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Obesity and Diabetes - Emerging Major Health Care Challenges in the Eastern Mediterranean Region

According to the World Health Organization’s Regional Office for the Eastern Mediterranean (WHO EMRO), obesity poses an emerging global health care problem and is considered a major risk factor in the development of diabetes and cardiovascular disease.

Presently more than 16 million people are living with diabetes in the Eastern Mediterranean Region. A staggering number which is expected to rise to almost 43 million by the year 2025.

Today, more than 1.1 billion adults are overweight worldwide, and among them312 million are considered to be obese. In addition, the International Obesity Task Force estimates that at least 155 million children worldwide are overweight or obese.

Over the past 20 years, obesity rates have tripled in developing countries that have been adopting a Western lifestyle involving decreased physical activity and over consumption of cheap, energy-dense food 1. Haslam DW, James WP. Obesity, The Lancet 2005

Such lifestyle changes are also affecting children in these countries; the prevalence of overweight among them ranges from 10 to 25%, and the prevalence of obesity ranges from 2 to 10%. The Middle East, Pacific Islands, Southeast Asia, and China face the greatest threat. 1. Source; Haslam DW, James WP. Obesity, The Lancet 2005

About 18 million people die every year from cardiovascular disease - diabetes and hypertension being among the major predisposing factors. Statistics and early epidemiological studies in the Gulf States have shown that diabetes is taking an epidemic form and is a public health risk at national level. 1 Source; Haslam DW, James WP. Obesity, The Lancet 2005

The prevalence of diabetes has reached 25% in the Kingdom of Saudi Arabia, Sultanate of Oman and the Kingdom of Bahrain. A very high rate compared to that of other countries.

2. Source ;

It is estimated that today almost 80 % of the 246 million people with diabetes live in the developing countries 3.

Source; International Diabetes Federation Atlas 2006, Third Edition, Brussels

and according to the World Bank non communicable diseases (NCDs) will be the leading cause of death in low-income countries by 2015. 4.

Source; World Bank, Public Policy and the challenge of Chronic Non-communicable diseases 2007.

“Addressing this challenge will require policy makers to design and implement economic, health, and social policies to address the links between NCDs and poverty and to minimize the health and economic losses among the population for example through public health interventions and improved health care—and simultaneously prepare to address the health system and economic pressures that will arise from the increase in NCDs due to the aging of populations”, said Dr Akiko Maeda, World Bank Sector Manager for Health Nutrition and Population in the Middle East and North Africa Region.

The importance of a preventative approach is crucial in the developing world and especially in middle and low income countries in order to avoid the huge social and economic impact of the predicted diabetes pandemic. The need is particularly strong in societies undergoing rapid economic transition, e.g. India, China and the Eastern Mediterranean Region. It is estimated that the largest rise in the incidence of diabetes is likely to occur in economically-productive age groups (20 – 64 years of age).

Source; 5 Western Pacific Declaration on Diabetes. June 2000.

If predictions of diabetes prevalence for 2025 are correct, total healthcare expenditure on diabetes worldwide for that year will be between USD 213 billion and USD 396 billion. In some developing countries this will be as much as 40% of their total annual health care budget.

Source; 6 Diabetes Atlas, second edition, International Diabetes Federation Brussels, 2003.

"It is unacceptable that so much disability and death are caused by diabetes and its severe complications, when the solutions are clear and affordable. Small investments in prevention, awareness and care can improve the quality of life for individuals and bring about dramatic reductions in health-care costs and improvements in productivity”, explains Dr Anil Kapur, Managing Director of the World Diabetes Foundation.

Regional Conference will address the growing burden of diabetes.

Diabetes in the Eastern Mediterranean Region and the Gulf is in focus at a major health economics and diabetes conference organised by the Health Minister’s Council for the Cooperation Council States in collaboration with the Ministry of Health, Kingdom of Saudi Arabia, King Faisal Specialist Hospital and Research Center, World Health Organization’s Regional Office for the Eastern Mediterranean, Arab Gulf Programme for United Nations Development Organization, World Diabetes Foundation, and the World Bank.

The conference will take place in Riyadh from 3-5 November 2007 and will address all aspects of the economics of diabetes, including medical and social issues at international, regional and Gulf levels. In addition, the conference will involve key stakeholders in the management of diabetes and impart significance to their role in combating diabetes.

The ultimate goal of the conference will be to increase the knowledge of governmental officials, policy makers and others concerned with the economic aspects of diabetes. Finally, the Executive Board of the Health Ministers Council for Gulf Cooperation Council States (GCC), will present a joint statement on diabetes control; the “Riyadh Declaration” as a guiding framework to address the challenges of diabetes, particularly from the economic standpoint.

“We are pleased to welcome key stakeholders and experts not only from the Gulf region, but from across the globe to the Regional Conference on Diabetes and Economics that will focus on how effective and sustainable approaches can be taken in the Gulf region that will ensure good cost effective outcomes. The “Joint statement on diabetes control”, truly emphasises the dedication of Health Ministers in the Gulf region to control this epidemic, and take the necessary actions to help decrease the burden of diabetes and implement national strategies to reduce the risk factors and complications caused by the disease. We consider the joint statement a turning point in the fight against diabetes mellitus in the Gulf region and we all look forward to putting it into action”, said Dr Tawfik A M Khoja, Director General of the Executive Board, and Council of Health Ministers for GCC States.

The upcoming conference in Riyadh will be the first major diabetes event in the Eastern Mediterranean and Gulf region since the adoption of the United Nations Resolution on Diabetes which was adopted on Wednesday the 20th of December 2006 in New York. The Resolution emphasises that strengthening public health is critical to achieving internationally agreed development goals and it recognizes that diabetes is a chronic, debilitating and costly disease associated with severe complications, which poses severe risks for families, Member States and the entire world and serious challenges to the achievement of internationally agreed development goals including the Millennium Development Goals.

Jamal Butt | alfa
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