This is a companion article to the feature, “Diabetes: In Search of Early Intervention.”
The first WHO Global Report on Diabetes underscores the enormous scale of the diabetes problem, and also the potential to reverse current trends.1 In its executive summary, the report itemizes key conclusions and recommendations.
According to WHO, the political basis for concerted action to address diabetes already exists, and is woven into the organization’s sustainable development goals, the United Nations political declaration on noncommunicable diseases (NCDs), and the WHO NCD global action plan. Where built upon, says the report, these foundations will catalyze action by all. The report recommends that countries take a series of actions in line with the objectives of the WHO NCD global action plan, 2013–2020, to reduce the impact of diabetes:
- Establish national mechanisms such as high-level multisectoral commissions to ensure political commitment, resource allocation, effective leadership, and advocacy for an integrated NCD response, with specific attention to diabetes.
- Build the capacity of ministries of health to exercise a strategic leadership role, engaging stakeholders across sectors and society. Set national targets and indicators to foster accountability. Ensure that national policies and plans addressing diabetes are fully costed and then funded and implemented.
- Prioritize actions to prevent people becoming overweight and obese, beginning before birth and in early childhood. Implement policies and programs to promote breastfeeding and the consumption of healthy foods and to discourage the consumption of unhealthy foods, such as sugary sodas. Create supportive built and social environments for physical activity. A combination of fiscal policies, legislation, changes to the environment and raising awareness of health risks works best for promoting healthier diets and physical activity at the necessary scale.
- Strengthen the health system response to NCDs, including diabetes, particularly at the primary-care level. Implement guidelines and protocols to improve diagnosis and management of diabetes in primary healthcare. Establish policies and programs to ensure equitable access to essential technologies for diagnosis and management. Make essential medicines such as human insulin available and affordable to all who need them.
- Address key gaps in the diabetes knowledge base. Outcome evaluations of innovative programs intended to change behavior are a particular need.
- Strengthen national capacity to collect, analyze, and use representative data on the burden and trends of diabetes and its key risk factors. Develop, maintain and strengthen a diabetes registry if feasible and sustainable.
There are no simple solutions for addressing diabetes, says the report, but coordinated, multicomponent intervention can make a significant difference. “Everyone can play a role in reducing the impact of all forms of diabetes. Governments, healthcare providers, people with diabetes, civil society, food producers, and manufacturers and suppliers of medicines and technology are all stakeholders. Collectively, they can make a significant contribution to halt the rise in diabetes and improve the lives of those living with the disease,” says the report.
- Global report on diabetes. Geneva, Switzerland: World Health Organization, 2016. Available at: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua=1. Accessed April 6, 2016.