Diabetes concerns every family, in every community, in every country across the globe. As the focus of World Diabetes Day 2018–2019 highlights, families not only share the burden and cost associated with diabetes in their next of kin, but are also a powerful means to help prevent and manage the disease. This is especially significant given more than 425 million people are currently living with diabetes globally, with an estimated 91 million of them in the WHO South-East Asia Region. Of that number, around 49 million are unaware of their condition.
The importance families have in creating awareness of the risks of diabetes – including overweight and obesity – and in preventing and managing it, is apparent. Where family members understand diabetes’ signs, symptoms, risks and complications, the prospect of a case developing and going undiagnosed is reduced. The likelihood of early detection is enhanced. These outcomes make managing diabetes all-the-more likely, with a ready-made support network able to assist a person avoid the heart, kidney, nerve, eye damage and premature death undiagnosed or poorly controlled diabetes type 1 and type 2 can cause.
Beyond enhancing health outcomes for people at-risk-of or currently living with diabetes, the benefits of empowering families are many. In several parts of the Region, as across the world, the cost of insulin injection and daily monitoring can be prohibitive. Seeking treatment can result in catastrophic health expenditure, pushing whole families into poverty. That outcome risks exacerbating the disease’s impact and increasing the long-term costs diabetes has for health systems and economies more generally.
Important initiatives have been taken Region-wide. All countries have developed and are implementing National Multisectoral NCD Action Plans. Each one of them includes specific measures to tackle diabetes, from advocating greater physical activity to helping reformulate the content of food and beverages. These initiatives are to be commended. Nevertheless, while consolidating the Region’s many gains, there is immense potential to accelerate progress by intensifying action in three key areas.
First, all families should have access to educational resources that help them better understand diabetes. This can be done via social and behavioral change campaigns that emphasize the family unit as a first line of defense, at the same time as highlighting how they can work together to develop healthy habits and diminish the risk of diabetes. This is particularly important given the overwhelming majority of diabetes cases are type 2, meaning they can be avoided altogether by healthy eating and adequate physical activity.
Second – and to enable this – Member States can increase the access individuals and families have to healthy environments. The creation of green spaces and outdoor gyms in urban areas, for example, can facilitate exercise and the weight management it brings. So too can efforts to decrease the amount of sugar and fat in foods and enhance people’s ability to make healthier choices. Though these measures go beyond the health sector, health authorities should act as nodal agencies, working across sectors to find solutions that advance the public good and diminish health care costs.
Third, all families everywhere should have access to affordable diabetes medicines, medical products and care. This starts with ensuring services at the primary level are equipped to detect the disease, and that a reliable supply of medicines and medical products used to manage it are on hand. It extends to ensuring those medicines and medical products are affordable to all and are of adequate quality. The WHO Package of essential noncommunicable disease interventions (WHO PEN), which has been implemented at the primary level in each of the Region’s countries, has advanced these outcomes, reflecting the priority interventions outlined in the Colombo Declaration adopted Region-wide in 2016.
Progress must continue. As part of the Region’s Flagship Priority of preventing noncommunicable diseases – to which diabetes is a major contributor – WHO will go on supporting Member States identify and implement ‘best-buy’ interventions that have real impact at the grassroots and beyond. As we mark World Diabetes Day, ensuring families are at the center of multisectoral action to tackle the disease should be an imperative we acknowledge and act on. Indeed, it should be an imperative that is at the core of diabetes awareness, prevention and management moving forward.