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October 22, 2012

Roman Madaus, an international relations student at Tufts University, spent the summer of 2012 in Tajikistan researching the impact that Project HOPE’s donated insulin has had on the health of diabetes patients in this country.  This article is based on information derived from that report.

The mountainous Central Asian country of Tajikistan is the poorest former Soviet republic.  While the average annual per capita income in Tajikistan is $780, the annual cost of reliable insulin for a patient with Type I diabetes is approximately $380 – making it prohibitively expensive for most people. 

“Life in the rural regions of Tajikistan is arduous,” said Colin Credle, Project HOPE’s Regional Humanitarian Assistance Manager for Russia and Eurasia.  “There is chronic poverty, unclean water, and finding transport to the city is very expensive.  Mountains cover more than 93 percent of Tajikistan, so getting around is also time consuming.”  

The Republican Clinical Center of Endocrinology (RCCE), the government health institution in Tajikistan responsible for aiding diabetes patients, is unable to purchase any significant quantities of insulin due to tight budget constraints.  Further compounding the situation is the fact that insulin requires a refrigerated storage system for transport to and within the country, which Tajikistan lacks due to its remote location.

Insulin to Tajikistan

Consequently, Tajikistan depends upon international humanitarian assistance from Project HOPE and the United States Department of State to meet the needs of its diabetes patients.The Department of State delivers insulin supplied by Project HOPE and its corporate donors by chartering a cargo plane to fly directly to Tajikistan, making it easier to maintain cold storage and to provide transportation.  

There are over 23,000 registered diabetics in Tajikistan.  The true number of diabetics is much higher and difficult to measure because individuals living in remote areas are disinclined to travel to RCCE in the capital Dushanbe, where they would register, due to high travel costs.  It is important for RCCE to register as many diabetics as possible so that it can collect and analyze statistical data on its programs to gauge their efficacy.  By having reliable data, RCCE is then in a better position to receive aid from international donors.

Project HOPE has supplied 95 percent of the reliable insulin in Tajikistan since 2001 with insulin donations from HOPE’s corporate donors totaling $10.6 million.  Although only 12% of the total need for insulin has been met since 2005, the benefits to diabetics in Tajikistan brought about by the donated insulin from Project HOPE and its corporate partners are well documented.  Here are some highlights of the results.

  • Registration of diabetics and attendance at education seminars on diabetes at the RCCE has surged; free insulin has been an incentive for diabetics in remote regions to travel to the capital
  • Incidences of lower limb amputations and diabetic comas have been substantially lower in years when donated insulin was received.
  • In years when insulin was donated through Project HOPE, the RCCE was able to treat many more Type II diabetes patients; funds that normally would have been spent on insulin were used to purchase non-insulin diabetes drugs.

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