The theme for World Health day 2016 is ‘Beat Diabetes’. To mark this UN day we are raising awareness about the rise in diabetes, the impact it is having in low- and middle-income countries, and what we can do to prevent it.
Diabetes today is a global epidemic, which affects around 366 million people worldwide. People affected by diabetes have bodies which cannot produce insulin, and so regular injections are needed to keep their glucose levels normal. Despite what people may believe, more than 90 years after the discovery of insulin, children and young people in many parts of the world still die or suffer from preventable complications due to a lack of insulin. Even though insulin is listed in the World Health Organisation (WHO) Essential Medicines List, it is not available in many parts of the world. Moreover, the cost of insulin and test strips are often excessive to the average monthly income for a local family in developing countries.
Diabetes kills and disables, impoverishes families, imposes a huge economic burden on governments and business, and overwhelms health systems. People affected by diabetes have to face many challenges as diabetes is a lifelong condition that causes a person’s blood sugar (glucose) level to become too high. It is very important for diabetes to be diagnosed, as soon as possible because it will get progressively worse if left untreated. These challenges can be greatly exacerbated in low and middle-income countries, where the majority of people with diabetes do not have access to education and primary health care. This is amplified by the restricted access to medical supplies and health services for the poor, inequities within the health system, insufficient drug supply system and inability to afford medicine. Almost 1 million people die because of diabetes each year with two-thirds of these in developing countries. This epidemiological trend is projected to continue over the next twenty years, with the greatest increase in numbers of people with diabetes occurring in the Africa, the Middle East and South-East Asia Region.
Diabetes has a significant impact on national and individual economies as well as on individual health. The indirect costs (such as loss of productivity) is very high, as people suffering from diabetes are very debilitated and their capacity to earn an income is often highly affected. Diabetes undermines other key development objectives such as promoting gender equality and reducing maternal mortality. Undiagnosed or uncontrolled, diabetes in pregnancy increases the risk of morbidity and mortality for both the mother and infant. People with diabetes are 2.5 times more likely to develop TB; in India up to 15% of TB is attributed to diabetes.
These fundamental links mean that preventing and controlling diabetes brings significant and measurable benefits for global development and the objectives prioritised in the Millennium Development Goals (MDGs). Investing in affordable and cost-effective solutions to prevent and treat diabetes makes sense in all resource settings. For diabetes, access to insulin and other diabetes supplies are both obvious and critical, but living a full and productive life with this is not assured without appropriate diabetes education and support. Diabetes education is equally important as is the access to insulin. For instance, eating a healthy, balanced diet and exercising regularly, avoiding high intake of sugary foods can all help to mitigate diabetes effects.
It does not make human or economic sense to save the lives of people with AIDS, only to have them die from diabetes. It is now up to governments and the international community to use these data to address the challenges of a growing diabetes problem.