Diabetes and COVID-19 – the impact on young African adults

It is no secret that COVID-19 has changed the world, from the way things are done to the way life is viewed. The African continent is no exception. The impact of the virus has been overwhelming for many communities. I have often asked myself what this “new normal” means for the world but mostly for the young, educated but unemployed adults living in Africa. It was not easy before the virus came along. Regardless, the majority managed, or just about managed. With most African countries facing high unemployment rates, many young adults resorted to self-employment as a survival mechanism and some who were employed looked for additional streams of income (casually known as “side hustles”) outside of their normal working environments. This is how most young Zimbabweans are getting by.

How does a person living with diabetes manage in such an economy? The answer is that they’re not. Young adults with diabetes are living day-to-day, getting by as best they can depending on what they can come across on a particular day. In Zimbabwe, the prices of diabetes supplies have gone up since the country was placed under lockdown in March of this year.  The majority of young adults in the country are unemployed. I graduated from college in 2016 but have never worked. I constantly ask myself what situation I would be in if I had not had the support of my parents and siblings. What about young adults like me without access to the resources that I have?

Africa has not been hit as hard by COVID-19 as many feared it would. When the pandemic subsides, it will not be surprising to learn that it has not caused too many deaths. The majority recorded during this period will have been due to treatable causes or chronic conditions like diabetes. Reduced income over the last few months has resulted in a significant increase in the number of people with diabetes rationing their insulin and other diabetes supplies. Lower incomes are linked to greater food insecurity. The United Nations has reported that over 60% of Zimbabwe’s population will be food insecure by the end of this year. For people with diabetes, this means having to ration food and diabetes supplies.

The immediate future does not give cause for optimism. Health systems are almost crippled and, with no one looking after of the needs of people living with diabetes during the pandemic, we can only expect the number of deaths and complications to rise in this vulnerable group. In the current context, how can governments and policy makers help young people living with diabetes achieve their dreams?

After speaking with young adults with diabetes across the continent, one issue stands out during the pandemic – the availability of insulin. Governments seem to have conveniently forgotten that other health conditions existed before COVID-19. Rising prices and the shortage of insulin and diabetes supplies in some countries have made access harder for those who need them most. With the result that many young people with diabetes have decided to go without their diabetes treatment to make ends meet. Governments should ensure that insulin is readily available at public hospitals to avoid people with diabetes having to pay out-of-pocket for the medications they need to survive.

For some young people living with diabetes, COVID-19 has brought awareness of how people with diabetes can be considered different from the rest of the population. Particularly as media has reported that many COVID-19 deaths have occurred in people with the condition. Working from home to tackle the spread of the virus has become the norm in many countries across the world, but not in most of Africa, where large parts of the population live hand to mouth. Young people cannot afford to sit at home because of the various responsibilities they have in their households and the often highly informal nature of their economies, which require them to go out and look for money to make a living. Without government support or subsidised care, young people with diabetes are forced to leave their homes to work, increasing their chances of exposure to the virus and its potentially serious effects.

Anxiety and burnout have been huge challenges for people living with diabetes during these times of uncertainty. Such problems are only likely to increase as the pandemic continues, as is the impact on mental health. The importance of mental health has been ignored by communities and governments in Africa for too long. COVID-19 offers an opportunity for African health systems to address this and provide people living with diabetes and other chronic conditions the support they require to manage the current situation and its aftermath.