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Non-communicable diseases, including diabetes, heart disease and cancers, cause 8 million premature deaths every year in low- and middle-income countries. The World Health Organization estimates that global deaths from these diseases will continue to rise over the next 10 years, with the African region expected to see the highest relative increase (27%). An increasing body of evidence shows that the human and financial impact of disease is undermining the achievement of the Millennium Development Goals. The omission of non-communicable disease indicators from the Millennium Development Goals has been a critical barrier to securing donor funding for non-communicable diseases. Ann Keeling describes the threat to development posed by noncommunicable diseases, and highlights some key achievements in the global campaign to tackle the growing pandemic.
The global community is waking up to the potentially calamitous impact across all regions of diabetes and other non-communicable diseases (NCDs). The numbers are alarming. In 2005, chronic diseases, including cardiovascular disease, diabetes and cancers, accounted for 60% of deaths worldwide and almost half of the global burden of disease. Today, cardiovascular disease is the world's number one cause of mortality: 17 million deaths each year. The number of people with diabetes is set to rise from the current 238 million to 440 million by 2030.
The recent Global Risks 2010 report issued by the World Economic Forum identifies chronic non-communicable diseases (NCDs) as one of the most important threats to the world’s agenda and a severe risk for global economic loss. NCDs, including diabetes, cardiovascular and respiratory diseases and cancer, are already extraordinarily costly to governments and the private sector, crowding out essential monies for needed government services and reducing profits.
The International Diabetes Federation (IDF) has led the global diabetes community for 60 years. Founded in Amsterdam, Holland, on 23 September 1950, IDF spent some years in London, UK, before setting up headquarters at its current location in Brussels, Belgium. It has developed into an umbrella organization of around 200 national diabetes associations, representing the interests of the increasing number of people with diabetes and those at risk. The Federation has grown up quickly and is now at the forefront of the fight to halt the epidemic of type 2 diabetes and other non-communicable diseases (NCDs).
In sub-Saharan Africa, infectious diseases still cause the majority (69%) of deaths; chronic non-communicable diseases such as cardiovascular disease, diabetes, chronic respiratory disease and cancers, contribute around 25%. But this picture is changing as sub-Saharan Africa undergoes an epidemiological transition with a rapidly increasing chronic non-communicable disease burden. The authors explore the relationships between tuberculosis and diabetes, HIV, its treatment and metabolic risk, look at some of the key issues surrounding these associations in sub-Saharan Africa, and describe the impact of globalization upon them.
In 1970, parents of children with type 1 diabetes in America organized what has become the Juvenile Diabetes Research Foundation (JDRF). The JDRF’s mission, then as now, has been constant: to find a cure for type 1 diabetes and its complications through the vehicle of research. JDRF has grown to be the world’s largest charitable funder and advocate for type 1 diabetes research. Although based in the USA, JDRF has always supported the best research in type 1 diabetes, wherever it may be. Concepcion Nierras and Robert Goldstein describe the structure and activities of JDRF and preview likely major developments in diabetes research in the near future.
In the three years since its inception and after two initial rounds of funding, the International Diabetes Federation’s BRIDGES programme has become one of the principal funding initiatives in diabetes worldwide. With the recent announcement of its third round of funding, BRIDGES has consolidated its position in the fast-developing and innovative sector of translational research. A new and related International Diabetes Federation initiative, D-START (Diabetes - Supporting TrAnslational Research Twinning), focuses on the implementation of translational research projects on the primary prevention of type 2 diabetes in low- and middleincome countries. D-START will bring together primary prevention leaders, committed groups from developing countries and their health authorities.
Globally, where the test is available, the measurement of haemoglobin A1c (HbA1c) has become central to the management of diabetes. By giving an objective assessment of glucose control over the preceding 2 to 3 months, it can guide treatment decisions in a way that single blood glucose measurements cannot. The authors describe efforts to standardize and improve the way HbA1c is reported, and explain the practical implications of the recent changes in the way the test is measured.
Hypoglycaemia at the wheel is the most common acute risk for drivers with diabetes, and a concern for public road safety. Drivers with diabetes worldwide are subject to special legislation, although the restrictions and requirements vary considerably from one country to another. But are drivers with diabetes really a danger? Are they more likely to provoke an accident than people without the condition? João Manuel Valente Nabais steers us through the related research and reports from Europe on the EU’s latest laws on driving with diabetes.
On 12 January 2010, a violent earthquake, measuring 7.0 on the Richter scale, rocked the Haitian capital, Port-au-Prince, and its surroundings. The exact number of victims remains unclear, but the Haitian Government has put the death toll at 230,000 people; 250,000 more were injured and more than 1.5 million reported homeless in the immediate aftermath of the disaster. The Haitian Foundation for Diabetes and Cardiovascular Diseases (FHADIMAC) launched a major campaign to help all people with diabetes and hypertension in the region. Nancy Larco and René Charles report from Port-au-Prince.