Diabetes treatment > Access and supply

As the number of people with diabetes continues to rise worldwide, huge increases in the prevalence of the condition are expected in Asia. Hospital and outpatient care for people with diabetes in the central Asian Republic of Uzbekistan, with a population of over 26 million people, is provided at state-funded healthcare centres. However, people with the condition have to pay for their insulin and other essential diabetes supplies out of their family income. Diabetes-

Editorial

President's Editorial

The human population of our planet is aging. According to UN projections, by the middle of this century, the number of elderly people in the world will exceed the number of young people – for the first time in history. This trend started during the last half of the 20th century. Yet policy-makers are only now becoming aware of the gravity of the implications for developing countries of the rapid pace at which our populations are ageing.

When I met Sonia Carrasco, 14 years ago, she was suffering from diabetes ketoacidosis – extremely high glucose levels, a sign of poorly controlled diabetes. Although she had been living with the condition for about 6 years, her diabetes knowledge was minimal, reflecting a general lack of health awareness. When I asked Sonia to describe her feelings the day she was given a diagnosis of type 1 diabetes, 20 years before, she recalls an experience made all the more terrifying by an acute fear of the unknown. She had understood that she had leukaemia.

It is estimated that about half of all homeless people suffer from chronic medical conditions. Unfortunately, these people frequently encounter many more barriers to care than the general population – exacerbating their health problems. The plight of homeless people with diabetes is particularly severe, since managing the condition requires adherence to a demanding care plan.

President's Editorial

The sale of counterfeit products is a problem in most countries. Every year, about 7% of world trade, valued at about 280 billion USD, is lost due to counterfeiting. In the information technology sector, products worth an estimated 20 billion USD are currently in circulation. But the huge financial losses incurred by manufacturers and individual customers as a result of the trafficking of fake goods are overshadowed by the tragic human costs: the pharmaceutical industry, and consequently the marketplace, are flooded with counterfeits.

Contrary to the now outdated idea of diabetes as a disease of rich people in rich countries, the condition is increasingly widespread in Africa. Mali, the second-largest country in West Africa, bordering the Sahara desert to the north and Côte d’Ivoire and Senegal to the south, has not escaped the budding epidemic of type 2 diabetes. Overall prevalence is thought to exceed 2% – nearly a quarter of a million people. Most of these have type 2 diabetes and live in the urban areas.

In Africa, there is said to be one traditional healer to every 200 people; an estimated 80% of people in the continent turn to traditional medicine as a source of primary care, including those with diabetes. In settings that are characterized by shortcomings in healthcare provision resources, traditional healers are making selective use of biomedical knowledge and language to enhance the perceived effectiveness of their treatments.