P-271: Intersectoral policy and capacity-building strategies to improve access to type 1 diabetes care for children and adolescents in Brazil
M Barone, A C Nogueira de Sá, R Wieselberg, P de Luca, Y Baxter, R Lauricella, M Silveira, H Pedrosa, M Micheletti, K F S MeloAbstract
Introduction
Gaps in diabetes care contribute to avoidable complications and inequities for children and adolescents with type 1 diabetes (T1D). The Intersectoral Forum of Noncommunicable Conditions (ForumCCNTs), established in 2017, convenes over 250 institutions to influence policy through multistakeholder action.
Objectives
To assess the contribution of intersectoral policy and capacity-building strategies (2017–2026) to improving access to T1D care in children and adolescents in Brazil.
Methods
A descriptive policy analysis of ForumCCNTs’ actions was conducted. Strategies included: (1) advocating for expanded access to insulin analogues, glucose monitoring, and point-of-care HbA1c through recommendations and letters to the Ministry of Health; (2) participating in public consultations for clinical guideline updates; (3) contributing to the National Health Plan 2024–2027; (4) multi-year capacity-building for civil society and advocates; and (5) developing a 2026 national T1D recommendation document. Institutional and policy documents were reviewed to assess outputs and uptake.
Results
Contributions to national guideline consultations supported clinical protocol updates. Recommendations, including insulin analogue expansion, were integrated into the National Health Plan 2024–2027. Capacity-building initiatives trained over 100 representatives from health organizations, strengthening policy participation. A 2026 national recommendation document addressed early diagnosis, monitoring, and equity. Additionally, two legislative proposals supported by ForumCCNTs were introduced in Congress: one establishing periodic HbA1c, lipid, and renal testing in the public system, and another expanding insulin analogue access in primary care.
Conclusions
An intersectoral approach can influence policies and reduce barriers to T1D care. Multistakeholder action drives regulatory advances and, with elements adopted as benchmarks in Latin America, provides a replicable governance framework.