Local anchoring is key

According to Dr Dejgaard, action is needed at the global, regional and local levels. Diabetes is a chronic, debilitating and costly disease, which threatens individuals, health systems and governments. He emphasises the importance of implementing national policies for effective diabetes prevention, treatment and care; developing awareness campaigns; and implementing sustainable diabetes programmes locally.

The last point is key. The WDF currently supports programmes in 117 developing countries, working with partners such as local diabetes associations, health authorities and NGOs. Many programmes are anchored in the Ministry of Health. As Dr Dejgaard notes, “it is critical that local anchoring is solid, so that project activities become sustainable in a given country when our financial support stops.”

With regard to awareness, WDF programme coordinator, Mr Jakob Sloth Yigen Madsen, says: increasing knowledge about the benefits of healthy lifestyle behaviours among people living in developing countries is crucial – but it is not enough. We also need to understand what drives and hinders certain behaviours. These drivers and barriers can be individual, sociocultural as well as structural.  

“It is essential to understand the target group and its surroundings, and design interventions accordingly. For example, schoolchildren and factory workers may have very different reasons for not exercising, as a result of differences in knowledge, socio-cultural frameworks and opportunities for physical activity,” he says.

When promoting healthy behaviours, we also need to assess whether these efforts work. Mr Madsen recommends collecting data about blood glucose levels, blood pressure and body mass index before and after such campaigns, to determine whether participants are in fact changing their behaviour to reduce their risk of diabetes.

 

Need for commitment

There are many hurdles. Lack of resources for health is probably one of the most significant global challenges in the coming decade, according to Dr Dejgaard. Yet the highest cause of mortality, morbidity and health care expenditure is chronic diseases – so preventing diabetes and its complications is highly cost-effective, and especially important in countries where resources are limited.

“There are opportunities for a positive outcome with preventive measures,” he says. “But we need high level commitment, involvement and a concerted effort by all stakeholders, including the patients, to make any sustainable impact.”