From Survival to Systems.

On Thursday the ALIGN-T1D Uganda Consortium submitted its proposal to ALIGN-T1D: "From Survival to Systems — A Government-Led Path to Aligning and Anchoring Universal Type 1 Diabetes Care in Uganda's Health System."

The proposal sets out how Uganda will move from fragmented, donor-dependent interventions to a resilient, equitable, and nationally owned T1D system — one capable of sustaining impact beyond external funding. It centres on timely diagnosis, uninterrupted access to insulin and monitoring, quality care across every level of the health system, and structured community and peer support.

Crucially, it does not build a parallel system. The programme operationalises Uganda's own commitments — the National Diabetes Management Guidelines (2025), the Uganda Clinical Guidelines (2023), and the National Operational Strategy for Priority NCDs 2025–2030 — and builds on the PEN-Plus plan for severe NCDs, strengthening Ministry of Health leadership rather than working around it.

Kabukye Trust's role was coordination. And coordination, in a consortium this size, is not overhead.

The ALIGN-T1D Uganda Consortium spans seventeen partners — four Ministry of Health departments, four objective anchors, a fiduciary anchor, a coordination lead, and eight implementing partners — working across forty-four districts.

"Without active coordination, submissions fragment, partners with weaker digital infrastructure miss deadlines, and the consortium's collective case weakens at its most important moment — first contact with a funder. Coordination is the mechanism through which seventeen organisations behave as one."

The proposal is now with ALIGN-T1D. If endorsed, it moves Uganda from scattered, project-funded pockets of care toward a single national pathway — the difference, for a child with type 1 diabetes, between surviving and being held by a system built to last.