Diabetes sufferers decry cost of drugs, appeal for govt intervention

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Adults living with diabetes whose lives depend on insulin have asked the Government to include them in the allocation of this life-saving drug, which is costly to many.

Insulin therapy is often an important part in diabetes treatment. It helps keep blood sugar under control and prevents diabetes complications.

In an exclusive interview on July 4, 2025, at the Uganda Diabetes Association Annual Scientific Conference at Hotel Africana in Kampala city with Edith Prudence Mukantwari, an adult who has lived with type 1 diabetes for close to two decades, rallied the Government on the management of the rising diabetes.

Mukantwari was aged 13 when she was diagnosed with type 1 diabetes in 2005. Her body had begun to shut down—she was constantly thirsty, losing weight rapidly, and passing urine excessively.

She says she could drink a five-litre jerrycan of water in half an hour and was eating constantly without feeling full. But her complaints were dismissed by the school nurse, who thought she was faking illness to go home.

She was initially treated for type 2 diabetes and only placed on the correct insulin treatment three years later, after a second diagnosis confirmed type 1 diabetes.

Today, Mukantwari is a trained nutritionist and diabetes educator. However, despite her medical knowledge and advocacy, she still struggles with the same thing thousands of Ugandan adults face daily: Inconsistent access to insulin.

“Insulin is not optional,” she says. “You stop taking it, you die. There is no negotiation.”

While children under 18 can access free insulin and care through the donor-funded Changing Diabetes in Children (CDiC) programme, adults with type 1 diabetes are left to fend for themselves.

Public hospitals frequently run out of stock. Pharmacies in rural areas rarely stock insulin due to high storage costs. Prices vary wildly, with improved analogue insulin (latest) costing up to shillings 280,000 per month, which is far beyond the reach of most Ugandans.

Even when insulin is available, proper storage remains a challenge. The drug requires refrigeration at 4°C before use and degrades at high temperatures.

“In the villages, people improvise with pots and cotton-lined metal cases to keep insulin cool,” Mukantwari says. “But without stable electricity or education on storage, it often spoils.”

Mukantwari says during a nationwide shortage in December 2024, insulin vanished even from pharmacies in Kampala and resorted to importing insulin from Nairobi, only to discover it had gone bad in transit due to poor cold chain handling.

“I lost shillings 500,000 on nonperforming insulin because it was not handled well in transit,” she says.

Mukantwari is now calling on the Government to urgently expand access to insulin for adults. She wants the health ministry to include analogue insulin on the essential medicines list, eliminate taxes on diabetes supplies, and ensure insulin is stocked in all public hospitals.

“Uganda has shown leadership in HIV and malaria,” she says.

“It’s time we show the same urgency for non-communicable diseases. Adults with diabetes deserve to live by accessing free insulin anytime and anywhere.”

Health facilities struggling

Uganda’s health ministry acknowledged the growing concerns over the inaccessibility of insulin for adults living with type 1 diabetes, a situation worsened by frequent drug stockouts and lack of transitional support once patients turn 18.

Dr Frank Mugabe, the Assistant Commissioner for Non-Communicable Diseases (NCDs), admitted that while insulin is provided in government hospitals, access remains uneven, especially for adults.

“Government provides insulin for all people,” Mugabe explained, “but some of the types available are not suitable for certain forms of diabetes, particularly type 1. And even then, the medicine stock is not enough, but we will address this with National Medical Stores.”

He further revealed that many public health facilities struggle with planning and ordering the right quantities or types of insulin from the National Medical Stores (NMS).

“Hospitals get what they request. If they don’t plan properly, they won’t get the right stock,” he noted. Additionally, Uganda’s NCD medicines are underfunded—less than 50% of what is required—leaving many adults to purchase insulin out of pocket, at times spending over shillings 250,000 monthly.

Mugabe warned that with changing lifestyles, the burden of diabetes in Uganda is expected to rise.

“We are seeing more diabetes, both in the young and old, due to inactivity, unhealthy diets, obesity, and even persistent malnutrition,” he said.

He also noted a growing concern over ‘type 5 diabetes’ linked to chronic undernutrition and the emergence of diabetes among street children exposed to illicit drugs.