GLOBAL PERSPECTIVES ON DIABETES Volume 57 – July 2012 The right environment f o ra l WORLD DIABETES DAY POSTER INSIDE Diabetes: protect our future www.worlddiabetesday.org Untitled-1 1 6/6/2012 2:27:39 PM Jamie Oliver starting a revolution 36 30 14 40 27 DiabetesVoice 33 CONTENTS DIABETES VIEWS 4 International Diabetes Federation Promoting diabetes care, prevention and a cure worldwide NEWS IN BRIEF 6 Diabetes Voice is published quarterly and is freely available online at www.diabetesvoice.org. THE GLOBAL CAMPAIGN This publication is also available in French and Spanish. Building capacity for care and prevention in Malawi 12 Timothy Ntambalika Editor-in-Chief: Stephanie A Amiel, UK Managing Editor: Olivier Jacqmain, [email protected] HEALTH DELIVERY Editor: Tim Nolan, [email protected] Advisory group: Pablo Aschner (Colombia), How to protect the children of the Food Revolution – Ruth Colagiuri (Australia), Patricia Fokumlah (Cameroon), Interview with Jamie Oliver 14 Attila József (Hungary), Viswanathan Mohan (India). Layout and printing: Luc Vandensteene, Ex Nihilo, Belgium, World Diabetes Day 2012 – expanding the circle of influence 17 www.exnihilo.be Isabella Platon Diabetes and climate change: two interconnected All correspondence and advertising enquiries should be addressed to the Managing Editor: global challenges 25 Katie Dain and Lucy Hadley International Diabetes Federation, Chaussée de La Hulpe 166, 1170 Brussels, Belgium Creating a network to tackle diabetes and Phone: +32-2-5431626 – Fax: +32-2-5385114 – [email protected] NCDs in Latin America 27 Noël Barengo and Ruby Trejo © International Diabetes Federation, 2012 – All rights reserved. CLINICAL CARE No part of this publication may be reproduced or transmitted in any form or by any means without the written prior permis- IDF breaking new ground – building BRIDGES around the world 30 sion of the International Diabetes Federation (IDF). Requests Ronan L’Heveder to reproduce or translate IDF publications should be addressed to the IDF Communications Unit, Chaussée de la Hulpe 166, 33 Exploring ethnicity in people with type 2 diabetes in Australia B-1170 Brussels, by fax +32-2-5385114, or by e-mail Margaret McGill and Stephen Twigg at [email protected]. DIABETES IN SOCIETY The information in this magazine is for information purposes only. Haiti fights for a brighter future 36 IDF makes no representations or warranties about the accuracy and Philippe Larco and Nancy Charles Larco reliability of any content in the magazine. Any opinions expressed are those of their authors, and do not necessarily represent the views of IDF. IDF shall not be liable for any loss or damage in connection Civil society facing down the diabetes emergency in Mali 40 with your use of this magazine. Through this magazine, you may Stephan Besançon and Sidibe Assa Traore link to third-party websites, which are not under IDF’s control. The inclusion of such links does not imply a recommendation or an endorsement by IDF of any material, information, products and services advertised on third-party websites, and IDF disclaims any liability with regard to your access of such linked websites and use of any products or services advertised there. While some information in Diabetes Voice is about medical issues, it is not medical advice and should not be construed as such. ISSN: 1437-4064 Cover photo : Jamie Oliver © Jamie Oliver July 2012 • Volume 57 • Issue 2 DiabetesVoice 3 DIABETES VIEWS At the recent Rio+20 sum- mit, the world leaders and experts came together to WIDENING IDF'S find effective solutions to the many deep fissures that are weakening the very fabric of human societal development – driven by the inexorable implosion of an inherently flawed and unjust financial FOOTPRINT system. Unfortunately, the event will change very little. During the first quarter of this year, we began to see the impact and The dismal results prove that there is still much work to be done results of the alliances and partnerships forged over the previous in changing the mentality of governments and decision-makers 12 months. We are seeing the increasing strength and influence worldwide. Diabetes is a real health issue with critical links to the of IDF’s Member Associations, amplified through global alliances environment and economic growth of countries. which underline our external focus. Diabetes is a complex condition – from its multi-pronged aetiology and relentless disease path to the multifaceted approach required to manage diabetes on a daily basis. Moreover, the world is waking up to the interplay between the multiplicities of interconnected external factors whose influ- ence is exacerbating the global rise in NCD numbers. In today’s world of intricately interwoven economies and globalized means of production and retail, diabetes appears to have found danger- ously fertile ground – particularly among poor and underserved people in low- and middle-income countries. Diabetes and other NCDs are stealthily engulfing even those communities that were previously considered low-risk. It is far from coincidence, then, that the launch of the World Diabetes Day 2012 campaign also aims to expand our circle of influence beyond the borders of diabetes, while remaining focused on our core disciplines, including the development, publication and distribution of clinical guidelines. We are all part of the solution to this diabetes epidemic. Therefore, we are convening the different stakeholders and catalyzing dialogue. Our aim is to change the way people think of diabetes on two levels. Our target audience is those who refuse to accept that diabetes is any of their business, those already affected and those at risk. We are engaging these groups by drawing the direct links between diabetes and global health issues. A good example is the climate change event at the recent World Health Assembly in Switzerland – a groundbreaking collabora- tion with a sector that is new to the all-of-society campaign be- ing mounted by IDF against the current pandemic of NCDs and diabetes. The private health company, Bupa, was IDF’s joint host at the expert dialogue on diabetes and climate, where health and climate sectors gathered to discuss how jointly to tackle these serious challenges. The event brought type 2 diabetes and climate change into the spotlight, as two of the most urgent challenges of the 21st century. Highlighted the connections between climate change and type 2 diabetes that are repeatedly overlooked in Jean Claude Mbanya is IDF President for global policy dialogue. the period 2009 to 2012. He is Professor A promising victory emerged from the 2011 UN High-Level of endocrinology at the University of Meeting on NCDs in New York: the target-25% by 2025. I would like Yaounde, Cameroon, and Chief of the to take this opportunity to acknowledge IDF Member Associations for their role in these achievements. However, we still have to fight Endocrinology and Metabolic Diseases for the other targets to be passed. Unit at the Hospital Central in Yaounde. 4 DiabetesVoice July 2012 • Volume 57 • Issue 2 DIABETES VIEWS Diabetes is, depress- ingly, coming of age – as has been forewarned incessantly in these PHOENIX RISING: pages over the past decade by a succession of IDF presidents, editors and expert authors. The paradox of the modern world offsets the potential benefits of globalization and rising prosperity (for some) with the personal and economic costs of the rising tide of diabetes A BETTER and other costly chronic diseases – adding to the con- stellation of other serious socioeconomic and health challenges facing the world. Geography, poverty, social re-structuring, under-developed infrastruc- FUTURE FOR ture and disruption by war and civil un- rest threaten the lives of people with type 1 DIABETES CARE? diabetes and feed the rising number of people with type 2 diabetes. end of a dangerously long queue for aid and life-sustaining medication. Although insulin is classified by the World Health Organization as Growing wealth in some sections of society bring about lifestyle an essential medicine, people with diabetes in Port au Prince faced change by revolution, not evolution, driving the diabetes pandemic agonizing periods without insulin in the aftermath of the earth- by mechanisms that remain unsuspected until after the event – and quakes that struck Haiti in 2010. We have recorded in earlier issues with unexpected side effects. In this issue, we learn that the obesity how civil society in Haiti, in the form of another small but highly pandemic now may be a threat to the very processes that created motivated diabetes NGO, the Haitian Foundation for Diabetes and it in the first place (like those obscure biochemistry formulae that Cardiovascular Diseases (FHADIMAC), strove to plug those gaps describe reactions that can go in either direction in textbooks with in care provision. An update from Haiti in this issue reports on the two arrows pointing in opposite ways) through a little-discussed situation in Haiti two years on. FHADIMAC has become a reference impact on climate change (page 25). But initiatives are underway of the government’s plans to tackle diabetes. From the ashes of failing that offer reason for optimism. healthcare systems, new and sustainable structures might arise to improve previous provisions of care for diabetes and beyond. Santé Diabète was created in Mali some 20 years ago as the first development-related NGO to focus on protecting people with dia- New initiatives look not just at treatment for existing diabetes but betes. It was a tiny outfit operating in a country facing multiple social also at its prevention. Noël Barengo’s article describes the develop- and economic difficulties, including an epidemic of HIV/AIDS. Two ment of a network for diabetes prevention under construction in decades later, with about half the population subsisting on USD 1.25 Latin America; IDF’s Bridges projects develop and test deceptively per day and multiple societal challenges – including political unrest simple interventions in both treatment and prevention.