Slide No 1 Corporate Social Responsibility Lars Rebien Sørensen CEO Novo Nordisk A/S Board Member World Diabetes Foundation

The number of people with diabetes in the world is expected to rise from 177 million today to 370 million in % of the total number of people with diabetes worldwide will be living in the developing countries

The developing countries carry 90% of this world’s total disease burden, yet they benefit from only 10% of global health resources WHO estimates that 1/3 of the world population lacks regular access to essential drugs, and this figure is expected to rise to over 50% in the least developed parts of Africa and Asia

WHO states that non-communicable diseases such as diabetes are the world’s main disablers and killers already now

Slide No 5 Epidemiology: Burden of diabetes is increasing Increased childhood and adult obesity Decreasing levels of physical activity Increasing urbanisation Increased longevity Earlier diagnosis A new patient is diagnosed with type 2 diabetes every 5 minutes Epidemic (WHO, 1997)

Slide No 6 The sufferings from diabetes Life expectancy is reduced by 5 to 10 years Premature death due to myocardial disease X 4 Stroke is increased X 2 Renal failure: 40% of all dialysed patients have diabetes New blindness: 30% of all cases are people with diabetes (>90% of these have type 2 diabetes) Two out of three amputees have diabetes

Slide No 7 The financial costs of diabetes ”With the present trend diabetes and its complications, will take more than one third of the health budgets in only 15 to 20 years – if vigorous steps to slow the progress of this ’epidemic’ are not taken” S. Orahilly, Science, medicine and the future. Non-insulin-dependent diabetes mellitus: the gathering storm. BMJ March 1997

Slide No 8 What can a diabetes company do?

Slide No 9 Financial Socio-& health economics Employees Patients Communities Environment Animals Bioethics Economically viable Environmentally soundSocially responsible The Triple Bottom Line

Slide No 10 Access to health in developing countries WHO recommendations: Development of national health strategies Building of national healthcare capacity Best possible pricing Additional funding

Slide No 11 Diabetes a national priority?

Slide No 12 Diabetes prevention programme NCD Unit for prevention /control National survey for hypertension No surveillance system nationally NCD policy Budget line for NCD Integrated primary care prevention NCD info in annual report Focus on chronic diseases? (167 countries) Alwan 2001

Slide No 13 National Diabetes Strategies programme Novo Nordisk facilitates development and collaboration on the implementation of national strategies for diabetes prevention and treatment We aim at identifying best practices from around the world The programme is systematic and can be a template for the other chronic diseases (CVD, hypertension)

Slide No 14 Understanding patients needs

Slide No 15 DAWN- A study to understand… People with diabetes Feelings, worries, wishes and needs Perceptions of their diabetes Health care professional attitudes Role of psychosocial factors

Slide No 16 Best Pricing

Slide No 17 Pricing Policy in LDC Countries Novo Nordisk offers its insulin products to the public health systems in the poorest countries at prices not to exceed 20% of the average price in North America, Europe and Japan LDC as defined by UN: 49 countries in Africa, Asia-Pacific and Central America

Slide No 18 Additional funding

The World Diabetes Foundation founded in March 2002 Initiated by a grant from Novo Nordisk of USD 80 million Majority of board members – non Novo Nordisk Chairman: Professor Pierre Lefèbvre 26 projects funded to date

WDF is dedicated to prevention and treatment of diabetes in the poorest countries with focus on: Awareness about diabetes Prevention of diabetes and its complications Education and training for patients and professionals Access to essential diabetes medication Detection, treatment and monitoring of diabetes

The role of the World Diabetes Foundation Creates partnerships and acts as a catalyst Links people and resources to advocate globally and provide care locally Aims at the poorest of the poor Focuses on innovative strategies to prevent diabetes Strives to achieve sustainable solutions

Regional projects in WDF portfolio Diabetes Education, Sub-Saharan Africa Clinical Practice Guidelines, Sub-Saharan Africa WDF/IDF Fellowships Nutrition Protocol, the Caribbean Postgraduate diabetes training, Africa

Local projects in WDF portfolio Cameroon: National Diabetes Programme China: National Diabetes Programme India: Diabetes Eye Care India: National Diabetes Programme India/Tanzania: Diabetes Foot Care India: Rural and semi-urban diabetes prevention and control Tanzania: 15 Diabetes Clinics Mozambique: Insulin Availability West Bank: Diabetes Prevention and Nutrition Cuba: Regional Diabetes Centers Congo / Kinshasa: Insulin Availability Vietnam: National Diabetes Project Bolivia: Diabetes Centre Nepal: Diabetes Education and Prevention Bhutan: Diabetes health care services Pacific Islands: Reducing diabetes complications

Memorandum of Understanding with DANIDA - Danish International Development Agency Memorandum of Understanding with DANIDA - Danish International Development Agency The objective of the partnership is to combat diabetes in the developing countries Lead to the identification of two projects in India and Bhutan

Application criteria Application criteria Sustainability Local champion Political will Co-funding Application form on

Multiplier effect Multiplier effect Project portfolio: 21 million USD of which 12 million USD were donated by the World Diabetes Foundation

Impact Impact The projects funded by the World Diabetes Foundation will in the coming 3-4 years potentially influence the diabetes treatment of 18, people directly and indirectly 50,000,000 people in the developing countries

Slide No 29 “The hottest places in Hell are reserved for those who, in time of great moral crisis, maintain their neutrality” Dante

Slide No 30 “…Governments only find the courage and resources to do the right thing when business takes the lead.” Kofi Annan

Slide No 31 Need for a new and different understanding of the disease Need for a new social equation in disease management An urgent need that governments, scientists, corporations, patients join forces against the disease Thank you!