Alberto Cremonesi
UNITED NATIONS, Aug 9 2006 (IPS) – In the last two decades, the number of people suffering from diabetes has increased almost seven-fold, straining health care systems around the world and leaving millions of families to struggle with the emotional and financial drain of a chronic disease.
Fearing that the pandemic will only get worse, diabetes advocacy groups have joined together in a global campaign called Unite for Diabetes that is seeking a U.N. resolution to declare Nov. 14, 2007 World Diabetes Day .
The campaign aims to empower and educate the estimated 230 million people with diabetes about the importance of self-management of the disease to avoid further disability, and to urge governments to promote cost-effective strategies to both prevent and treat its complications.
The expectations are that enough developing countries and a significant number of developed countries will recognise the utility of a U.N. world diabetes day to draw attention to the magnitude of this epidemic, said Martin Silink, head of the International Diabetes Federation (IDF), an umbrella organisation of over 190 diabetes associations in more than 150 countries.
The day would highlight the social and economic impacts of chronic disease, which now accounts for 60 percent of global deaths and illness, with the major burden being felt by the developing world, he told IPS.
The other outcome of a U.N. resolution would be to urge the U.N. organisations such as the WHO (World Health Organisation), UNICEF (U.N. children s agency), World Bank and FAO (Food and Agriculture Organisation) to work within their mandates to promote preventive strategies, Silink said.
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Diabetes is one of the most dangerous consequences of the world s growing obesity crisis. In 2002, the Washington-based Worldwatch Institute reported that, for the first time in history, the number of overweight people in the world had outstripped those who are malnourished.
Diabetics fall into two categories Type 1, which is hereditary and usually emerges during infancy or adolescence, and Type 2, which is generally adult-onset and related to obesity and a sedentary lifestyle. Most diabetics are Type 2.
The disease is triggered by malfunctioning levels of insulin, a hormone made in the pancreas that regulates blood sugar levels. It is either absent or impaired in diabetics, who must regulate their diets, inject synthetic insulin, or both. Diabetes can lead to blindness, heart disease, coma and death.
The spread of the disease is mainly related to Type 2 diabetes, due especially to obesity factors and poor living conditions, Dr. Mapoko Ilondo, an associate professor at the University of Kinshasa in the Democratic Republic of Congo, told IPS.
According to the World Health Organisation, an estimated 30 million people had the disease in 1985. By 1995, the number of diabetics had increased nearly five-fold, to 135 million, and by the year 2030, it is estimated to hit a stunning 366 million.
Today, More than 230 million people worldwide are affected. Each year, six million people contract diabetes and three million die, said Dr. Ilondo.
Like many other diseases, diabetes is growing fastest in developing countries. Seven out of the 10 countries with the highest number of people living with diabetes are in the developing world.
With an estimated 35 million people with diabetes, India has the world s largest diabetic population. Studies have found that 25 percent of family income may be devoted to diabetes care there.
The resolution is likely to be most relevant to the developing nations, Silink noted. However, diabetes is a major problem in all countries because of increasing obesity, decreased physical activity, ageing of the populations and urbanisation.
In many developing countries, the prevalence rate among adults is greater than 10 percent. The solutions to the diabetes epidemic will involve intersectoral whole-of-government responses. It is recognised there is reluctance for more U.N. world days to be declared. However, what is being asked here is to elevate an existing WHO world diabetes day to the level of a U.N. recognised day in view of the immensity of this epidemic, which has largely been under-appreciated, he said.
Obstacles to treatment and prevention include lack of trained medical personnel, inadequate stocks of insulin, and the absence of a coordinated effort to curb the disease. According to the World Diabetes Foundation, in developing countries, less than half of people with diabetes are ever officially diagnosed.
In Africa there are no strategies on a large scale to prevent the outbreak, Ilondo said. The first major issue a large-scale strategy has to deal with is the large number of persons with diabetes around the world. The second issue is that in many countries, especially developing countries, diabetes is not a public care priority, it is a neglected disease.
But why it is neglected? It is killing a lot of people and many more develop serious complications everyday. The third issue is that diabetes is very costly, especially when it comes to treating its complications, he observed.
According to U.N. figures, next year, the world will spend 215-375 billion dollars caring for diabetics.
Prevention is the key, Ilondo said. First we need to treat those people that have been diagnosed with diabetes, and we need to treat them well. There are two different levels of prevention. Prevention of complications, which is part of the treatment, and prevention of diabetes itself, and both preventions are much cheaper than treating diabetes directly.
A U.N. resolution requires the support of at least one member state as a sponsoring country, which drafts the text. The proposal then needs 45 other countries to act as signatories and place the resolution on the agenda of the U.N. General Assembly.
According to Silink, Bangladesh has agreed to sponsor the resolution, and several other countries have already indicated their willingness to co-sponsor or support it.
A draft should be presented by the end of the year, Ilondo said. I think it is a reasonable period of time for this kind of resolution. I do not see any potential conflict, I would not expect any difficulty in adopting it. It is not easy, but it can be done.
