Breaking barriers: Liberia’s journey from modest diabetes clinic to national NCD response

A little rain each day will fill the rivers to overflowing.

This Liberian proverb seems to embody the progress in addressing non-communicable diseases (NCDs). With WDF funding, Liberia’s first national NCD programme completed this year has been showing how small, consistent actions can drive results in a country in recovery. 

Home to 5.4 million people, Liberia has endured many hardships – a 14-year civil war (1989-2003) shattering its political and economic stability, followed by the Ebola epidemic (2014-2015) and an ongoing malaria burden – leaving 85% of the population below the poverty line. The severely strained health system could hardly prioritise NCDs like diabetes, given the prolonged focus on communicable diseases causing multigenerational losses in the country. This added to the pressure on patients and their families, to whom living with diabetes continues to equal to battling food insecurity, inaccessible care and using faith to cope, a 2023 study reveals. To navigate this sensible landscape informed by the Liberia NCDI Poverty Commission Report, which stated that NCDs accounted for 37.9% of disability-adjusted life years and 43% of all deaths in the country in 2016, Liberia has slowly shifted to rebuilding the health workforce and infrastructure to address NCDs. 

In support, local and international organisations rallied to empower Liberia to lead change for people with diabetes living in low-resource settings – including WDF. Throughout our more than a decade-long engagement in the country, our partners have been improving diabetes care in the most remote areas of Liberia. The seed planted in 2009 through a local project initiated by a faith-based hospital in Nimba County has since grown into the recent national programme led by the Ministry of Health.

As the programme is ending this year, we went to Liberia to revisit our partners and take stock of the changes they have enabled, with a resilient young generation at the forefront.