In responding to diabetes epidemic, U.S. too slow

If an epidemic disease were killing more people than AIDS each year, would we notice? If over 170 million people in the developing world were crippled by illness, would we care? If we knew of cost-saving interventions that could avert death for these millions of people, would we act?

Diabetes is the disease that I’m referring to, and today it is the newest epidemic facing our world. Over the past 10 years, the prevalence of diabetes has more than doubled, and worldwide, one person dies from diabetes every 10 seconds. The impact is particularly felt in developing countries where millions are dying prematurely and where health systems are not prepared to cope with the costly burden of chronic diseases.

I highlight the parallels between diabetes and HIV/AIDS not only because of their surprising similarity but also because of the need to learn from the past before we are doomed to repeat it.

Just as at the beginning of the AIDS epidemic, many leaders are in a state of denial about diabetes. Twenty-five years ago, people said that AIDS was a “gay disease” linked to immoral lifestyles. Today, some people similarly believe that diabetes is a disease of affluence caused entirely by a lack of self control.

The fact is, however, that like AIDS, diabetes predominately affects low-income populations around the world and that many risk factors of the disease are outside ones individual control. Ignoring this epidemic like leaders did for AIDS will only put our world at greater risk.

When we act to prevent diabetes, it is important to act wisely. Just as we now know that abstinence-only education doesn’t work, we also know that simply telling people to eat healthy doesn’t work either. We need to make healthy choices easy choices and work to change the systems that have created the current epidemic.

When people do develop diabetes, it is also important to effectively manage the disease. Like HIV/AIDS, diabetes doesn’t kill people right away. Instead, if left unmanaged it slowly disables the entire body, leading to blindness, heart disease, kidney disease, amputation, depression, immune deficiency, and eventually death. We have the medication and treatment to reverse this disease, however, and just as the international community has mobilized to provide anti-retroviral therapy for AIDS, it is important to mobilize to provide insulin and oral hypoglycemic medication to diabetic patients in need.

Fortunately, the world is beginning to realize that the global diabetes epidemic demands attention. Nov. 1 has traditionally been the start of American Diabetes Month, but today it is the start of World Diabetes Month, in celebration of a new United Nations Resolution to make Nov. 14 World Diabetes Day. While there is much that the United States needs to do itself to confront the challenges of diabetes, it is also important that our nation steps up to the global challenge.

The United States is already a leader in research on diabetes prevention and treatment, but it is important that we share this expertise with the developing world. We must take a critical look at how our country’s farm subsidies are negatively impacting the health of other countries by facilitating the export of cheap, unhealthy food.

Most importantly, however, we must fund proven interventions to control diabetes. There is a reason why Bangladesh was the sponsoring country of the recent U.N. diabetes resolution – the high cost of diabetes care is overwhelming health systems in the developing world and threatening recent development gains. While about 80 percent of the burden of diabetes is expected to occur in the developing world, 80 percent of diabetes expenditures are currently spent in the developed world.

Unfortunately, international funding for diabetes prevention and control has been limited. Billions of dollars in international funding go to fight HIV/AIDS, but less then $2.9 million is dedicated to support all non-communicable diseases. We can do a better job. The International Diabetes Federation is now creating a new global fund to fight diabetes, and it is important for the United States to play a leading role in supporting this initiative.

The rationale for the United States to take a leading role in addressing diabetes is made even stronger by the fact that strategically important countries are affected. The Middle East, in particular, has one of the highest rates of diabetes in the world, and diabetes is increasing in countries like China, Mexico and Russia at a rapid rate. Helping these countries better control diabetes would not only curb the epidemic but also could improve America’s standing in key parts of the world.

In the end, we can’t wait. The world’s slow response to HIV/AIDS in its early years led policy makers to promise that such an epidemic would never happen again. Now that the diabetes epidemic exceeds HIV/AIDS in terms of its deadly reach, it’s time to act before history repeats itself.

Robert Nelb is a senior in Timothy Dwight College. His column runs on alternate Tuesdays.

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