How to Maintain Access to Diabetes Care in a World in Crisis? Lessons learned from Assam

By Anna Thabuis

For this year’s World Diabetes Day (14th November), I invite you to reflect on how to maintain access to diabetes care, especially for the most vulnerable, in a world in turmoil. For this purpose, let’s turn to the three ongoing World Diabetes Foundation (WDF) projects in Assam, India; and to the lessons learned from promoting access to diabetes care despite external pressures.

World Diabetes Foundation supported clinic in Assam, India. Photo courtesy of World Diabetes Foundation. 

What drives WDF’s work is the necessity to provide care to those living with diabetes and those at risk. Over the span of a decade, WDF has supported three projects in Assam, India, aimed at improving the lives of individuals living with diabetes, as well as strengthening the healthcare system. Yet, between the COVID-19 pandemic and the growing threat of climate change, important obstacles have arisen putting the “long term sustainability” of WDF’s programs in Assam to the test (spoiler: the projects lived up to the challenge).

Mette Skar and Kirza Buch Kristen (World Diabetes Foundation) standing outside a clinic with healthcare providers and partners. Photo courtesy of World Diabetes Foundation.

Although there is no one size fits all approach to developing and implementing projects in low- and middle-income countries (LMICs), with 20 years of experience from the field, WDF has developed a successful strategy centered around three key principles: collaboration, capacity building, and commitment. 

A Collaborative Process 

WDF-supported projects derive their strength from the hard work of local partners.  WDF has been collaborating with Piramal Swasthya Management and Research Institute (PSMRI) since 2010. This partnership has allowed the projects to be driven by local demand, as well as to tap into local knowledge and systems.

Together, not only have PSMRI and WDF strengthened local clinics, but we have also integrated a state-wide village health outreach program; expanded basic diabetes screenings, referrals, and care to rural regions; and promoted primary preventive programs for at-risk individuals and schoolchildren.

Capacity Building 

A focus on capacity building and empowerment has revealed itself key to creating strong and sustainable interventions. All 3 of WDF’s projects in Assam seek to train healthcare providers in the hopes of enabling the provision of diabetes care. 

One of WDF’s projects, Strengthening NCD services in Assam, takes an innovative approach to capacity building by training primary care doctors to become master trainers who will educate 9,900 community health workers through cascade training. Additionally, the project aims to increase connectivity between people seeking care and health care workers by equipping them with upgraded telemedicine technology, electronic medical records, and even portable artificial intelligence devices capable of screening for diabetic retinopathy and diabetic foot! According to Mette Skar, WDF Programme Manager and KU MSc. Public Health alumni, these digital health solutions empower healthcare providers by giving them the tools necessary to deliver quality care to underserved areas. 


Commitment and dedication are essential to the success of projects.  During a crisis, those most vulnerable are the most at risk. Given the strain on healthcare systems imposed by COVID-19 and the floods exacerbated by climate change, those living with diabetes in Assam saw their access to care threatened. Nevertheless, WDF’s mission to provide care to all served as fuel to remain committed to showing up and contributing the resources needed to guarantee the success of the projects in Assam.  In times of turmoil, maintaining support and care to the most vulnerable no longer can only be considered as an ambition but a necessity.

Diabetes screening of women at World Diabetes Foundation supported clinic in Assam, India. Photo courtesy of World Diabetes Foundation.

All in all, promoting access to diabetes care in a world in crisis is no easy task, but through strong partnerships, commitment, and a focus on capacity building and integrated care, we can bring about change and achieve health for all. 

You can find the full Assam story here: In Assam, a roadmap to improved diabetes care | World diabetes foundation.

To learn more about WDF’s work, you can check out the website: World diabetes foundation | Fighting diabetes worldwide.

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