TAKING ACTION: DIABETES POLICY AND HEALTHCARE RESPONSE
System-level changes are an important part of the response to the increasing diabetes burden. This means improving the way that diabetes is planned for at a national level, improving the political and organizational environment within which diabetes care is provided and establishing standards for reporting that help us to monitor progress.
Previous sections have shown the magnitude of the burden of diabetes, and summarized what we know about the prevention and management of diabetes. The prevalence of diabetes is increasing globally, as are the economic costs both to countries and individuals. There is increasing evidence that prevention strategies do work to prevent type 2 diabetes, and that education of healthcare workers and people with diabetes needs to play a key role in improving outcomes. These efforts are most likely to be effective if undertaken within a comprehensive framework that includes society, the health system and a supportive policy environment.
This section examines aspects of the response of policy-makers and health systems. The macro level of the World Health Organization’s Innovative Care for Chronic Conditions Framework 1 provides guidance to governments regarding the content of health systems for diabetes care. National Diabetes Programmes are an important method of providing a co-ordinated and supportive policy and financial environment and the existence and content of national diabetes programmes can be seen as indicators of national commitment to preventing diabetes and caring for people with diabetes. The status and content of national diabetes programmes as reported by IDF member associations are presented here.
This section also builds on the issues of access to insulin covered in the third edition of the IDF Diabetes Atlas 2 and examines the broader picture of what is needed to provide care for people who require insulin. Results from assessments conducted in a number of low-income countries show that simply making affordable insulin available is not sufficient and that other factors, many outside of the health sector, such as the policy environment, have a major impact on the quality of care for people with diabetes who require insulin.
Finally this section reviews the medical literature on global efforts to monitor the quality of diabetes care and identifies issues that inhibit the most basic monitoring at a global level. These issues appear to be relatively simple to solve and yet have so far proven to be intractable.
The reports in this section demonstrate that at the level of policy and healthcare systems action is being taken to improve care for people with diabetes; however, they also show that there is considerable room for improvement.
1: Jordan EJE, Pruitt SD, Bengoa R, et al. Improving the quality of health care for chronic conditions. Quality and Safety in Health Care 2004; 13 (4): 299-305.
2: International Diabetes Federation. The Diabetes Atlas. Third Edition. Brussels: International Diabetes Federation; 2006.