India's Public and Private Sectors Should Unite to Address Diabetes Epidemic

Central and state governments as well as private industry and universities are among some of the groups that should unite to enact policy changes addressing India's growing diabetes epidemic, say leading U.S. and global diabetes researchers.

The researchers include Karen Siegel, MPH, a research associate at MATRIX Public Health Solutions, Inc., K. M. Venkat Narayan, MD, MSc, MBA, of Emory University's Rollins School of Public Health, and Sanjay Kinra of the London School of Hygiene and Tropical Medicine in the United Kingdom. Their recommendations for diabetes prevention and control policies in India are published in the July 8, 2008 issue of Health Affairs.

"Diabetes is part of a larger global epidemic of noncommunicable diseases," says Narayan. "Because these diseases share many risk factors, policies that encourage healthy eating and active living will prevent not only diabetes, but also obesity, cardiovascular disease, chronic respiratory illnesses and diet-related cancers. An integrated system can maximize disease prevention while avoiding the need to develop separate courses of action."

India is currently home to 35 million people with diabetes, a number that is expected to double by the year 2025. This places a large burden on India's health system, and threatens to cripple the country's rapidly growing economy. The World Health Organization estimates that India will lose $237 billion in national income due to diabetes, stroke and heart disease.

Siegel, lead author of the paper, adds, "Economic growth policies aimed at transforming India into a developed nation by 2030 are contributing to escalating diabetes rates that threaten to cripple the rapidly emerging economy. Research shows that diabetes is preventable through physical activity and healthy eating, but current conditions in India promote sedentary lifestyles and unhealthy eating.

"Updated policies and comprehensive action to address diabetes are needed to incorporate health as a national priority, and to encourage healthy lifestyles as well as economic growth," says Siegel.

Among the policy recommendations proposed by Siegel and Narayan are comprehensive, multisectoral national actions that address diabetes risk factors.

Players, they say, should include central/state governments, multilateral organizations, private sector, nongovernmental organizations, academics and researchers, public-private partnerships, health care sector and the media.

Siegel and Narayan also recommend "best buys" for diabetes prevention and treatment based on impact, cost and effectiveness, including:

• Working with the private sector to encourage investments in employee health Promoting physical activity, especially active transport
• Modifying agricultural policies and practices to encourage consumption of fruits and vegetables
• Creating research and development policies that focus on innovative ways to deliver affordable fruits and vegetables on a mass scale
• Spearheading national efforts to reduce salt, fat and sugar in processed foods
• Building capacity in public health schools, medical schools and other institutions