MINYA GOVERNORATE, EGYPT – Nine-year-old Adam needs an insulin shot before meals, and seems unphased when his father checks his sugar levels with a finger pricking. He looks away when a small blood drop wells on the tip of his finger. Adam turns back to his plate of rice and stewed vegetables, continuing to ramble about the kids in his summer camp.

Both Adam and his father are diabetic in a rural village in Upper Egypt, where their struggle to access insulin mirrors a broader struggle across the country, and the continent. 

In a country where over 18% of adults live with diabetes, and with the number of adults living with diabetes expected to hit 20 million by 2045, diagnosis, monitoring, and medication are all difficult to come by. 

In response, Egypt is now taking significant steps to expand insulin access and diabetes prevention–in the context of rising prevalence. But financial and logistic barriers as well as  competing political priorities still leave rural families at the ‘last mile’ of service in a precarious situation.