By Dr Patrick Ngassa Piotie, Chairperson of the Diabetes Alliance South Africa
In South Africa, two people can live with the same chronic condition yet face vastly different realities.
One may rely on a continuous glucose monitor that sends real-time readings to a smartphone, helping them keep their blood sugar in range. The other may test sporadically with strips – if they’re available – relying on symptoms to guide care.
One may use an easy-to-use pen for their insulin injections, while another may use a syringe and a vial – less convenient, less practical, and less safe.
Both are living with diabetes. Only one benefits from innovation.
This stark contrast illustrates a widening innovation divide – a gap between what is scientifically possible and what is accessible in the public health system. It is a divide that has life-and-death consequences.
Innovation that changes lives
The past decade has brought remarkable advances in diabetes treatment. Newer classes of medicines —such as glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT2) inhibitors — do more than lower blood glucose; they reduce the risk of heart disease, kidney failure, and premature death.
Similarly, technologies such as insulin pens and continuous glucose monitors (CGMs) empower people to monitor and manage their condition more effectively. In countries where these tools are widely available, they have transformed diabetes care, improving both outcomes and quality of life.
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Yet, for millions of South Africans, these innovations remain out of reach. Access to new drugs and devices is largely determined by income or medical aid coverage. For those relying on the public health system, treatment options are often limited to older, less effective therapies.
The result is predictable: poorly controlled diabetes leading to complications such as amputations, blindness, and kidney disease. These are not failures of science; they are failures of equity — and of a health system that remains more reactive than proactive, slow to embrace innovation, to the detriment of thousands of South Africans.
The cost of inaction
South Africa has one of the highest diabetes prevalence rates in Africa, with an estimated 4.3 million people living with the condition. Many are undiagnosed, and diabetes is now among the leading causes of death in the country. The economic cost is immense, driven by hospitalisations, disability, and lost productivity.
Investing in modern, evidence-based and personalised diabetes care is therefore not just a moral imperative — it is sound public policy. Effective management prevents complications and reduces the long-term burden on the healthcare system. In this sense, innovation is not an expense; it is an investment in life and productivity.
The 2023 Diabetes Summit underscored this point, recommending the introduction of new drugs and devices in the public sector to allow clinicians to tailor care to each patient’s needs. This is a practical, achievable step toward improving outcomes and closing the equity gap.
Partnerships that deliver progress
Translating innovation into access requires more than new products; it requires collaboration and commitment. Government, academia, civil society, and the private sector must work together to build a system that ensures modern diabetes care is available, affordable, and sustainable.
Civil-society organisations play an essential role in this effort. The Diabetes Alliance brings together advocates, healthcare professionals, researchers, and people living with diabetes to ensure that community voices inform policy. Similarly, the Healthy Living Alliance (HEALA) continues to advance health equity by addressing the environmental and social determinants that shape non-communicable disease outcomes.
These partnerships demonstrate the power of collective action. When coalitions unite around shared goals — whether to expand access to treatment, promote healthier food environments, or improve health literacy — progress follows.
The 2025 Diabetes Summit
From 11 to 13 November 2025, the 3rd Biennial Diabetes Summit will take place at the Radisson Hotel & Convention Centre in Johannesburg, under the theme “Innovate for Impact: Transforming the Future of Diabetes in South Africa.”
This gathering will bring together leaders from government, academia, industry, and civil society to explore how innovation can strengthen prevention, care, and policy implementation. It is a timely reminder that innovation fulfils its purpose only when it reaches those who need it most.
South Africa has the scientific expertise, policy frameworks, and partnerships to lead the way in equitable diabetes care. What is now required is coordinated action and sustained political will.
Innovation has given us extraordinary tools to prevent suffering and save lives. The next step — and the true measure of progress — is ensuring that these tools are accessible to everyone, regardless of income, geography, or circumstance.
Because in the end, innovation without access is inequality, and inequality undermines our vision of a long and healthy life for all South Africans.
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Dr Patrick Ngassa Piotie is a Senior Programme Manager at the University of Pretoria Diabetes Research Centre and the Chairperson of the Diabetes Alliance
The views expressed in this opinion piece are those of the author, who is not employed by Health-e News. Health-e News is committed to presenting diverse perspectives to enrich public discourse on health-related issues.
