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

Dec 23, 2015

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Page 1: 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

Page 2: 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

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

150 MILLION

Page 3: 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

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

171 MILLION

Page 4: 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

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

Page 5: 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

Burden of diabetes in 2007 (IDF Diabetes Atlas 2006)

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

~230 million

Page 6: 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

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

Page 7: 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

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

Page 8: 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

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]

Page 9: 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

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)

Source: WHO long-term strategy for prevention and control of leading chronic diseases© World Health Organization [2004]

Page 10: 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 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

Source: WHO long-term strategy for prevention and control of leading chronic diseases© World Health Organization [2004]

Page 11: 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

International Diabetes Federation (IDF)

• A natural ally and partner to WHO

• In official relations > 50 years

Page 12: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

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

Page 13: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Supported by the World Diabetes Foundation

Page 14: 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

Main aim…..

• To achieve a major increase in the awareness of the impact of diabetes in low and middle income countries

• To propose solutions

Page 15: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

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

Page 16: 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

Formulating messages and dispelling misconceptions …..

Page 17: 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

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……….

Page 18: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Risks are increasing

Page 19: 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

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

Page 20: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

The economic impact: billions

Page 21: 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

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

Page 22: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

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

Page 23: 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

Number of persons with diabetes in 2007 (millions)

050

100150200

Developing countries Developed countries

Diabetes Atlas, IDF (in print)

Page 24: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: double burden = double response

Page 25: 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

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

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

Page 26: 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

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%)

Page 27: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: chronic diseases are concentrated among the poor

Page 28: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: almost half in people under age 70 years

Page 29: 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

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

Diabetes Atlas, IDF (in print)

Page 30: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: chronic diseases affect men and women almost equally

Page 31: 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

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

Diabetes Atlas, IDF (in print)

Page 32: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: poor and children have limited choice

Page 33: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

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

Page 34: 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

• Upcoming WHO Technical Report:

Prevention of diabetes mellitus and its complications

Page 35: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: inexpensive and cost-effective interventions exist

Page 36: 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

• Diabetes chapter in the recent publication from the Disease Control Priorities Project

Page 37: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

Reality: these people are the rare exceptions

Page 38: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

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

Page 39: 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

In 2007 diabetes is estimated to cause…..

~3.5 million excess deaths globally

Diabetes Atlas, IDF (in print)

Page 40: 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

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)

Page 41: World Health Organization Department of Chronic Diseases and Health Promotion World Health Organization Gojka Roglic THE GLOBAL BURDEN OF DIABETES AND.

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.