New programme to speed up action to tackle diabetes in the Caribbean

WASHINGTON, United States (CMC) — The Pan American Health Organization says the World Health Organization's (WHO) new Global Diabetes Compact aims to bring a much-needed boost to efforts to prevent diabetes in the Caribbean and other places and to bring treatment to all who need it. 

The compact was launched at the Global Diabetes Summit, which was co-hosted by WHO and the Government of Canada, with the support of the University of Toronto. 

During the event, the president of Kenya joined the prime ministers of Fiji, Norway and Singapore; the WHO Global Ambassador for Noncommunicable Diseases and Injuries, Michael R Bloomberg; and ministers of health from a number of countries, as well as diabetes experts and people living with diabetes, to highlight the ways in which they will support this new collaborative effort. 

Other UN agencies, civil society partners and representatives of the private sector also attended.

“The need to take urgent action on diabetes is clearer than ever,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The number of people with diabetes has quadrupled in the last 40 years.  It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down,” he added. “And a high proportion of people who are severely ill in hospital with COVID-19 have diabetes.”

Dr Tedros said the Global Diabetes Compact will help to “catalyse political commitment for action to increase the accessibility and affordability of life-saving medicines for diabetes and also for its prevention and diagnosis.” 

“Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to 100 years later, we continue working to support people living with diabetes,” said Patty Hajdu, Minister of Health, Canada. “But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives — in Canada and around the world.”

“Diabetes prevalence has been increasing rapidly, especially over the last two decades, largely driven by increases in overweight/obesity,” PAHO said. “A large proportion of people with diabetes go undiagnosed and/or their condition is poorly controlled, leading to increased morbidity and mortality due to diabetes.  

“The rise in diabetes in the Americas signals the critical need to strengthen the health system response in order to improve quality of care for people living with diabetes,” it added.  

At this time, while the COVID-19 pandemic continues, Dr Carissa Etienne, PAHO's Dominican-born director underscored, during the Global Diabetes Summit, that “Among the most concerning aspects of this pandemic is the impact on people with diabetes and other NCDs (non-communicable diseases). 

“Although the exact toll is yet to be fully understood, we are very concerned about the consequences of adverse lifestyle changes, the interruptions in healthcare services and the supply chain disruptions which limited access to medications,” she said. 

Dr Etienne called for urgent action to maintain essential health services, “to ensure continuity of care for people living with diabetes.” 

She said “one of the most urgent areas of work is to increase access to diabetes diagnostic tools and medicines, particularly insulin, in low- and middle-income countries.

“The introduction of a pilot programme for WHO prequalification of insulin in 2019 has been an important step,” Dr Etienne said. Currently, the insulin market is dominated by three companies. 

“Prequalification of insulin produced by more manufacturers could help increase the availability of quality-assured insulin to countries that are currently not meeting demand,” she added. “In addition, discussions are already underway with manufacturers of insulin and other diabetes medicines and diagnostic tools about avenues that could help meet demand at prices that countries can afford.”

Dr Etienne said insulin is not the only scarce commodity, stating that “many people struggle to obtain and afford blood glucometers and test strips as well.” 

Additionally, she said about half of all adults with type 2 diabetes remain undiagnosed, and that 50 per cent of people with type 2 diabetes don't get the insulin they need, “placing them at avoidable risk of debilitating and irreversible complications such as early death, limb amputations and sight loss.” 

PAHO said innovation will be one of the core components of the compact, with a focus on developing and evaluating low-cost technologies and digital solutions for diabetes care. 

It said the compact will also focus on catalysing progress by setting global coverage targets for diabetes care. 

PAHO said a “global price tag” will quantify the costs and benefits of meeting these new targets. 

“The compact will also advocate for fulfilling the commitment made by governments to include diabetes prevention and treatment into primary health care and as part of universal health coverage packages,” it said. 

“A key aim of the Global Diabetes Compact is to unite key stakeholders from the public and private sectors, and, critically, people who live with diabetes, around a common agenda, to generate new momentum and co-create solutions,” said Dr Bente Mikkelsen, director of the Department of Noncommunicable Diseases at WHO. “The 'all hands on deck' approach to the COVID-19 response is showing us what can be achieved when different sectors work together to find solutions to an urgent public health problem.”

In the Region of the Americas, including the Caribbean, 62 million people are living with diabetes.

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