World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND THE WHO RESPONSE TO FACE THE CHALLENGE

World Health Organization Department of Chronic Diseases and Health Promotion What is the global burden of diabetes? First WHO global estimates (King et al, 1998) 150 MILLION

World Health Organization Department of Chronic Diseases and Health Promotion What is the global burden of diabetes? Updated WHO global estimates (Wild et al, 2004) 171 MILLION

World Health Organization Department of Chronic Diseases and Health Promotion Latest update: International Diabetes Federation Diabetes Atlas 2006 Third edition of the IDF Atlas Will be launched at the 19 th IDF Congress in Cape Town, December 2006 Prevalence and numbers for 2007 and 2025 in age group years

World Health Organization Department of Chronic Diseases and Health Promotion Burden of diabetes in 2007 (IDF Diabetes Atlas 2006) Estimated number of persons age years with diabetes in the world ~230 million

World Health Organization Department of Chronic Diseases and Health Promotion Results from new surveys have been published… Cambodia 2005 PR China 2003 Philippines 2004 Thailand 2003 Viet Nam 2004 India 2004 Nepal 2003 Sri Lanka 2005

World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization 2.9 million Number of deaths attributable to diabetes in the year 2000 (Roglic et al, 2005) (5.2% of total mortality) HIV/AIDS deaths: 3 million

World Health Organization Department of Chronic Diseases and Health Promotion Funding for Noncommunicable Chronic Diseases at WHO Global NCD disease burden Total WHO expenditure on NCDs In 2002, 3.5% of total budget of US$ 43.6 million on NCDs Source: WHO long-term strategy for prevention and control of leading chronic diseases © World Health Organization [2004]

World Health Organization Department of Chronic Diseases and Health Promotion Official Overseas Development Aid to the health sector in 2002 Donor aid for the health sector Increased health support by donors mostly directed towards HIV/AIDS, not NCDs allocated to NCDs (including mental health) Source: WHO long-term strategy for prevention and control of leading chronic diseases © World Health Organization [2004]

World Health Organization Department of Chronic Diseases and Health Promotion World Bank and Regional Development Banks of their $4.2 billion total to health, population and nutrition between 1997 and 2002 World Bank loans for chronic diseases Source: WHO long-term strategy for prevention and control of leading chronic diseases © World Health Organization [2004]

World Health Organization Department of Chronic Diseases and Health Promotion International Diabetes Federation (IDF) A natural ally and partner to WHO In official relations > 50 years

Complementary strengths of WHO and IDF for awareness raising Works with governments Strong public health voice WHO offices in almost every country Global reference centre for health statistics Has prestige among governments/health ministries Works through member associations Strong lay and professional advocacy voice Network of member associations Well-developed secretariat to respond to calls for information Has prestige among NGOs and private sector WHO IDF

Supported by the World Diabetes Foundation

World Health Organization Department of Chronic Diseases and Health Promotion Main aim….. To achieve a major increase in the awareness of the impact of diabetes in low and middle income countries To propose solutions

Evidence base Surveys of diabetes awareness in India and Cameroon Studies of economic impact of diabetes in China and Iran WHO Technical report: Prevention of diabetes and its complications

World Health Organization Department of Chronic Diseases and Health Promotion Formulating messages and dispelling misconceptions …..

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes affects a considerable proportion of almost all populations…… IDF Atlas 2003 WHO estimates 2004 WHO/IDF estimates (IDF Atlas 2006) And its prevalence is increasing……….

Risks are increasing

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes is costly and has the potential to cripple any health care system

The economic impact: billions

World Health Organization Department of Chronic Diseases and Health Promotion Ten popular misconceptions on diabetes and related chronic diseases…..

Reality: 80% of chronic disease deaths occur in low & middle income countries

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes Atlas, IDF (in print)

Reality: double burden = double response

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes is an obstacle to achieving the Millennium Development Goals…… Diabetes is likely to be responsible for 15% of new tuberculosis cases in India

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes is an obstacle to achieving the Millennium Development Goals…… Diabetes is likely to be responsible for 15% of all new tuberculosis cases in India (AIDS accounts for 3-4%)

Reality: chronic diseases are concentrated among the poor

Reality: almost half in people under age 70 years

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes Atlas, IDF (in print)

Reality: chronic diseases affect men and women almost equally

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes Atlas, IDF (in print)

Reality: poor and children have limited choice

Reality: 80% of premature heart disease, stroke and type 2 diabetes is preventable, 40% of cancer is preventable

World Health Organization Department of Chronic Diseases and Health Promotion Upcoming WHO Technical Report: Prevention of diabetes mellitus and its complications

Reality: inexpensive and cost-effective interventions exist

World Health Organization Department of Chronic Diseases and Health Promotion Diabetes chapter in the recent publication from the Disease Control Priorities Project

Reality: these people are the rare exceptions

Reality: death is inevitable but it does not need to be slow, painful or premature

World Health Organization Department of Chronic Diseases and Health Promotion In 2007 diabetes is estimated to cause….. ~3.5 million excess deaths globally Diabetes Atlas, IDF (in print)

World Health Organization Department of Chronic Diseases and Health Promotion In 2007 diabetes is estimated to cause….. ~3.5 million excess deaths globally ~58,000 thousand excess deaths in Egypt (one in seven adult deaths is due to diabetes) Diabetes Atlas, IDF (in print)

The global goal A 2% annual reduction in chronic disease death rates worldwide, per year, over the next 10 years. The scientific knowledge to achieve this goal already exists.