Diabetes diagnosis has been difficult in Africa so far; situation will change by 2030 though: WHO

Timely diagnosis of diabetes is vital for efficient management and possibly a reversal of the widespread health condition. However, many developing countries lack the infrastructure or the awareness to diagnose diabetes. In Africa, merely 46 per cent of diabetic people were diagnosed in 2023. But the situation is about to change. 

The World Health Organization (WHO) has stated that by 2030, the percentage of diabetics getting diagnosed in its 47 member countries in Africa will rise to 80 per cent.  The WHO has committed to this target in its public document titled ‘Framework for Implementation of the Global Diabetes Compact In the Who African Region’. 

This is one of the targets proposed in the 16-page regional framework submitted at the 74th session of the WHO Regional Committee for Africa in Republic of Congo’s capital city of Brazzaville. 

It is significant for the African region that faces heightened vulnerability due to health system limitations, insufficient health literacy, and significant social, cultural, and economic barriers, which exacerbate the diabetes burden and hinder access to prevention and control services. 

As a result, the African region is estimated to have the highest proportion of undiagnosed diabetes cases.

In response, WHO launched the Global Diabetes Compact (GDC) in 2021, aimed at reducing diabetes risk and ensuring equitable, comprehensive, affordable, and quality treatment and care for all diagnosed individuals. 

The regional framework underscores the need for regular monitoring, evaluation, and adaptability for sustained progress, and has set number of targets and milestones for achievement by 2030. 

Curbing unhealthy food and beverages

Another milestone proposed by 2030 for the WHO African region is to restrict unregulated marketing of unhealthy foods and beverages to children.

“By 2030, 90 per cent of member States should adapt and implement policies to achieve a 20% reduction in the sugar, salt, and unhealthy fat content of processed foods through industry reformulation. All member states should adopt policies to integrate comprehensive nutritional and physical education programmes in schools and major workplaces,” the framework document stated. 

Such targets proposed in the document are significant when diabetes presents a serious risk to achieving UN Sustainable Development Goal target 3.4  to reduce premature mortality from NCDs by one third.

Thirteen years after the Brazzaville Declaration on non-communicable diseases in 2011, NDCs remain a low priority in many WHO Africa member countries. Political commitment to addressing NCDs is weak, often overshadowed by the focus on infectious diseases.

The framework proposes collaboration between governments, WHO, and the food process industries, for creating an environment conducive to healthy eating, significantly contributing to the reduction of diabetes incidence and the promotion of overall public health.

The new WHO Framework for diabetes in the African Region is grounded in universal health coverage and equity, ensuring that all individuals with diabetes have access to essential care, regardless of demographics. It underscores the critical need for tailored, cost-effective programmes to prevent and control diabetes.

Host of measures to ensure a healthy Africa

The priority interventions and actions in the framework  include developing diabetes programs, strengthening healthcare capacity, integrating diabetes services into primary care and other critical health initiatives, improving access to essential medications like insulin, fostering partnerships and advocacy, securing resources, and conducting rigorous monitoring, evaluation, and operational research. 

Each member nation should allocate a specific budget for diabetes within the health care sector suggests the document presented to the Regional Committee.

The framework emphasises evidence-based practices, financial protection, and adherence to human rights, ensuring culturally sensitive, cost-effective interventions to safeguard individuals and families from the financial burden of diabetes care.

The proposals in the document are significant as the national plans to prevent and control diabetes are in place in 32 WHO African member nations, but most remain unfunded and unimplemented. 

Africa ranks second lowest in diabetes-related expenditure globally, with just $13 billion, or one per cent of global spending.  Insulin is a crucial medicine for treating and managing type-1 diabetes and type-2 diabetes but the access to insulin in public health facilities across the region is limited, with availability ranging from 18 per cent to 45 per cent. 

Insulin prices also vary widely, and only one in three people with type 2 diabetes can obtain the insulin they need. For some, it can take up to 15 days’ wages to afford a single vial, said the document citing a research paper on availability and affordability of insulin in 13 low-income and middle-income countries which included — Ethiopia, Ghana, Kenya, Mali and Uganda. 

So, acknowledging the need to prioritise support for vulnerable populations, it emphasises the importance of providing equitable, comprehensive, and high-quality care, including access to essential medicines like insulin. 

Additionally, the framework advocates for the integration of diabetes management into tuberculosis (TB) services, ensuring a holistic approach to care.