What has been preventing the emergence of a broad social movement on diabetes (and NCDs)? Insights from the mobilisation of diabetes patients' associations in Bamako, Mali

摘要

Non-communicable diseases (NCDs) are among the leading causes ofmorbidity and mortality globally. While international strategies for theirprevention and control call for greater civil society participation, manyobservers regret the lack of a broad social movement to address thesediseases. This study focuses on diabetes patients’ associations engagedfrom 1991 to 2014 in Bamako, Mali, and explores what factorsinfluenced their capacity to build a collective national movement toaddress this disease and shape policy reforms in this area. Our findingsshow that the emergence of such a movement was limited by severalconstraints. The focus of diabetes patients’ associations on technicalbiomedical issues silenced the daily embodied experience of patientsand reduced the use of human-rights approaches. Moreover, fewfinancial, material and social resources coupled with a fragmented baselimited the scope and strength of claims made by patients’ associationsto obtain treatment at reduced coasts. Finally, modes of actionsperformed failed to challenge more structural inequalities andimbalances of power. Exacerbated by limited political opportunities,these constraints weakened the associations’ ability to drive policychange on diabetes. They reflect some of the current weaknesses of theglobal mobilisation to address diabetes and NCDs.