 years has supported projects concerning diabetes and health in Tanzania. As a response to the COVID-19 outbreak, World Diabetes Foundation was given the approval by Novo Nordisk Foundation of a DKK five million (EUR 700,000) grant to Tanzania with special focus on chronic diseases.

“It is important that patients with chronic diseases are also assisted in difficult times as these with the COVID-19 pandemic. The grant from Novo Nordisk Foundation is important, so that our many years of progress to support chronic disease patients will not be set back”, emphasizes Bent Lautrup-Nielsen.

120,000 patients with continued access to care
With the grant from Novo Nordisk Foundation, World Diabetes Foundation has been able to support national partners in Tanzania, first and foremost Tanzania Diabetes Association and the national and Dar Es Salaam regional health authorities. The resources provided have been invested into capacity building at so far ten hospitals across the greater Dar Es Salaam urban area (counting more than six million people), noting that as in the rest of the world, densely populated and urban areas were those most severely affected by COVID-19.

The support from World Diabetes Foundation has also contributed to the training of more than 400 health care professionals in COVID-19 and chronic disease management, and protective materials and test equipment etc. have been procured and distributed, test centers established and intensive care units made operational. So far, the support provided has helped ensuring that at least 120,000 chronic disease patients have been able to continue accessing health care services.

“In Tanzania, public health and disease patterns are different from Denmark. There are also malaria, HIV and many other challenges. Tanzanian health authorities constantly have to keep a balance between efforts. COVID-19 certainly has not made this work easier, and the support from Novo Nordisk Foundation, which was given at a very early stage in the outbreak, has been of great value so far and will continue to be so going forward. You can do a lot with five million kroner (DKK) in Tanzania and the support has helped the health care system to hopefully also being more prepared to handle acute care, infectious diseases and chronic diseases in the future”, says Bent Lautrup-Nielsen.

He adds that World Diabetes Foundation has gained some important learnings which can be taken onwards. “Now we know more about how to assist countries like Tanzania with a reorientation after COVID-19 in the crossing between different diseases.”

Posters, signboards and community sensitization
World Diabetes Foundation’s national partners in Tanzania have communicated during the pandemic to patients through different platforms. Chronic disease patients have been able to contact health authorities and health care professionals and get guidance and information about symptoms and share concerns.

During the time of first wave of infections, patients were able to see posters and signboards with messages about COVID-19 and how to take care if you have a chronic disease. Simple prevention messages were disseminated in Kiswahili and English language related to care and protective behavior at schools, at home and at community gatherings.

Fast reaction from health authorities and a new reality
The efforts in Tanzania are still ongoing and as in the rest of the world the development of the pandemic over the coming time is difficult to predict. Bent Lautrup-Nielsen emphasizes as something very positive the fact that decisions were made very fast:

“Health authorities in Tanzania quickly rolled out a plan of action to contain the outbreak and treat patients with COVID-19. Such plans are normally time demanding to develop. It is quite extraordinary and encouraging that the health system has been able to incorporate the pandemic quickly into its services. The contributions from Novo Nordisk Foundation and World Diabetes Foundation in this regard are important to note.”

He also observes that the initiatives taken in the health system in Tanzania might be signs of change in the approach to health globally.

“The pandemic has made it clear that it no longer makes sense to distinguish the same way between chronic and infectious diseases.”

Further information

Christian Mostrup, Senior Programme Lead, phone: +45 3067 4805, [email protected]