World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND

World Health OrganizationDepartment of Chronic Diseases and Health PromotionDepartment of Chronic Diseases and Health Promotion

World Health Organization

Gojka Roglic

THE GLOBAL BURDEN OF DIABETES AND THE WHO RESPONSE TO FACE

THE CHALLENGE


What is the global burden of diabetes?First WHO global estimates (King et al, 1998)

150 MILLION


What is the global burden of diabetes?Updated WHO global estimates (Wild et al, 2004)

171 MILLION


Latest update: International Diabetes Federation Diabetes Atlas 2006

• Third edition of the IDF Atlas

• Will be launched at the 19th IDF Congress in

Cape Town, December 2006

• Prevalence and numbers for 2007 and 2025 in age group 20-79 years


Burden of diabetes in 2007 (IDF Diabetes Atlas 2006)

• Estimated number of persons age 20-79 years with diabetes in the world

~230 million


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

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


Funding for Noncommunicable Chronic Diseases at WHO

Other NCDs

Injuries

CVD

DM

CD

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]


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 toNCDs

(including mental health)



World Bank and Regional Development Banks

of their $4.2 billion total to health, population and nutritionbetween 1997 and 2002

World Bank loans for chronic diseases



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


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


Formulating messages and dispelling misconceptions …..


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


• Diabetes is costly and has the potential to cripple any health care system

The economic impact: billions


Ten popular misconceptions on diabetes and related chronic diseases…..

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


Number of persons with diabetes in 2007 (millions)

050

100150200

Developing countries Developed countries

Diabetes Atlas, IDF (in print)

Reality: double burden = double response


Diabetes is an obstacle to achieving the Millennium Development Goals……

• Diabetes is likely to be responsible for 15% of new tuberculosis cases in India


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


Age distribution of persons with diabetes

0

20

40

60

80

20-39 40-59 60-79

Age group (years)

Per

sons

with

dia

bete

s (m

illio

ns)

Developingcountries

Developedcountries


Reality: chronic diseases affect men and women almost equally


Diabetes prevalence by age group, Egypt 2007

0

510

15

20

2530

35

20-29 30-39 40-49 50-59 60-69 70-79

Age

Pre

va

len

ce

(%

)

Males

Females


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


• Upcoming WHO Technical Report:

Prevention of diabetes mellitus and its complications

Reality: inexpensive and cost-effective interventions exist


• 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


In 2007 diabetes is estimated to cause…..

~3.5 million excess deaths globally



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)


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.

Documents

World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND