Diabetes in Society

The World Diabetes Day campaign is led by the International Diabetes Federation and its member associations. It is a multiple-stakeholder partnership that includes diabetes organizations and their members around the world and Official World Diabetes Day Partners. Each campaign is centred on a theme that is established by the IDF Executive Board and approved by the World Health Organization. This year sees the second half of a 24-month campaign focussing on diabetes in children and adolescents. The main campaign slogan is ‘Know the warning signs’.

South Africa is a land of paradoxes. South Africans deservedly celebrated an exceptional Rugby World Cup victory in 2007, but we most definitely are not yet winning the battle against inactivity and overweight among the nation’s young people – which is placing them at substantial risk for chronic diseases such as type 2 diabetes, obesity, heart disease, and certain types of cancer. South Africa has the added challenge of dealing with a double burden of disease: the chronic non-communicable diseases mentioned above and communicable diseases such as HIV/AIDS and tuberculosis.

The BRIDGES grant programme is dedicated to supporting translational research in diabetes worldwide. The structure of BRIDGES is in place and the programme has taken the first steps towards accomplishing its overarching objective: to bridge the gap between science and people with diabetes – between clinical research and clinical practice – by supporting cost-effective and sustainable interventions to prevent and control diabetes.

The World Health Organization (WHO) estimates that in 2005, HIV/AIDS, TB and malaria combined were responsible for around 4 million deaths. In the same year, chronic non-communicable diseases killed nearly 30 million people. Shocking as they are, these figures do not tell the full story of the disability, suffering and personal hardship that results from diabetes complications; or, on a larger economic scale, the enormous healthcare costs and lost productivity attributable to diabetes.

Heart disease, stroke, diabetes and cancer are now among the leading causes of death and disability around the world. The causes of these diseases include modifiable lifestyle-related risk factors, such as smoking, poor diet, lack of physical activity, as well as non-modifiable risk factors, including age and genetics. Due to population growth and the relative success of efforts to reduce communicable diseases, the number of people with non-communicable diseases will continue to rise in the future.

Much is heard of late about the high costs of chronic diseases like diabetes: chronic diseases are going to ‘break the bank’, impose tremendous costs on already struggling healthcare systems, and, very possibly, hinder growth in developing countries. Often, however, the suffering of people with chronic diseases seems to be lost in all the talk of money.

Chronic diseases are increasing in global prevalence and seriously threaten developing nations’ ability to improve the health of their populations. Indeed, chronic disease has become the dominant health burden in many developing countries. It is estimated that in 2005, chronic diseases were responsible for 50% of deaths and illness in 23 selected developing countries. Surveys from countries in all corners of the world reveal significant health and economic consequences from chronic diseases, with the greatest impact likely to occur in the poor countries that are least able to respond.

The lack of access to scientific and medical literature has historically been a major challenge in developing countries. In a world that is increasingly digital, effective opportunities now exist for connecting healthcare providers, researchers and policy-makers with online research and clinical information. The authors report on HINARI, AGORA and OARE programmes built on partnerships between publishers and UN organizations which provide researchers from developing countries with access to the world’s latest scientific literature.

Over recent decades, there has been a worldwide increase in the number of people with obesity – currently around 300 million according to the International Obesity Task Force – and there are no signs of a slow-down. Furthermore, rates of overweight and obesity in adults and children are rising dramatically in developing countries. A large and growing body of evidence points to the transformation of lifestyles worldwide – over-consumption of energy-dense food and decreased physical activity – as the driving force behind this pandemic.

The development of leaders in healthcare is recognized as being integral to improving the quality of care. However, where most leadership development focuses on an individual, a recent intervention in the UK operated on the theory that improvements are more likely to last if all team members are involved in developing leadership skills and understanding. In this article, Jan Walmsley and Andy Brown report on ‘Shared Leadership for Change’, which aimed to improve team effectiveness in six diabetes clinical networks.