Can We Rethink Delivery of Essential Medicines?


By Inyang Ebong-Harstrup, Ph.D

The COVID-19 global pandemic has altered the way in which people with chronic illnesses interact with the world. While for most this means virtual doctors’ visits or increased emphasis on social distancing measures, for soon-to-be 13-year old Peter Anzovule Lagu and thousands of other children with type 1 diabetes in Africa, COVID-19 means a treacherous but imperative search for insulin.

Every month Peter leaves school and undertakes a costly six-hour journey by bus, motorcycle, and on foot to the Gulu Regional Referral hospital in northern Uganda in order to obtain the insulin that keeps him alive. However, Uganda like many other countries, responded to COVID-19 through nationwide public transportation shutdowns. This left Peter with a 70-mile walk as the only means of procuring his insulin and had to ensure that he could heed the 2 pm curfew that was in place. For a boy with erratic blood sugars and limited access to glucose, this journey could be dire. Peter is just one of many children with type 1 diabetes in Africa for whom the inability to access insulin would be and often is fatal.

Project Boda-Boda by SNF

Photo by SNF

In light of this urgent need, the Sonia Nabeta Foundation (SNF) promptly launched Project Boda-Boda (Boda-boda is a local term in Uganda that refers to a motorcycle taxi). This motorcycle delivery system mitigates against transportation closures and medical supply chain disruptions during COVID-19, by delivering essential medical supplies to children with type 1 diabetes (aka warriors) in even the most remote of villages. Through a small blue cooler attached to the back of a motorcycle, insulin is able to arrive at a diabetic child’s doorstep without putting them at risk of the current pandemic and the difficulties involved in their insulin procurement.

Project Boda-Boda by SNF

Photo by SNF

Concurrent with the transportation closures throughout Africa, the public-school system, as in many other countries, has been closed since March 2020. Moreover, the digital learning experience available to many in the developing world has limited use in the African context. This means that when everyday life resumes again, children throughout Africa might be a grade or two behind in school.

While this will be detrimental to the development of children throughout the continent, it will be especially harmful to children with type 1 diabetes for whom education is a major determinant of health. It has been proven that in the absence of leading medical technology that is accessible in the developed world, literacy and numeracy skills are essential in monitoring and controlling the complexities of type 1 diabetes.

SNF understands the importance of education in type 1 diabetic children’s health and therefore has been sponsoring the education of a group of children through a program called Project Mishra. SNF has found a way to continue these Mishra warriors’ education during COVID-19 through Project Boda-boda, using the same motorcycles that serve insulin delivery to drop off teachers during the educational shutdown.

Teachers commissioned by SNF travel to each Mishra warriors’ local village 3 times a week using these motorcycles. There they use the classrooms that SNF has rented to tutor warriors, like Peter. For Peter, who dreams of being a doctor, continuing his studies in science gives him hope that he will someday live a normal life and help warriors just like him. While children throughout sub-Saharan Africa have been deprived of an education during COVID-19, SNF’s Mishra warriors have been able to continue to progress in their studies, which is paramount in managing their type 1 diabetes towards good health outcomes.

Project Boda-Boda by SNF

Photo by SNF

Project Boda-boda’s success allows us to imagine what an Africa would look like if this model of educational and medical accessibility through motorcycles was exported throughout the continent. Imagine an Africa where the education system was reconstructed around trained, proficient, and adequately paid teachers being deployed to even the most rural and impoverished communities. Imagine a future for children, like Peter, where the chance to escape the poverty they were born into and become a doctor as they dreamed is possible.

Imagine an Africa where inadequately managed medical supply chains or pricey bus fares do not dictate whether a child has reliable access to lifesaving medicine that is so readily accessible in the developed world. Imagine an Africa where this model of access inspires partners and governments to rethink how to dynamically and innovatively bring medicine and teachers to children, no matter their affliction, throughout Africa and the developing world.

In Uganda, a country that is home to over 1 million boda-bodas, SNF intends to maximize this resource and scale up this program beyond the crisis situation that was COVID-19.

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