Today, diabetes and other noncommunicable diseases (NCDs) that share the same risk factors represent a leading threat to health and human development. An estimated 8 to 14 million people die prematurely every year in developing countries due to preventable NCDs — mainly cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases. These people are dying too young as a result of increased exposure to the common risk factors for NCDs: unhealthy diets, physical inactivity, tobacco use and the harmful use of alcohol.

Unless addressed, the mortality and disease burden from diabetes and other NCDs will continue to increase. WHO projects that globally, deaths caused by these health problems will increase by 17% over the next decade, with the greatest increase in low- and middle-income countries, mainly in the African (27%) and Eastern Mediterranean (25%) regions. An estimated 80% of mortality from NCDs occurs in developing countries. Similarly, and as the IDF Diabetes Atlas illustrates, the highest rates of diabetes occur in economically developing populations.

We have the right vision and knowledge to address diabetes. Although cost-effective strategies exist, high-level commitment and concrete action are still sorely needed at the global and national level. Despite imposing a heavy burden on health as well as socio-economic development, the prevention of diabetes and other NCDs remains dramatically underfunded.

Working closely with Member States, WHO has, therefore, developed an Action Plan, based on the Global Strategy for the Prevention and Control of Noncommunicable Diseases. The Plan was endorsed by all Member States in May 2008. It provides a six-year road map for addressing this global challenge by raising the priority accorded to diabetes in development work at global and national levels, and integrating its prevention into policies across all government departments. The Plan also aims to establish and strengthen national policies and plans, and promote interventions to reduce the main modifiable risk factors. A coordinated agenda for research is essential. WHO is currently working with the International Diabetes Federation and other partners to establish such an agenda and to enhance international collaboration to promote and support the multi-dimensional and multi-sectoral research needed to strengthen the evidence base for prevention.

Once people develop diabetes, health services in many developing countries are unable to provide effective care to control it and prevent its complications and premature death. Available data indicate that a substantial proportion of household income among poor populations is spent on healthcare for a family member affected by diabetes. Integrating diabetes care into primary healthcare and ensuring universal coverage for basic health interventions should therefore be given top priority.

Despite the enormity of the diabetes problem, requests from developing countries for technical assistance to prevent it remain largely unanswered by the international community mainly because diabetes and other NCDs are beyond those targeted by the Millennium Development Goals (MDGs).

We cannot afford to remain a bystander. It is time to give diabetes and other NCDs the attention they deserve. The Ministerial Declaration adopted at the 2009 session of the High-level Segment of the United Nations Economic and Social Council recognized the need to address this important health problem. It is hoped that the Declaration will mark the beginning of intensive work to integrate the prevention of diabetes and other NCDs into the global development agenda. The Declaration also called for urgent action to implement the Global Strategy and its Action Plan.

Diabetes has many faces — but very few voices. And that is why I am so grateful to the International Diabetes Federation for taking such a strong leadership role in giving a voice to the challenges faced by the millions of people with diabetes.

I hope that governments, civil society, national associations, international and regional bodies, and the global development community will find the IDF Diabetes Atlas a useful tool for advocacy and for motivating a serious discussion about one of the major challenges for development in the twenty-first century.

Ala Alwan
Assistant Director-General
World Health Organization