IDF between serious pandemic and difficult solutions

Prof. ADEL A EL-SAYED MDChair Elect

Middle East and North Africa (MENA) RegionInternational Diabetes Federation (IDF)

Professor of Internal MedicineSohag Faculty of Medicine

Sohag-EGYPT

The Story

• Man on earth.• His dreams: hunger and hard work. • His achievements: control of food

production – leading a comfortable life. • The cost.

Why diabetes mattersThe epidemic

• Already, 366 million people have diabetes and another 280 millions are at identifiably high risk of developing diabetes.

• By 2030 this number is expected to rise to 552 millions with diabetes and an additional 398 million people at high risk.

• Three out of four people with diabetes now live in low-and middle-income countries. Over the next 20 years, Africa, Middle East and South-East Asia regions will shoulder the greatest increase in diabetes prevalence.

Why diabetes mattersThe epidemic

• Even in rich countries, disadvantaged groups such as indigenous people and ethnic minorities, recent migrants and slum dwellers suffer higher rates of diabetes and its complications.

• No country, rich or poor, is immune to the epidemic.

Why diabetes mattersHealth consequences

• Every seven seconds someone somewhere dies from diabetes, accounting for more than four million deaths globally each year.

• Tens of millions more suffer disabling and life-threatening complications such as heart attack, stroke, kidney failure, blindness and amputation.

• Diabetes is also implicated in, and has negative consequences for certain infectious diseases, other non-communicable diseases (NCDs) and for mental health.

Why diabetes mattersSocial and Economic Consequences

• Diabetes is not only a health crisis, it is a global social catastrophe.

• Governments worldwide are struggling to meet the cost of diabetes care.

• Costs to employers and national economies are escalating and every day low-income families are being driven into poverty by loss of earnings due to diabetes and the life-long costs of healthcare.

The Top 10s (number of people with diabetes)

The Top 10s (prevalence %)

Undiagnosed diabetes

Deaths due to diabetes• 4.6 million

deaths due to diabetes in 2011

• 8.2% of all-cause mortality

• 48% in people under 60

Healthcare expenditures

• USD 465 billion spent on healthcare for diabetes

• 11% of all healthcare spending is for diabetes

• USD 1,274 is spent on diabetes care per person with diabetes in 2011

Regional highlights

Africa: 78% of people with diabetes are undiagnosed

Europe: the highest prevalence of type 1 diabetes in children

Middle East and North Africa: 6 of the top 10 countries by diabetes prevalence

North America and Caribbean: 1 adult in 10 has diabetes

South and Central America: 12.3% of all deaths were due to diabetes

South-East Asia: almost one-fifth of the world’s people with diabetes live in just seven countries

Western Pacific: 132 million adults have diabetes, the largest number of any region

Diabetes and Tuberculosis

• Focused on the linkages between the two diseases and a review of the evidence

• Calculated the attributable cases of tuberculosis to diabetes

• Highlights areas where there is a high double burden

Global Problems Need Global Solutions

IDF

• The International Diabetes Federation (IDF) is an umbrella organisation of over 200 national diabetes associations in over 160 countries.

• The Federation has been leading the global diabetes community since 1950. IDF’s mission is to promote diabetes care, prevention and a cure worldwide.

• the International Diabetes Federation (IDF) has to do something global.

The opportunity

• “Preventing and treating diabetes is effective and cost effective” (WHO, 2005)

• Diabetes and its complications are largely preventable. There are proven, affordable interventions available.

• Global and national political and business leaders are increasingly aware of the magnitude and consequences of the diabetes epidemic.

• There is growing awareness that investing in diabetes prevention and care brings substantial returns in other disease areas and in productivity and human development

IDF Initiatives

• Three gobal initiatives:

1- UN General Assembly Resolution December 2006.

2- UN High-Level Summit NCD Meeting September 2011-2021.

3- Global Diabetes Plan 2011 – 2021.

UN General Assembly Resolution

• Diabetes is a chronic, debilitating and costly disease associated with severe complications, which poses severe risks for families, Member States and the entire world and serious challenges to the achievement of internationally agreed development goals including the Millennium Development Goals.

• Encourages Member States to develop national policies for the prevention, treatment and care of diabetes

UN SUMMIT ON NCDS

• The UN High-Level Summit on Non-Communicable Diseases held on the 19th-20th September 2011 in New York was a major milestone in the history of global health and development.

• A record 34 Heads of State and Government attended, and 120 Member States made statements expressing their concern about the global burden of NCDs and committing themselves to action.

UN SUMMIT ON NCDS

• The Political Declaration on NCD Prevention and Control was adopted unanimously at the meeting by 193 Member States.

• The Political Declaration includes a set of commitments that firmly position diabetes and NCDs at the top of global and national health and development agendas.

• For the first time the world's governments have taken ownership and recognised diabetes and NCDs as a major challenge in the 21st century and Committed to global action on this problem.

10 HEADLINE MESSAGES

• National leadership and ownership to drive progress

• Prioritise early diagnosis and treatment• Prevention must be the cornerstone of the

response• Strengthening health systems is of critical

importance• Enhance the knowledge base through research

and development

10 HEADLINE MESSAGES

• Additional resources required• Diabetes and NCDs and the global

development agenda• Collaborative partnerships with NGOs• Monitoring trends and progress• Partnerships, reports and reviews to drive

and monitor follow-up action

Global Diabetes Plan 2011-2021

• The Global Diabetes Plan was launched in 2011, a milestone year when world leaders met at UN headquarters in New York to agree actions on diabetes and other non-communicable diseases.

• The UN High-Level Summit on NCDs was just the start. Work will continue to turn political promises into global action for people who have diabetes now and to reduce the rate of the future development of diabetes and its serious complications.

The purpose of the Global Diabetes Plan1. Reframe the debate on diabetes to further political awareness

of its causes and consequences and the urgent need for action at the global and country levels.

2. Set out a globally consistent plan to support and guide the efforts of governments, international donors and IDF member associations to combat diabetes.

3. Propose proven interventions, processes and partnership for reducing the personal and societal burden of diabetes.

4. Support and build on existing policies and initiatives such as the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non-communicable Diseases.

5. Strengthen the global movement to combat the diabetes epidemic and to improve the health and lives of people with diabetes.

The objectives

1- Improve health outcomes of people with diabetes: Early diagnosis, cost effective treatment and self-management education.

2- Prevent the development of type 2 diabetes: Lifestyle interventions and socially responsible policies to promote healthy nutrition and physical activity.

3- Stop discrimination against people with diabetes: Supporting legal and policy frameworks and encouraging awareness of diabetics rights campaigns.

The key strategy

Implement National Diabetes Programmes: Which are feasible and desirable for all countries to have, and successful models are already in place in some countries.

Delivering results

- Strengthen institutional frameworks.- Integrate and optimise human resources and

health services. through training and workforce development, particularly at primary care level

- Review and streamline supply systems: Optimise the provision of essential diabetes medicines and technologies through reliable distribution systems

- Generate and use research evidence strategically: apply evidence to policy and practice

Delivering results- Monitor, evaluate and communicate outcomes:

to assess progress.- Allocate appropriate and sustainable domestic

and international resources: including Official Development Assistance (ODA) for low-and middle-income countries.

- Adopt a whole of society approach: Engage governments, the private sector and civil society (including healthcare workers, academia and people with diabetes) in working together to turn the tide on diabetes.

Global Diabetes Plan

• We already have the evidence. Now, with the Global Diabetes Plan in our hands, we are one step closer to stopping avoidable deaths and reducing the suffering caused by diabetes.

THANK YOU