Have we found our celebrity?

Part of the difficulty in gaining media coverage and donor support for diabetes and other non-communicable diseases is that the issues are out of the spotlight; we have no “celebrity” endorsement.

This may have changed. According to Novo Nordisk’s website:

Former President Bill Clinton will be the keynote speaker at the Global Changing Diabetes Leadership Forum, taking place on 13 March 2007 in New York hosted by Novo Nordisk and supported by the International Diabetes Federation (IDF).

The Forum will be a provocative dialogue on redefining healthcare focusing on the needs of people with diabetes, and will involve politicians, government officials, international organizations, patient organizations, healthcare professionals and media from more than 18 countries.

“Diabetes will constitute the most significant public health challenge of the 21st century if no action is taken now. It is already causing as many deaths as HIV/AIDS. We need to explore practical ways of redefining healthcare, by focusing on the needs of people with diabetes,” says Lars Rebien Sørensen, president and CEO of Novo Nordisk.

The discussions at the Forum will explore the concepts described last year by Harvard Professor Michael E Porter and Professor Elizabeth Teisberg in their book Redefining Health Care: Creating Value-Based Competition on Results. Professor Elizabeth Teisberg will be attending the Global Changing Diabetes Forum and share her thoughts on the importance of focusing on the needs of patients over the full cycle of care – from prevention and diagnosis through recovery to long-term disease management.

The Global Changing Diabetes Leadership Forum is the most recent initiative taken by Novo Nordisk to call for a worldwide change in diabetes care.

“We can offer ourselves as partners and be catalysts for change for the benefit of people with diabetes across the world. However, the industry cannot fulfil this task alone and should not play the role of governments. Only by joining forces can we reach our objectives,” says Lars Rebien Sørensen.

In its efforts to call for a worldwide change in diabetes care, Novo Nordisk is also working actively to implement the recently adopted United Nations (UN) Resolution on diabetes by raising awareness among policy-makers.

From press release on Novo Nordisk website

Chronic disease in the developing world

The NEJM published two articles today about neglected chronic disease in developing and low-income countries.

The first, ‘Obesity and Diabetes in the Developing World: A Growing Challenge’ by Hossain et al., describes the growing obesity and diabetes pandemics, and attributes adoption of a “Western lifestyle involving decreased physical activity and overconsumption of cheap, energy-dense food” as the main causes. A growing population, especially in urban areas in the developing world, also contributes to rising obesity/diabetes/cardiovascular rates that are devestating the rapidly developing economies of India and China, among many other countries. The article suggests that public health initiatives to make affordable, healthful foods available, as well as education and community planning initiatives to facilitate exercise will be effective, but may be met by opposition from food manufacturers and rights-oriented consumer groups.

And who will fund these needed interventions?

The second article, ‘Expanding Priorities: Confronting Chronic Disease in Countries with Low Income’ by Gerard Anderson and Edward Chu, considers why international donors have failed to address chronic diseases among “the top 20 diseases.” The authors cite global rates of communicable and non-communicable diseases similar to those in the above article, illustrating that cardiovascular disease alone accounts for 30% of all deaths worldwide; 27% of all deaths and 9% of the disease burden in low-income and middle-income countries. In comparison, tuberculosis, HIV/AIDs and malaria together, which attract the greatest attention from donors, are responsible for 10% of deaths and 11% of disease burden worldwide, and 12% of deaths and 13% of disease burden in low-income countries.

Reasons for disproportionate attention to infectious disease include:

• Successful decreases in prevalence of infectious diseases in developed countries suggest that it should also be feasible to decrease – or eradicate – infectious disease in low-income countries
• International aid creates a market for effective vaccines
• International concern about the spread of infectious disease
• Infectious diseases are prone to a “permanent, quick fix” – and a huge payoff – while chronic diseases take decades to treat. This matters to policymakers, who want to see results from their investments while they are still in office
• Media draws sympathy for infectious disease victims from the public

However, due to their chronic nature, conditions like diabetes and cardiovascular disease can have much more costly consequences, especially in low-income countries that may have already overwhelmed health systems. The WHO, for instance, estimates that China, India and Russia could lose up to $550 billion in GDP in 10 years due to heart disease, stroke and diabetes. Cost-effective solutions to chronic diseases exist, but must be put into action!

Hopefully with the recent passage of the UN Resolution on Diabetes, international aid foundations and donors will begin to prioritize diabetes and other obesity-related chronic diseases, giving these killer diseases the attention they deserve. However, this is only possible with cooperation from the media, which unfortunately did not seem to pick up the news of the sweeping passage of the UN Resolution on Diabetes (stay tuned for an upcoming post about this).

Source:
NEJM — Obesity and Diabetes in the Developing World — A Growing Challenge

NEJM — Expanding Priorities — Confronting Chronic Disease in Countries with Low Income

Honda invests in India

Illustrating a growing demand for cars in India – and an increasingly sedentary lifestyle dependent on technology – Honda has announced it will invest between $150-200 million to build a second automobile plant in the northwestern state of Rajasthan in India. The plant is expected to open in 2009, building 50,000 cars per year – future hopes are to produce 200,000 cars annually to cater to the 1.1 billion people living in India. Currently, Honda’s plant in Uttar Pradesh produces 50,000 cars annually, but will increase to 100,000 by the end of this year.

The new plant will undoubtedly create many jobs, increasing economic growth, productivity and prosperity in the country, as well as improving efficiency with better methods of transportation. At the same time, however, it represents potential indirect productivity losses down the road.

India is currently the “diabetes capital of the world”, with 35 million people with diabetes and just as many with pre-diabetes. Reasons for this epidemic of diabetes are varied, but a major risk factor is decreased physical activity due to urbanization and improved technology – many newly-created jobs in India are in information technology, which requires long hours sitting in front of computers. Now with the introduction of even more cars, physical activity has the potential to decrease even more, contributing to higher risk for obesity and diabetes. Cars alone cannot cause chronic disease, but Honda’s announcement demonstrates the larger picture, which is that India’s population is undergoing a rapid transformation from an active, traditional lifestyle to one that is more sedentary and Western-influenced, and which concentrates the risk for chronic diseases of lifestyle.

A major concern is that diabetes has the potential to wreak havoc on India’s emergence as a global economic super-power, with both direct (healthcare spending) and indirect (a less productive workforce, coping mechanisms for diabetics and families, and premature retirement) costs.

Honda’s move highlights the opportunity for multinational companies to invest in India’s booming economy, as cited by global experts, including the Boston Consulting Group. However, responsible companies are encouraged to invest in health at the same time, by combining business interests with health interests. Food companies are advised to invest in healthier products in India; other companies can create products that encourage physical activity. Economic growth and improved health can, and should, go hand in hand.

Source: Honda to Build 2nd Plant in India