What can Arab governments do to take on the region's biggest health crisis?
- In the Middle East, diabetes is the leading health care challenge facing the region - 1 in 10 adults live with diabetes
- Arab countries must enhance awareness and prevention programs that promote healthy eating and physical exercise as well as awareness of risk factors
The World Government Summit hosted annually in Dubai is emerging as a key forum to define the agenda for the next generation of governments. Tahseen Consulting is honored to have contributed its thoughts on how Arab governments can innovate to solve some of the most significant challenges facing the region.
In the following interview, Tahseen Consulting’s Chief operating Officer, Wes Schwalje, spoke with representatives from the World Government Summit regarding his thoughts on how the Arab governments are tackling the regional diabetes epidemic.
World Government Summit: What are the prevention strategies for diabetes in the Middle East?
Schwalje: According to the International Diabetes Federation, more than 400 million adults have diabetes worldwide, and 642 million adults will have diabetes by 2040. In the Middle East, diabetes is the leading health care challenge facing the region.
With 1 in 10 adults living with diabetes, the Middle East has the highest diabetes prevalence globally.
Today, over 36 million adults in the region are living with diabetes. By 2040, the number of adults with diabetes is expected to increase to over 72 million adults, which some experts estimate will represent a quarter of the Middle East’s population. Six countries in the Middle East, Bahrain, Egypt, Kuwait, Oman, Saudi Arabia and the United Arab Emirates, have amongst the world’s ten highest prevalence rates for both diabetes and impaired glucose tolerance, which often leads to diabetes.
Many of the diabetes sufferers in the region have not been diagnosed and are at higher risk of developing harmful and costly complications. Without intervention, diabetes has the potential to lead to significant socio-economic challenges that will affect individuals, families, businesses, and society as a whole. Several of countries in the Middle East have established comprehensive national diabetes awareness, prevention, and control programs. These strategies involve multi-stakeholder collaboration between public health agencies, social sector organizations, and the private sector to promote public education about diabetes and its risk factors, early detection through screening, prevention of onset through lifestyle modification, and support for disease management to avoid future complications.
World Government Summit: Are they being implemented efficiently? Are they working?
Schwalje: Although 9% of the world’s diabetes sufferers live in the Middle East, regional governments spend only 2.5% of the world’s healthcare diabetes budget. In 2015 the Middle East spent $17 billion on treating diabetes, which is approximately 15% of the total health care budget in the region.
Regional spending on diabetes treatment is expected to surge to $31 billion by 2040. However, regional spending on treating diabetes is far less than in other countries.
However, regional spending on treating diabetes is far less than in other countries. A key risk if budgets for diabetes treatment are not increased will be the inability to adequately treat all people with the disease. There is evidence in some countries that national prevention strategies are working For example, diabetes prevalence rates in the United Arab Emirates declined by 5.5% from 2003 to 2015. From 2003 to 2015, 7 of the 22 countries in the Arab World reduced their diabetes prevalence. The other remaining Arab countries saw increases in diabetes prevalence rates. For example, diabetes prevalence rates in Egypt, Lebanon, Libya, and Djibouti increased by 5% from 2003 to 2015. In terms of preventing diabetes in the region, national prevention strategies have a mixed track record of success. However, the case of the UAE is a notable exception which might represent a good practice for other Arab countries to follow.
| Country | Prevalence 2015 | Prevalence 2003 | Change |
|---|---|---|---|
| Algeria | 6.8 | 4.1 | 2.7 |
| Bahrain | 15.6 | 14.9 | 0.7 |
| Egypt | 14.9 | 9.8 | 5.1 |
| Iraq | 7.2 | 7.7 | -0.5 |
| Jordan | 9.1 | 7 | 2.1 |
| Kuwait | 14.3 | 12.8 | 1.5 |
| Lebanon | 12.2 | 6.4 | 5.8 |
| Libya | 9.2 | 3.7 | 5.5 |
| Morocco | 7.7 | 4.2 | 3.5 |
| Oman | 9.9 | 7.4 | 2.5 |
| Qatar | 13.5 | 8.5 | 5 |
| Saudi Arabia | 17.6 | 16 | 1.6 |
| State of Palestine | 6.5 | 9.4 | -2.9 |
| Sudan | 7.7 | 3.1 | 4.6 |
| Syrian Arab Republic | 7 | 6.2 | 0.8 |
| Tunisia | 9.5 | 4.6 | 4.9 |
| United Arab Emirates | 14.6 | 20.1 | -5.5 |
| Yemen | 3.8 | 7.7 | -3.9 |
| Comoros | 7.5 | 7.7 | -0.2 |
| Mauritania | 2 | 2.3 | -0.3 |
| Djibouti | 7.4 | 2.1 | 5.3 |
| Somalia | 4.4 | 7.3 | -2.9 |
Source: International Diabetes Federation Diabetes Atlas
World Government Summit: What level of intervention do we need?
Schwalje: There are some success stories of national diabetes prevention strategies from the region. However, as evidenced by comparatively low levels of spending on diabetes treatment relative to other regions, more can be done. This will involve implementing the following measures:
- Increasing awareness of the key lifestyle risks, such as sedentary lifestyle, poor nutrition, and lack of physical exercise, which can lead to diabetes
- Enhanced programs that enable early diagnosis of diabetes cases so that individuals can be treated quickly as soon as it is detected to avoid complications and costly burdens on national healthcare systems
- More information and education for people with diabetes on how to manage the condition effectively and increase treatment compliance
- More community support for people with diabetes
- Enhanced physician training to help medical professionals with diagnosis and providing effective treatment
World Government Summit: What are the biggest barriers to diabetes prevention?
Schwalje: A recent survey on the delivery of diabetes care in the Middle East showed that the most important barriers to optimal diabetes care remain unhealthy lifestyles, lack of education about risk factors, and poor diet. These findings point towards the need for Arab countries to enhance awareness and prevention programs that promote healthy eating and physical exercise as well as awareness of risk factors.
World Government Summit: What are the consequences of not stemming the diabetes tide?
Schwalje: Diabetes caused 342,000 deaths in 2015, and over half of those deaths were in people under the age of 60. The cost of specialized medical services for treating diabetes in Arab countries is leading to a significant increase in the portion of government healthcare budgets required for treatment. Diabetes is a chronic condition that can lead to serious complications if not detected and treated. The high level of undiagnosed and poorly controlled cases of diabetes in the region further increases the costs associated with treating diabetes in the region.
Throughout the region, the struggle with diabetes has significant economic costs that, if gone unchecked, can have implications on the quality of other government services by claiming vital funds that would have been used for other social services spending.
Diabetes also has a tremendous emotional impact upon families who lose loved ones too early. The economic and social impacts of early mortality, which have not been systematically assessed in the region, should not be underestimated.
