Adrian M Sanders
Member of Parliament, House of Commons, London, UK
Address for correspondence: Mr Adrian M Sanders MP
House of Commons, London, SW1A 0AA, UK
Tel: +44 (0)20 7219 2390
E-mail: sandersa@parliament.uk
Br J Diabetes Vasc Dis 2014;14:35-37
http://dx.doi.org/10.15277/bjdvd.2014.007
Advances in science and technology, mainly during the 20th century, have facilitated extended survival amongst those for whom such ailments would previously have been a death sentence. Despite its increasing prevalence amongst people of all ages and its far-reaching ramifications, diabetes is in danger of being diluted in an ever increasing murky pool of long term conditions. The Melbourne Declaration on Diabetes, described herein by the first President of the Parliamentary Diabetes Global Network, aims to raise the profile of the condition and spur action to address the diabetes pandemic.
Key words: diabetes, Melbourne Declaration, pandemic, political
There is a great deal of cross-national communication among medical professionals, pharmaceutical companies, health ministers and patient groups but until now nothing for parliamentarians who can set the agenda, influence budgets and vote for policies.
For example, EURADIA facilitates cross fertilisation between healthcare professionals, researchers and industry. The St Vincent Declaration was an early European effort to bring together government health officials, patient organisations and diabetes experts to agree general goals and standards of diabetes care and ways to improve the lives of people with diabetes – setting 5 year targets, some being more realisable than others.1-3 Indeed in the first issue of this journal there is a copy of a letter from the Prime Minister of the day endorsing the 10 years of activity prompted by the 1989 Declaration.4 More recently the UN resolution (61/225) designating World Diabetes Day (14th November) as a UN day has furthered international recognition of the increasing prevalence and impact of diabetes.3
On 2nd December 2013 invited parliamentarians representing 50 countries attended the first PDGN meeting in Melbourne, Australia. At this meeting in the Victoria State Parliament building, MPs from across the globe reported on the state of diabetes care in their countries, discussed how to raise the profile of the condition and agreed and signed a declaration calling for urgent action to address the diabetes pandemic.5 It committed the signatories to work across parliaments to help prevent diabetes, ensure early diagnosis and improve the treatment of people with the condition (Box 1).
The PDGN, which is the first global network of parliamentarians for a specific medical condition, elected two Vice-Presidents, Dr Rachael Nyamai MP (Kenya) and Simon Busuttil MP (Malta) and myself as the first President. My background is as the Chairman of the United Kingdom All Party Parliamentary Group for Diabetes and Chariman of ExPAND. I have also lived with Type 1 diabetes for a quarter of a century. The PDGN will create a platform to raise the profile of diabetes within governments across the world. Through the communication of ideas and best practice and the encouragement of action within parliaments around the world, we can move towards the better allocation of resources and effort to prevent, diagnose and treat diabetes.
The urgency required cannot be over-stated given the rising tide of diabetes across all continents and countries rich and poor. Already the scale of the challenge threatens the healthcare budgets of most countries and the economies of many.
There are over 382 million people with diabetes, most of whom are aged between 40 and 59, and 80% of them live in low- and middle-income countries. All types of diabetes are on the increase, type 2 diabetes in particular: the number of people with diabetes will increase by 55% by 2035.6 An additional 21 million cases of hyperglycaemia in pregnancy are estimated to contribute to the global burden of diabetes: that is equivalent to 17% of live births to women in 2013 that had some form of high blood glucose in pregnancy.
In human as well as financial terms, the burden of diabetes is enormous, provoking 5.1 million deaths and taking up some 548 billion US dollars in health spending (11% of the total spent worldwide) in 2013.
The priority of the PDGN in its early years will be to build a coalition of advocates for action to tackle the pandemic at local, regional, national and trans-national level. The focus will be on raising the matter in parliaments and assemblies across the globe to spread better understanding and awareness of diabetes and the urgency with which it needs to be addressed.
From Bolivia to Scotland, several Parliaments and Assemblies have already endorsed or debated the Melbourne Declaration on Diabetes. Following the Melbourne Declaration a group of Parliamentarians has formed in the Russian Duma to advocate for diabetes, while in Europe a complementary initiative, the ExPAND Diabetes Toolkit, has just gone live that will greatly assist the aims of the declaration.7
The ExPAND Diabetes Policy Toolkit is a practical guide to help diabetes advocates challenge national governments to raise the profile of diabetes. It is the first comprehensive resource aimed specifically at helping MPs and other policy makers to shape and influence national policy to ensure we prepare our healthcare systems for the challenges of the 21st century.7
With input from parliamentarians, patient representatives and other opinion formers, the ExPAND toolkit provides a one-stop resource covering the economic case for investment, evidence of what works, and best practice from across Europe as well as practical steps for leading and developing new diabetes policies fit for purpose. Key topics include prevention, self-management, innovation and person-centered care. There are also dedicated chapters to care and treatment of children and older people.
The ExPAND toolkit is a resource to turn words into action.7
It is a great honour to be tasked with leading this unique group and I am grateful for the support and guidance of the International Diabetes Foundation through its President Sir Michael Hirst, his co-chair behind the initiative, former Australian Senator, Guy Barnett, and the global co-ordinator the Network has appointed, the Hon Judi Moylan. A formidable back-up to what I hope will become a positive force governments will not be able to ignore.
While the Melbourne Declaration on Diabetes is a clarion call for action across the world, we also need momentum to reach that tipping point where no one questions why the global pandemic of diabetes receives priority attention for resources to prevent, diagnose and treat the condition.
Conflict of interest None
Funding sources None
1. EURADIA. http://www.euradia.org/(Accessed March 2014)
2. Workshop Report. Diabetes care and research in Europe: the St Vincent Declaration. Diabet Med 1990;7:360. http://dx.doi.org/10.1111/j.1464-5491.1990.tb01405.x
3. Felton A-M, Hall MS. Diabetes – from St Vincent to Glasgow. Have we progressed in 20 years? Br J Diabetes Vasc Dis 2009;9:142-4. http://dx.doi.org/10.1177/1474651409341318
4. Keen H. Translating wish lists to blueprints: A National Service Framework for diabetes. Br J Diabetes Vasc Dis 2001;1:57-61. http://dx.doi.org/10.1177/14746514010010010901
5. The Melbourne Declaration on Diabetes https://www.idf.org/sites/default/files/Melbourne_Declaration.pdf (Accessed March 2014)
6. IDF Diabetes Atlas, 6th edn. International Diabetes Federation 2013. www.idf.org/diabetesatlas
7. The ExPAND Toolkit www.idf.org/sites/default/files/ExPandPolicyToolkitonDiabetes_0.pdf (Accessed February 2014)