The close link between diabetes and poverty is triggering the rapid advancement of the disease in low and middle income populations of the world, Ala Alwan, Assistant Director-General, Non-Communicable Diseases and Mental Health, World Health Organisation (WHO), Geneva, said on Sunday.

Dr. Alwan, who was presented the IDRF Gold Medal Oration Award instituted by the India Diabetes Research Foundation (IDRF), said Non-Communicable Diseases (NCDs), including diabetes, had become the single biggest cause of mortality by accounting for 60 per cent of the 35 million deaths occurring globally every year.

It was estimated that 80 per cent of the deaths caused by NCDs were in the low and middle income countries, he said.

In the South East Asian region, NCDs accounted for 50 per cent of all deaths, and mapped by income levels, the mortality rates of diabetes and other NCDs was worse in the low income population.

Noting that rapidly changing disease profile in developing nations held serious implications for health and socio-economic development, Dr. Alwan identified ageing population, unplanned urbanisation and globalisation of unhealthy environments and behaviour as the three major drivers of this change.

Health systems in developing countries with an estimated 10 million deaths due to NCDs annually have been overwhelmed with costs of managing the NCD burden that had assumed proportions similar to that of communicable disorders, he said.

The WHO global strategy for NCDs laid down a framework for tobacco control, diet modifications, physical activity and health promotion, Dr. Alwan said.

Mike Nithavrianakis, British Deputy High Commissioner in Southern India, who presented the IDRF Gold Medal Oration Award to Dr. Alwan, said the U.K. Government was keen on having a second joint higher education and research initiative with India. The first such initiative was drawing to a close on a successful note later this year, he said.

T. Ramasami, Secretary, Science and Technology, who presented the Life Time Achievement Award to Anil Kapur, president, World Diabetes Foundation, Denmark, said a global consortium of researchers, involving India, would soon be launched to study alternative dietary modifications that can lower diabetes risk.

Lifestyle condition

He stressed the need for treating diabetes as a lifestyle condition and planning its management in the context of projections that India would lead the world in the proportion of diabetic population.

In his acceptance speech, Dr. Kapur noted that in several remote regions across the world, diabetes was seriously impacting on the lives of the poor who lacked awareness and resources to cope with the condition.

NCDs such as diabetes should be seen not as a clinical problem but as a public health issue requiring multi-sectoral intervention, he said.

A.K. Das, steering committee member, National Programmes for Control and Prevention of Diabetes, Cardiovascular Disease and Stroke (NPDCS), said the national programme aiming at early diagnosis and appropriate management was being expanded from pilot phase involving ten places to cover 20,000 sub-centres and 700 Community Health Centres.

A Union Cabinet-approved screening programme for diabetes and hypertension targeting 7 crore people in the first phase would be upgraded to a universal screening programme in the next five years, he said.

A. Ramachandran, IDRF president, said the low and middle income families were worst hit by diabetes. Surveys showed that the cost of caring for a diabetic member of the family in poor households had risen from 20 per cent a few years ago to almost 35 per cent of family income.

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