United Nations Resolution on diabetes
On 20 December 2006, the United Nations General Assembly passed Resolution 61/225. This landmark Resolution recognizes diabetes as a chronic, debilitating and costly disease associated with major complications that pose severe risks for families, countries and the entire world. It designates 14 November, the current World Diabetes Day, as a United Nations Day to be observed every year.
Governments have acknowledged that diabetes is increasing at epidemic rates and is affecting all countries. For the first time, a non-infectious disease has been seen as posing as serious a global health threat as infectious epidemics such as HIV/AIDS.
The full impact of the World Diabetes Day Resolution will take many years to unfold. There are two main challenges that need to be addressed: the prevention of diabetes itself, and the prevention of complications in those affected by diabetes − now numbering almost 250 million or roughly 6% of the world’s adult population. Different strategies and responses will be required. The Resolution, by calling on UN Member States to develop national policies for the prevention of diabetes, underscores the need to stem the tide of new cases to prevent the world’s healthcare systems from being overwhelmed.
The development of national policies for the prevention of diabetes will create many challenges, not the least of which will be to understand better the environmental and societal factors that are driving what has been called the epidemic of the 21st century. Individual lifestyle choices and changes in the living environment beyond the control of the individual will need to be scientif cally evaluated. Simplistic responses (“no-one told you to over-eat and not exercise”) do little to solve the problem. It will require increased public awareness of the prevention of type 2 diabetes and the responsibility that individuals and families over the lifestyle choices they make. However, strategies must be developed to address the negative changes to the living environment that are behind the pandemic. These strategies will demand whole-of-government actions, not just the actions of agencies responsible for healthcare.
The reality is that there will be no automatic increase in funds for diabetes for either prevention or treatment in the short term. The International Diabetes Federation recognizes that the diabetes world will need to be part of the solution and not simply be regarded as the problem. People with diabetes, when educated in self-care and empowered, are critical to the success of any programme. The diabetes world demonstrated how it was able to Unite for Diabetes to achieve the Resolution.
Through this unity, the diabetes world could bring many assets to future partnerships for the prevention and care of diabetes with inter-sectoral government agencies, UN organizations, non-governmental organizations, civil society and industry.
One of the ways the International Diabetes Federation would facilitate this, is by creating a Global Diabetes Fund to attract, manage, and disburse additional funds for the prevention and care of diabetes through private public partnerships. The Global Diabetes Fund would be closely modelled on the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Diabetes is one of the world’s most important causes of expenditure, mortality, disability and lost economic growth. There are simple, cheap treatments that can help prevent these losses, many of which will actually save money in countries, rich and poor. The economic returns of improved diabetes prevention and treatment are relatively higher in the world’s low- and middle-income countries, where the majority of people with diabetes live but where few of them are treated cost-effectively.
For most of the world, the solutions to the spiralling diabetes pandemic will involve improving access to proven but low-cost therapies, especially in low-income countries that face major environmental and social issues as well as poverty. Developing countries will need to be supported by international and national partnerships but will ultimately need to take ownership and leadership of the solutions that they will need to implement. Country-specif c data on the burden of diabetes are required urgently, together with a clear understanding of the extent of national policies for the prevention and care of diabetes. In developing countries, many vertical streams of excellence in delivering diabetes care exist. Yet all too often they work in isolation. Horizontal integration of their efforts would greatly enhance their effectiveness.
The World Bank recently identified seven diabetes treatments that would actually save money if prescribed, even in the poorest regions of the world, and five more that would be highly cost-effective (in the poorest regions, between USD 60 and 660 per life year saved). It is tragic that these treatments are not used more. This situation presents an opportunity. The International Diabetes Federation believes that the fastest and most efficient way to improve health in poor and middle-income countries is to provide cheap, simple, proven treatments to people threatened with diabetes and cardiovascular disease. Doing so will help strengthen primary care, stabilize families, liberate women to seek greater educational and employment opportunities, and improve standards of living.
The International Diabetes Federation commits itself to developing programmes for the prevention and treatment of diabetes with partners such as governments, UN organizations (the World Health Organization, Food and Agricultural Organization and UNICEF etc.), World Bank, non-governmental organizations, civil society, philanthropic and service organizations, as well as industry.
