Context & key figures
Mali, one of the poorest countries in the world, faces a critical shortage of healthcare professionals, with only 0.7 doctors and 2 nurses per 10,000 inhabitants. At the same time, the burden of Non-Communicable Diseases (NCDs) continues to grow, with 3.6% of the adult population suffering from diabetes and 18% from hypertension.
This shortage seriously compromises the healthcare system’s ability to guarantee adequate, efficient and equitable services. Moreover, the epidemiological transition accentuates this problem, combining a persistent prevalence of infectious diseases with an exponential rise in non-communicable diseases such as diabetes.
Santé Diabète began its actions in Mali in 2003 with an expert analysis of the capacities of the Malian health system in the fight against diabetes.
This assessment, carried out in collaboration with the International Insulin Foundation (IIF), highlighted a catastrophic situation regarding the care of people living with diabetes.
- only 2 specialist doctors providing diabetes care in only 3 national facilities located in the capital city, Bamako,
- a lack of adequate equipment (blood glucose meters, strips etc.) which led to delayed diagnosis and made patient follow-up nearly impossible,
- a regular lack of medicines in public structures due to numerous supply disruptions,
- the measurement of glycated hemoglobin (HbA1c) was only available in a single private laboratory in the capital city, Bamako, at a prohibitive price (15 euros per test, representing almost 30% of the average salary),
- fewer than 10 children were being monitored for type 1 diabetes. The challenges in care resulted in a very low life expectancy, with patients surviving only about one year after their diabetes diagnosis,
- no specific prevention program or therapeutic education.
Our action
In response to this situation, Santé Diabète decided to develop a program with a comprehensive approach, covering all the necessary aspects to establish high-quality diabetes prevention and care.
This innovative approach has been put into practice through a five-level strategy aimed at achieving the following objectives:
strengthening human resources
access to medicines
strengthening of technical platforms and biological diagnostic tools
developing prevention and therapeutic education programs
supporting the structuring of diabetes patient associations at the local, regional, and national levels.
Our impact
Since 2003, the programs we have implemented in Mali have brought significant progress in the care of people living with diabetes. Between 2020 and 2023, these actions have led to major results:
Prevention
Opening of houses for the prevention of diabetes and its risk factors :
- In 2021, the launch of a Diabetes Prevention House, in partnership with the NGO Walé, marked the beginning of prevention and patient support workshops within these houses.
- Launch in 2021 of regional prevention houses (Kayes, Timbuktu, Ségou and Sikasso).
- Training of 20 patient peer educators (PPE) and development of prevention tools used by the PPE.
- Within the Diabetes Prevention Houses, in the community, in health facilities, and during prenatal consultations, peer educators conducted 764 awareness sessions reaching 7,921 people.
Celebration of World Diabetes Day (WDD) with the presence of the Minister of Health. Broadcast of TV trailers, radio programs and a press conference.
- Training of a network of 25 journalists on issues related to diabetes, with awards presented for the best contributions across various media.
Screening and hypertension days: : 162 screening days were conducted, reaching a total of 16,538 people in the six municipalities of Bamako and in the regions.
- Actions in schools : Two training sessions were conducted for 78 education staff in the regions and districts of Bamako (Koulikoro, Sikasso, Mopti, Timbuktu). These led to 84 awareness sessions in 28 classrooms, reaching 1,296 students.
- Strengthening of patient associations : Strengthening of prevention skills for 30 people from Fenadim member associations in Bamako, Sikasso, Kayes, Ségou, and Timbuktu.
Strengthening access to care
- Continuation of our diploma courses (D.E.S in endocrinology and diabetology and DU in diabetology). 23 students benefited from it in West and Central Africa.
- Continuation of our training actions for 3rd reference and 2rd reference health professionals, in particular post-graduate education (UPE) provided by the Malian Society of Endocrinology and Diabetology (Somed).
- Strengthening the clinical skills of 32 diabetes focal point doctor–nurse teams from Bamako and various regions of Mali, who provide care to more than 20,000 patients in the field, in collaboration with the Ministry of Health and Somed.
- Type 1 diabetes care and therapeutic education: In partnership with the Hospital of Mali and the University Hospitals of Geneva, strengthening the care and therapeutic patient education for children and young adults with type 1 diabetes, and training of 11 diabetes reference doctors on T1D. Organisation of 24 therapeutic education days for 260 children and their parents. Training of 10 pediatricians from the capital, Bamako, and five regions of the country on pediatric and adolescent diabetes care at the Hospital of Mali. Strengthening of Dr Togo’s skills as part of the ETP diploma from Geneva hospitals.
- Intensive online nutrition course : in Mali, 65 health professionals enrolled in the intensive nutrition course, including 27 doctors, 28 nurses and 10 doctor students in endocrinology.
Chair of Philosophy in the Hospital
In 2021, launch of the Chair of Philosophy in the Hospital in Mali: development of a curriculum on the holistic approach to care to strengthen the relationship between healthcare professionals and patients with diabetes, and delivery of a three-day intensive course by Professor Cynthia Fleury on health humanities and the caregiver/patient relationship at the Hospital of Mali.
Prevention and management of comorbidities Diabetes/HIV and diabetes/TB
As part of a project on diabetes/HIV and diabetes/TB comorbidities, aimed at better integrating the care of affected individuals:
- Development and revision of prevention tools and training modules for peer educators, patients and health professionals.
- Implementation of training activities for health workers in collaboration with the Ministries of Health and national training teams of: 38 doctors and 34 paramedical diabetes reference staff; 24 doctors and 24 paramedical HIV reference staff; 20 doctors and 20 paramedical tuberculosis (TB) reference staff.
- Implementation of patient prevention actions with the training of 19 peer educators to carry out community-based diabetes prevention for people living with HIV and to prevent HIV/TB among people with diabetes.
- Production of an advocacy note for national stakeholders on issues related to diabetes / TB and diabetes / HIV comorbidities.
Strengthening national policy frameworks
Santé Diabète supported the Ministry of Health in the graphic design of national policy documents on the fight against non-communicable diseases and national strategies for the fight against diabetes. These documents were disseminated by the Ministry of Health.
Strengthening national dialogue frameworks and access to medicines
Establishment of a framework for dialogue and presentation of the various data on the availability of antidiabetic treatments as well as their prices, and discussion on ways to improve their availability.
The university training, established by the Ministry of Higher Education and Research, the Hospital of Mali, and the NGO Santé Diabète, enabled the training of 85 endocrinologists from 11 different African countries, more than 30 of whom are already working in various healthcare facilities in Mali.
Example of an educational tool developed for Mali.
Testimony
Rokia Sanogo, 17 years old
living in an isolated village in Mali
Thanks to the programs of the NGO Santé Diabète, I now have access to consultations with specialized doctors at Sikasso Hospital and receive fully free care for my diabetes, including insulin doses and glucose test strips.
Having no electricity or a fridge at home, storing my insulin - which must be kept absolutely cool - was a big problem for me.
During the education sessions, the doctors taught me to store insulin in a plastic pouch placed in cool soil, and this system works very well. I can finally live with my diabetes!
Dr Graham Ogle
Director of the international program Life for a Child
"Ten years ago, there were less than 15 children with type 1 diabetes alive in Mali, with a life expectancy of no more than 1 year on average after their diagnosis.
Thanks to the excellent work of Santé Diabète in partnership with Life for a Child, the situation has improved considerably, with more than 1,500 young diabetics now living normally with type 1 diabetes in the country."
Focus : Education days for young people with diabetes
Since 2017, Santé Diabète has been organizing education days in Bamako for young people, supervised by both doctors and facilitators.
Divided into two groups (children aged 2 to 14 accompanied by their parents, and adolescents over 15), the aim of these days is twofold: to allow young people to share experiences and support each other, while improving the management of their condition through therapeutic education workshops.
These days have been highly successful, with over 500 young people having already participated in the program.
The aim of this programme will be to improve the quality of life and health of people in the target countries (Burkina Faso, Mali and the Union of the Comoros) by consolidating the place and role of civil society (patients' associations and associations of healthcare professionals) in a multi-player diabetes network to improve prevention, care and support for people suffering from this disease. It will also aim to strengthen the use in the North of expertise developed in the South. Finally, it will enable the governance and organisation of the Santé Diabète NGO to be further strengthened.
The goal of this three-year program is to continue strengthening political and strategic frameworks that integrate diabetes care into the health system, in order to train more specialists and general healthcare professionals, thereby increasing the care available to people living with diabetes. It also aims to maintain geographic and financial accessibility to antidiabetic treatments, particularly insulin. Additionally, by supporting the establishment of a Diabetes Prevention House in each intervention country, Santé Diabète will reinforce prevention, care, and support activities for people with diabetes and those at risk, while guiding civil society toward greater autonomy.
Although this program is being implemented in Burkina Faso, the Union of Comoros, and Mali, specific objectives have been defined for each country based on needs identified in collaboration with the various national implementation partners.
ACHIEVING THESE OBJECTIVES IN MALI WILL REQUIRE :
- Celebration of 3 world diabetes days and the organization of 150 free screening events for diabetes and its risk factors, offered at no cost to participants.
- Awareness raising :
- of 35,000 people and 7,000 people with risk factors thanks to a prevention programme using peer educators and the media
- of 3,500 primary and secondary school pupils through a health behavior prevention cycle.
- Train 25 journalists working on health-related topics.
- Strengthening the health system through the training of : la formation de :
- A network of 40 diabetes referral doctors and their nurses
- 750 healthcare professionals to enhance their skills in the detection and management of uncomplicated diabetes and co-morbidities
- 280 tertiary level healthcare professionals
- 50 specialists in endocrinology and diabetology within a graduating course
- Strengthening therapeutic education for patients with type 2 diabetes through the establishment of a network of peer educators
- Support the care and therapeutic education of 1 750 children and young adults with type 1 diabetes
- Improving the availability and decrease of the price of essential medicines in the fight against diabetes
- Computerization of medical data on a pilot basis in Mali
- Associations to set up a prevention centre to step up prevention and therapeutic education initiatives
- Strengthening 39 patient and healthcare professional associations
- Consolidation of the role and actions of these associations
- Reinforcing:
- the national response to diabetes
- national standards and procedures for the management of diabetes at the level of the Ministry of Health
- other policy documents including diabetes (nutrition, maternal health, etc.)
- the inclusion of diabetes in the Universal Health Coverage (UHC)
This programme is supported by two main partners: the World Diabetes Foundation (WDF) and the Helmsley Charitable Trust. It also receives support from other international partners such as the Life For A Child program.
2ND PHASE OF THE PROJECT ON PREVENTION AND MANAGEMENT OF DIABETES/HIV/TB COMORBIDITIES
This project builds on an initial innovative three-year initiative aimed at integrating the prevention and management of Diabetes/HIV and Diabetes/Tuberculosis (TB) comorbidities in Burkina Faso and Mali. The new project will continue in these two Sub-Saharan African countries targeted by the previous initiative and is expanded to include the Union of the Comoros in the Indian Ocean.
The project ended in March 2025 in Burkina Faso and the Union of the Comoros. It concluded on December 31, 2023, in Mali.
This new project makes it possible to:
- At the level of public policies and national strategies: the development of detailed standards and procedures based on the established health professionals’ curricula, along with the related technical documents; the inclusion of comorbidities in upcoming country concept notes; and finally, the strengthening of knowledge and capacity of the Country Coordination Mechanisms (CCM) on these issues.
- At the operational level: continuing to build the capacities of health professionals involved in the management of diabetes, TB and HIV with the development of a clinical mentoring component complementary to theoretical training; the extension of community prevention actions carried out by the PEP networks formed in the two countries with stronger mobilization of civil society organizations (CSOs) and of patient organizations; strengthening of therapeutic education strategies adapted to the comorbidities developed during the previous project.
Achieving these objectives in Mali involves:
- Strengthening of 3 national diabetes programs on the prevention and management of HIV and tuberculosis co-morbidities
- Strengthening the Country Coordinating Mechanis on the prevention and management of co-morbidities
- Strengthening the skills of 7 patient associations and CSOs
- Establishment of a community network of 14 trained community PEPs
- Training on the management of comorbidities of :
- 60 students following a medical specialization
- 192 healthcare professionals working in 3rd referral structures
- 80 healthcare professionals working in 2nd referral structures
- 2,250 patients in total with diabetes and TB or diabetes and HIV who will have access to better quality care
- 15,000 people with diabetes will have access to HIV and TB awareness
- 10,000 PLWHIV will have access to awareness raising on the risk factors for diabetes and TB.
This programme is supported by the Global Fund.
