Expanding Type 1 Diabetes Care through PEN-Plus

The Bukhman Foundation is proud to announce a $450,000, three-year commitment to the Center for Integration Science in Global Health Equity at Brigham and Women’s Hospital. The grant will support the expansion and evaluation of educational and recreational camps for children and young people living with type 1 diabetes (T1D) in some of the lowest-income countries in sub-Saharan Africa.

In much of the region, specialised treatment for T1D remains concentrated in referral hospitals in major cities, leaving many children and families in rural communities without access to affordable care. Even where a diagnosis is made, limited healthcare training, social stigma and economic barriers can make the condition exceptionally difficult to manage. In some rural areas, the average life expectancy of a child newly diagnosed with T1D is less than one year.

The Center, led by Gene Bukhman, MD, PhD, is working with partners across the NCDI Poverty Network to address this inequality through PEN-Plus. Integrated into public health systems, PEN-Plus equips frontline healthcare providers to diagnose and manage severe, chronic noncommunicable diseases—including T1D, sickle cell disease and rheumatic and congenital heart disease—closer to where patients live.

The Foundation’s support will focus on helping children and young people take a greater role in the day-to-day management of their insulin. Early experience in Rwanda has shown that peer-support groups and educational camps, connected to the ongoing care available through PEN-Plus clinics, can provide an effective and safe environment in which to develop these skills.

Held during school holidays, the week-long camps combine practical education with peer support, games and recreational activities. They offer children an opportunity to learn about their condition, build confidence and connect with others facing similar challenges. Uniquely, the programme also brings together children living with other severe chronic conditions, creating wider networks of understanding and community support.

The grant will enable the Center and its in-country partners to expand the programme into additional countries and undertake a rigorous, multi-cohort evaluation of its impact. The study will examine whether participation improves insulin self-management, glycaemic outcomes, the frequency of hypoglycaemic episodes and participants’ overall quality of life. Each camp is expected to reach approximately 30 to 60 children living with T1D.

This month, the first camp supported by the Bukhman Foundation took place from 3 to 7 August in Bo, Sierra Leone. Camp Wan Wod—named after a Krio phrase expressing unity—brought together approximately 60 children, adolescents and young adults living with T1D or sickle cell disease who receive care through PEN-Plus clinics in Sierra Leone’s Kono and Pujehun districts.

Through practical disease-management training, peer-support sessions, confidence-building exercises, music, games and team activities, Camp Wan Wod helped participants develop the knowledge and support networks needed to manage their conditions and pursue their futures with greater independence and hope.

For the Bukhman Foundation, this collaboration reflects our commitment to ensuring that advances in T1D care reach children and families wherever they live. By bringing specialist care, education and community support closer to home, PEN-Plus is helping to build stronger and more equitable health systems for people living with severe chronic conditions.

About the Center for Integration Science

Based in the Mass General Brigham health system in Boston, Massachusetts, the Center for Integration Science in Global Health Equity at Brigham and Women’s Hospital develops integrated health care delivery models and nurtures integrated social movements to advance global health equity.

Together with Universidade Eduardo Mondlane in Mozambique, the Center also serves as the co-secretariat of the NCDI Poverty Network, a coalition of technical, policy, funding, and advocacy partners collaborating with governments to solve one of the world’s starkest inequities. Each organization brings its expertise to different aspects of the systemic change needed to ensure that people living with severe NCDs can access care close to home.

A major Network focus is the implementation of PEN-Plus, an integrated care-delivery model that brings health care close to home for people living with severe, chronic noncommunicable diseases, such as type 1 diabetes, sickle cell disease, and childhood heart disease, in rural, resource-scarce areas of sub-Saharan Africa, South Asia, and the Caribbean.

Images

The NCDI Poverty Network, the Sonia Nabeta Foundation, and the Center for Infectious Disease Research in Zambia (CIDRZ) partnered to host Camp Tuli Bonse in August 2025 in Lusaka, Zambia.

Photo credit: DOD Media Hub, for the NCDI Poverty Network.