As the global disease burden continues to shift from communicable to non-communicable diseases, type 1 and type 2 diabetes have emerged as major contributors to death and disability worldwide, directly causing an estimated 1.6 million deaths per year.

Syria is no exception.

As the country’s 7-year conflict wages on and trauma-related injuries and deaths continue to mount, Syrians also are experiencing this epidemiological transition towards chronic disease.

One in 10 Syrians lives with diabetes, according to the World Health Organization, and diabetes now ranks among the top 10 causes of death and disability in the country.

Since the war began, many health centers specializing in diabetes treatment – and all insulin production centers – have been shut down, damaged or destroyed, creating acute shortages of this life-saving medication. Almost all insulin must now be imported, resulting in inflated prices and affordability issues for most diabetes patients, especially those who have been internally displaced.

To address insulin shortages in Syria, Direct Relief and the International Diabetes Federation’s Life for a Child program partnered with the Syrian American Medical Society to deliver approximately 15,500 vials insulin to more than 700 Syrians under the age of 26 with type 1 and 2 diabetes.

The delivery was made possible by a generous donation from Eli Lilly and comes as fighting throughout Syria has displaced thousands, many with co-morbid chronic diseases, into the northwestern directorates of Idleb and Hama.

For aid groups distributing insulin for free or at steeply reduced prices, logistical hurdles to importing and storing the medication must be overcome. These include keeping the medicine at a consistent temperature despite lengthy travel times and unreliable electricity.

Direct Relief ships temperature-sensitive medicines like insulin inside specialized packaging that maintains a constant temperature range between 35.6-46.4 degrees Fahrenheit for 120 hours. To ensure and verify that the cold-supply chain has been maintained throughout the transit process, temperature-data loggers are inserted into each package to record the internal temperature of the shipment every two minutes.

The latest shipment of insulin to Syria is part of a larger collaboration with the Life for a Child program, which aims to provide insulin, syringes, blood glucose monitoring equipment, test strips, HbA1c testing, and diabetes education to healthcare centers in 42 low and middle-income countries for the benefit of 18,000 children and young adults living with diabetes.

Since the start of the crisis in 2011, Direct Relief has delivered over 200 tons of medical aid valued at $100 million to approximately 30 healthcare organizations providing critical care to Syrians across eight countries – constituting one of the largest and longest-sustained emergency response efforts in Direct Relief’s 70-year history.