Lack of insulin brings health concerns

Parents of insulin dependent children and adults suffering from insular diabetes, as well as health officials, are concerned over the lack of insulin in Kyrgyzstan. "My child has been on insulin for eight years. His development is good and he doesn't differ from the children of his age," Tatiana Guliayeva, a mother of an insulin dependent child, living in the Kyrgyz capital, Bishkek told IRIN. "However, switching to animal-based insulin might affect my child's health." Yelena Bayalinova, a press-secretary at the Kyrgyz Health Ministry told IRIN that the ministry was concerned about the situation regarding the supplies of insulin preparations. According to the health official, companies supplying insulin rejected providing the medicine unless the debts, totally some US $750,000 as of September 2003, including some $165,000 remaining from 2002, were paid. Diabetes mellitus [insular diabetes] is a chronic disease caused by inherited and/or acquired deficiency in the production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damages many of the body's systems - in particular blood vessels and nerves. In an insulin-dependent individual, the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life. Svetlana Mamutova, the country's chief endocrinologist and chief doctor at the endocrinology hospital of Bishkek, told IRIN that the Kyrgyz Health Ministry had applied to the government, finance ministry and treasury department for assistance. "The stocks of insulin will be sufficient only for 1.5 months, but it will take two to three months for a tender announcement, procurement and registration," she said. "If the money is not allocated immediately, doctors won't be able to help the patients," Lidia Fomova, the head of the Social Protection Society, a local NGO, said previously at the meeting of pensioners with health ministry officials. She said that people, suffering from insular diabetes had no other choice that to apply directly to Kyrgyz President Askar Akaev on the issue. In an effort to tackle the issue, Kyrgyz Prime Minister Nikolay Tanayev reportedly ordered the 'Kyrgyzresursy' state procurement office to buy insulin from Ukraine, given the opportunity to barter it for Kyrgyzstan-produced cereal. However, Mamutova said that the Ukrainian insulin preparations of animal [pig] origin, containing 40 units of amino acids in a millilitre, were not suitable for diabetes patients. According to the Belgium declaration of the International Diabetes Federation [adopted in 1999] universal concentration of 100 units was adopted all over the world, she explained. "Utilisation of animal insulin could cause serious complications and treating them might cost more than buying good quality insulin," the chief endocrinologist warned. Meanwhile, parents of the children suffering from diabetes and adults having the disease remain concerned over the situation. "If the government doesn't take appropriate measures regarding the purchase of insulin, we as parents and the Association of Diabetics of Kyrgyzstan, will employ extreme measures, including going on a hunger strike," Guliayeva warned. A letter from the Ukrainian Association of diabetics reportedly stated that diabetes patients in Ukraine didn't use animal-origin insulin drugs, but good quality western insulin , hinting to the dubious quality of the Ukrainian insulin. According to some sources, more than 16,000 people in Kyrgyzstan are suffering from diabetes, of which 4,000 are insulin dependent, including some 155 children. At present procurement of vitally important medicines for insular diabetes patients in the country is funded by the state, given the fact that monthly consumption of insulin costs some US $20 - while the average monthly salary in the Cetnral Asian state is some $30. [For more information on diabetes mellitus please go to www.who.int]