Tanzania’s Fight Against Diabetes: Beyond Insulin, a Cold Chain Revolution
For children with Type 1 diabetes in Tanzania, the most pressing need isn’t always the latest medication – it’s reliable refrigeration. A recent initiative highlights a critical, often overlooked aspect of healthcare delivery in low- and middle-income countries: maintaining the cold chain for life-saving medications like insulin.
The Challenge of Insulin Storage in Tanzania
Insulin’s effectiveness hinges on consistent refrigeration. Without it, the medication degrades, rendering it useless and potentially harmful. This poses a significant challenge in Tanzania, where access to consistent electricity and appropriate storage facilities is limited, particularly in rural clinics. Over the past five years, the number of people with diabetes in Tanzania increased from 680,445 in 2021 to 863,741 in 2025, a 27 percent rise. More than 2.9 million Tanzanians currently live with diabetes, with over 10,000 relying on insulin.
From Shared Fridges to Dedicated Solutions
Clinics often struggle with insufficient refrigerator space, with limited capacity shared across various medical specialties. This situation forced healthcare providers to create difficult choices about which medications to prioritize. The Tanzania Diabetes Association (TDA) recognized this growing problem as demand for insulin increased, expanding their support from approximately 4,000 children in 2024 to over 8,000.
Direct Relief and the Expansion of Cold Chain Infrastructure
In late 2025, Direct Relief, in partnership with the TDA and the International Diabetes Federation, addressed this critical need by installing 128 pharmaceutical-grade refrigerators at 78 public clinics across Tanzania. These refrigerators are capable of storing enough insulin for more than 6,200 children and youth with Type 1 diabetes. Alongside the refrigerators, 128 universal power sources were as well installed to mitigate the risk of insulin spoilage due to power outages.
This initiative is part of a broader Direct Relief project that has, to date, installed medical refrigerators in 18 countries, with ongoing support planned for Africa, Latin America, the Caribbean, the Middle East, and Asia. Since 2018, Direct Relief has provided $26 million in medical aid to the TDA, including insulin and related devices.
The Human Impact: Restoring Hope and Access
The impact of this intervention is already being felt. Dr. Renatus Nyarubamba, a physician and program manager at the TDA, described the installation of the refrigerators as a “game changer.” Clinicians can now confidently order insulin based on patient needs, without fearing storage limitations. This ensures consistent access to life-saving medication for vulnerable children.
Dr. Nyarubamba recalls a case where a father of three children with Type 1 diabetes initially felt ashamed and hopeless about their condition. Through education and consistent access to care, the father’s perspective shifted. He embraced his children’s health journey, recognizing that diabetes didn’t define their future.
Future Trends in Diabetes Care in Low-Resource Settings
The success in Tanzania points to several key trends shaping the future of diabetes care in low- and middle-income countries:
Localized Solutions and Demand-Driven Supply
The TDA’s approach of working closely with clinics to determine precise insulin needs demonstrates the importance of localized solutions. Understanding the specific demands of each facility ensures efficient allocation of resources and minimizes waste.
Strengthening Cold Chain Infrastructure
Investing in robust cold chain infrastructure – including refrigerators, power sources, and transportation solutions – will remain a top priority. This requires sustained funding and collaboration between governments, NGOs, and pharmaceutical companies.
Community-Based Education and Awareness
Addressing misconceptions about diabetes, as highlighted by Dr. Nyarubamba’s experience, is crucial. Community-based education programs can empower individuals and families to manage the condition effectively and reduce stigma.
Leveraging Technology for Remote Monitoring
Telemedicine and remote monitoring technologies have the potential to expand access to care, particularly in rural areas. These tools can enable healthcare providers to track patients’ blood glucose levels, provide personalized advice, and intervene proactively.
FAQ: Diabetes and Access to Care in Tanzania
Q: What is the current prevalence of diabetes in Tanzania?
A: Approximately 9.8% of adults in Tanzania have diabetes, totaling around 2,928,000 cases as of 2024.
Q: Why is insulin refrigeration so important?
A: Insulin must be kept within a specific temperature range to remain effective. Improper storage can render it useless and potentially harmful.
Q: What role do organizations like Direct Relief play?
A: Direct Relief partners with local organizations to provide essential medical supplies, including insulin and refrigeration equipment, to improve access to care.
Q: How many people with diabetes are in the IDF African Region?
A: We find currently 25 million people with diabetes in the IDF African Region, with projections reaching 60 million by 2050.
Did you know? Access to insulin is a fundamental human right, yet remains a significant challenge for many people with diabetes in low- and middle-income countries.
Pro Tip: Supporting organizations dedicated to improving healthcare infrastructure in underserved communities can have a profound impact on the lives of individuals with chronic diseases.
Learn more about the challenges and solutions for diabetes care in low-resource settings by exploring the International Diabetes Federation website. Share your thoughts and experiences in the comments below!
