Some say that the world should prepare itself for the next pandemic, but I would argue that we are already in the next pandemic.
Non-communicable diseases, or NCDs — diseases that are not transmitted from person to person — are considered “silent killers”, with symptoms that are mostly irreversible generally only appearing when the disease is well established.
NCDs have emerged as a major global health challenge, affecting millions of individuals worldwide, and include diabetes, cardiovascular diseases, cancers and chronic lung diseases, with diabetes often the nexus between cardiac and metabolic disease, or cardiometabolic diseases, which present as a cluster of diseases.
Tuesday, 14 November, was World Diabetes Day and we should reflect on why it is necessary to dedicate a day to diabetes.
First, it draws global attention to the massive impact this particular NCD has on global healthcare systems, quality of life and economies.
Covid-19 taught us valuable lessons about the linkages between the disease burden and public health systems. The more we’re able to manage the rising tide of NCDs, the less likely these diseases will be to disrupt our lives, affect our societies and destroy our economies.
Second, World Diabetes Day allows us to reflect on the tremendous strides that have been made in diagnostic tools, monitoring devices and therapeutics/treatment, all of which have significantly improved the quality of life, mobility and mortality of type 1 and type 2 diabetes patients.
However, the only problem with this statement is that while it has improved lives across the world, access to diagnostic tools, monitoring devices and treatment interventions remains elusive for patients in resource-constrained communities. This is especially true for Africa’s estimated 24 million adults living with diabetes, with an alarming projection of it rising by 129% to 55 million by 2045 — which is why I believe that we are already in the midst of “the next” global pandemic.
And so, our challenge every World Diabetes Day should be increased accessibility for those in resource-constrained areas — with a particular focus on Africa — to the array of diabetes diagnostic tools, monitoring devices and treatment therapies.
To put this into context, the global prevalence of diabetes is around 6% — most of which is in Africa. While not all diabetes patients require insulin, of the estimated 24 million adults in Africa with diabetes, 2.2 million receive insulin, many of whom do not get the most advanced and convenient dosage forms of insulin.
This is concerning, not only because of the growth in diabetic mortality but also the fact that many people are not aware they have diabetes, and the already devastating consequences of the condition are exacerbated if diagnosed late in the day.
A recent report by Stats SA revealed the number of deaths in SA due to diabetes had increased by 36.5% over a decade — from 19,692 in 2008 to 26,880 in 2018.
Another valuable lesson from Covid was that Africa had very little of its own manufacturing capabilities and capacities, relegating our continent’s patients to the back of the queue when it came to personal protective equipment, vaccines and other medicines.
One of the most effective ways of enhancing access to vaccines and ensuring the security of supply, which ultimately saves lives and livelihoods, is to entrench our own capacities on the continent.
Aspen played a big part in ensuring that Africa developed the capacity and capability to manufacture, market and distribute its own vaccines, and now that project is under way, equal focus needs to be placed on the production of biologics/biosimilar medicines for NCDs, including diabetes and cancer.
During the height of the HIV pandemic, we saw the emergence of global funds, such as Pepfar and the Global Fund to Fight AIDS, Tuberculosis and Malaria. I believe it is high time that similar alacrity is shown for the establishment of an NCD fund.
In this month of commemorating World Diabetes Day, I urge you to check your diabetes status, because as with all illnesses and diseases, “Prevention is better than cure”. DM