For the past two years, researchers in India have been undertaking an ambitious effort to count the number of people across the country suffering from diabetes. The importance of this initiative extends well beyond one chronic disease. The results will also illuminate the extent to which non-communicable diseases from heart disease to stroke to diabetes to cancer to chronic respiratory conditions are at the centre of public health and development problems worldwide. The Indian researchers recently released the first of their results: In the industry-heavy region of Maharashtra, a survey examining 4,000 people found that 8 per cent of the region's population suffers from the disease. Other regions had similar or higher percentages. According to the Times of India, 1.2 million people are now living with diabetes in Maharashtra. These numbers are simply staggering. And they're not unusual. According to a new report from the World Health Organisation (WHO) on non-communicable diseases, or NCDs, 36 million people died in 2008 from conditions such as heart disease, strokes, chronic lung diseases, cancers and diabetes. Nearly 80 per cent of these deaths occurred in low and middle-income countries. The economic impact is also devastating. The WHO estimates that national income losses due to NCDs may add up to $237 billion in India alone between 2005 and 2015. In addition, projected losses in China of $558 billion and in Russia of $303 billion, and suddenly NCDs have swept away a trillion dollars. NCDs also push millions of people below the poverty line every year. What can we do to turn the tide? There is no single solution. But what will work over time is a sustained and balanced approach that involves governments, international bodies, civil society and private companies. Collaborative efforts need to develop healthcare systems that emphasise better healthcare at all stages, from prevention to early diagnosis to treatment to long-term disease management. Government policies in areas as diverse as education, labour, transportation, environment and urban planning can have a major impact on fighting NCDs. Schools and workplaces can screen for NCDs and encourage healthy lifestyles. Cities and towns can encourage fitness and mobility, and improve access to care. Private sector companies stand ready to work with other stakeholders to develop innovative public health programmes. Take India's diabetes problem. The country accounts for nearly 20 per cent of the world's diabetes patients an estimated 50 million cases but is home to just 6,000 specialists trained to treat the disease. My company, Medtronic, is supporting the efforts of the Madras Diabetes Research Foundation in Chennai to develop a high-quality education system that will train the diabetologists, diabetes educators, ophthalmologists, podiatrists and other medical professionals the country needs. A different type of education effort is underway in China, where the WHO estimates that over 7 million people died from NCDs in 2004. Even residents of the biggest cities, with the greatest access to care, report that, on average, they have just a few minutes to consult with their doctors meaning few are adequately informed about available treatments. So in August of 2010, Medtronic, working in conjunction with the Chinese government and a leading Beijing hospital, opened the nation's first patient care centre, a facility located in Beijing where patients can get quality information about their conditions and medical technology therapies, and consult at length with experts. It's like Apple's Genius Bar but for medical education. New technologies and systems are being developed that leverage existing infrastructures. Maestros, an Indian company, is developing a mobile phone enabled system that allows for remote interpretation of heart patients' electrocardiograms. With mobile phone adoption surging across the globe and especially in lower- and middle-income countries it's an easy-to-use, accessible technology that can make a real difference in places where patients may not have adequate access to cardiac screening. These are just a few of the ways that partnerships between governments, private companies and healthcare providers can begin to produce better health outcomes. In September, the United Nations will convene the first-ever "High-Level Meeting" on non-communicable diseases. It will be a unique opportunity to raise public awareness of the scale of the problem globally, as well as to secure commitments from governments and other stakeholders for a coordinated global response. Partnerships can help ensure a balanced approach and increased access to care in emerging markets and hard-to-reach parts of the planet. They're a good beginning. In places like Maharashtra, more help can't come soon enough.
Butel is the Executive Vice President and Group President, International, at Medtronic.
