Capacity Advancement Program (CAP)

Partnership objectives

This 5 year program aims to provide people who are directly affected by diabetes with sustainable access to how to prevent, manage and diagnose the disease and prevent it from turning into a national epidemic.  It aims to expand professional capacity in developing countries in the areas of research and development, advocacy building, supply-chain integrity and efficiency, pharmacovigilance, medical education, and community awareness.

More than 1,000 medical students from medical universities in Africa have benefited from accredited clinical diabetes management training, which provides them with the skills to help patients avert the diabetes epidemic. More than 1,000 medical students from medical universities in Africa have benefited from accredited clinical diabetes management training, which provides them with the skills to help patients avert the diabetes epidemic. Copyright Merck

What are the health needs and challenges?

The majority of the 422 million people living with diabetes worldwide are aged between 40 and 59, and 80% of them live in low- and middle-income countries. The number of people with diabetes is expected to increase by 55% by 2035; in Africa by 109% by 2035.  The proportion of cases of diabetes (20-79 years) that remain undiagnosed in Africa is 62%. According to IDF 2015 estimates, about 75% of the people with diabetes live in LMICs. 

People with type 2 diabetes can remain undiagnosed for many years, unaware of the long-term damage being caused by the disease. Poorly managed diabetes leads to serious complications and early death; diabetes caused 5.0 million deaths in 2015.

Diabetes is a huge and growing problem and the costs to society are high and escalating. IDF 2015 Atlas suggests that the estimated number of people with diabetes in the Africa Region is between 9.5 million and 29.3 million. The report also highlights that three quarters of these are estimated to be undiagnosed, constituting the highest undiagnosed figure among other IDF regions.

Africa accounts for less than 1% of global health expenditure on diabetes. Moreover, this region faces further challenges resulting from the limited number of trained health workers who can help patients with prevention, diagnosis and care.

Description of partnership activities and how they address needs and challenges

Merck is collaborating with ministries of health, universities and local diabetes associations across 5 African countreis (Kenya, Uganda, Namibia, Mozambique and India) and expanded to Asia in 2015. It aims to raise diabetes awareness in Africa by educating the public and supporting the healthcare system on ways to prevent, diagnose and manage diabetes effectively.  

Merck has engaged a wide range of relevant local stakeholders across Sub-Saharan Africa in order to inform the approach to program initiatives which includes identifying learning and capacity gaps, tailoring the learning materials to suit the local environment, implementation and follow up as well as performance management and sustainability plans.CAP includes partnerships with Ministries of Health, academia, patient associations, pharmaceutical and medical associations and societies, and research institutions.

This effective engagement has helped to develop structured, country specific and partnership based program initiatives that are aligned with countries' national strategies.

The program was launched and implemented across Africa in partnership with Ministries of Health, health sciences universities and diabetes patients associations. Several partnership models with national and local stakeholders have been built to ensure the successful implementation and outcomes of the program. The campaign is targeted to reach more than 20,000 by 2018.

CAP signature initiatives:

- Merck Universities program – program is striving to improve the quality of and access to diabetes and cancer therapy in Africa and Asia. We also seek to combat infertility, as well as to increase awareness and prevention of non-communicable diseases such as diabetes, hypertension, thyroid disease and cancer. The goal is to raise awareness of these conditions by educating healthcare providers, as well as to support healthcare systems with measures to prevent, diagnose and manage them effectively. By the end of 2016, the program had reached more than 17000 medical students. Merck is planning to target more than 25,000 students by the end of 2018 expanding to more African, Asian, Latin American and Middle Eastern countries. 

- Merck Africa Diabetes Day - In 2015, Merck announced a pan African initiative “Merck Africa Diabetes Day” to provide 300,000 community members with free screening and education about diabetes across the continent. The campaign has already kicked off first in Kenya and Uganda and will extend to more African countries. In Kenya, it is in partnership with Kenya Diabetes Management Initiative, Ministry of Health and the County Government of Nairobi. 

- Merck Cancer Access Program – it aims to increase the number of medical oncologists hence improve access to cancer care in Africa. The Merck Cancer Access Program is an outcome of Merck Cancer Control Program (MCCP) that started in 2015, in partnership with top global oncology experts, African universities and ministries of health to assist in developing and implementing comprehensive cancer prevention and control programs and to educate medical students and healthcare providers about cancer early detection and prevention. As a combined effort, more than 100,000 people will be targeted with free Diabetets - hypertension and cancer education and diabetes screening.

- "Merck More Than a Mother" Campaign will support governments to define policies to improve access to safe and effective fertility care; address the need for interventions to reduce stigmatization and social suffering of infertile women; and raise awareness about male infertility and the necessity for a team approach to family building among couples. 

- UNESCO-Merck Africa Research summit-MARS – it aims to bring together researchers from across Africa to discuss the generation, sharing and dissemination of research data and to prepare the road ahead for Africa’s development as an international hub for research excellence and scientific innovation. 

- Merck Supply Chain Forum was launched in April 2015 in partnership with University of Nairobi, Kenya Medical Supplies Authority (KEMSA) and Pharmaceutical Society of Kenya (PSK) in order to contribute to improving supply chain efficiency in Kenya by providing training and technical support to help the development and application of Good Distribution Practice (GDP) and Good Storage Practice (GSP) international guidelines in the country. 

- Merck e-Health Initiative – a first e-Diagnostic and Consultation Clinic in May 2015 as part of Merck e-health initiative in Africa to improve access to better cancer and diabetes care for patients in rural areas connecting them with disease specialists in teaching/referral hospitals.

- The Merck CAP has launched Merck Diabetes and Hypertension Awards to help create a platform of diabetes and hypertension experts in Africa and Asia. These awards help medical students to think of innovative ways to improve awareness and diabetes early detection, and apply multistakeholder approaches to achieve these goals.

- The Merck Africa fellowship program is developed for sub-saharan African countries with the aim to increase the limited number of medical oncologists hence to improve access to cancer care in Africa.

- In 2016, Merck announced its first Africa Medical Oncology Fellowship Program for sub-saharan Africa (SSA) in partnership with the University of Nairobi. As a first step, Merck will sponsor nine medical doctors from SSA such as Kenya, Tanzania, Ethiopia and South Africa for a period of two years. The program will be extended to other African countries in following years.

- Merck More than a Patient is a new initiative to empower women cancer surveyors through access to information, awareness and early detection.

-#MerckDiabetestips. In addition to building capacity among healthcare professionals to provide quality diabetes care, Merck also runs a social media campaign providing diabetes patient education through videos and information materials in English, French, Portuguese, Spanish and many local languages focusing on diabetes early symptoms and complications to raise awareness on diabetes and the importance of early detection and prevention among communities.

The Community Awareness Initiative of the CAP program, known as the “Get Informed Get Active Get Healthier” provides community members in Kenya and Uganda with free screening and medical check-ups and with necessary disease education and awareness. The campaign has been implemented in partnership with the Ministries of Health of both Kenya and Uganda, the Kenya Diabetes Management and Information Center (DMI) the Uganda Patient Association, the University of Nairobi, the University of Makerere and the Kenya Medical Research Institute (KEMRI).

Activities under CAP include the following:

- Train healthcare providers, medical students, new graduates and community health workers

- Provide in-country training and conduct community awareness campaigns and screening through medical camps

- For diabetes, empower patients to better manage their diabetes condition.

- Develop a diabetes awareness SMS campaign in Africa

- Integrate medical education and community awareness of diabetes with other chronic care models (such as hypertension)

- Align Merck’s CAP strategy with targeted countries’ national health priorities and ensure that it is grounded in a sustainable business rationale

- Improve basic clinical research courses with a specific focus on diabetes through partnerships from 2014 onwards

- Extend Merck’s CAP strategy to more developing countries in the next 5 years

- Supply medication and diagnostics to local patients’ diabetes foundations in order to ensure a cost effective supply chain.

- For cancer, conduct community awareness programs to improve access to information, awareness and early detection. 

- Patient education materials were developed in cooperation with African patient diabetes foundations in the countries in order to suit local environments.

- Medication and diagnostics have been supplied to patients and local patients’ diabetes foundations.

Partnership information

Company(ies) Merck

Partner(s) Ghana Medical Association, Ghana National Association of Diabetes, Ghana Pharmaceutical Society, Ghana University, Kenya Diabetes Management and Information Center, Kenya Medical Research Institute, Kenya Ministry of Health, Makerere University, Mozambique Diabetes Patient Association, Mozambique Ministry of Health, Nairobi University, Namibia University, Serono Symposia International Foundation, Uganda Ministry of Health, Uganda Patient Association, Universidade Eduardo Modlane

Type of Partner(s) Academia / Hospitals, Government, NGOs, Professional Associations

Therapeutic Focus Non-Communicable Diseases

Disease(s) Diabetes

Program Type(s) Availability of Treatment - Differential Pricing, Availability of Treatment - Financial Support, Availability of Treatment - Product Donations, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach

Targeted Population(s) Health professionals, Marginalised / Indigenous People, Men, Patients in needs of treatment, People with low income, Women

Region(s) Sub-Saharan Africa

Number of Countries 2

Country(ies) Kenya, Uganda

Start Date 2013

More information Merck Awareness

Anticipated completion date 2018