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

Having a hard time getting tech support help?

80 percent of India's Internet service went down Wednesday night. Turns out two cables snapped and poof, Internet doesn't exist of much of the Middle East. As I type, Egypt is still almost completely down. Yep, the article below says they're getting sporadic service at best.

As I'm sure most know, India is now handling a large portion of our tech support and other type calls. I recently had a HUGE problem with Amazon and could only talk to people who definitely weren't located on this hemisphere. Snotty attitudes, horrible follow-up, such poor service that I cancelled my account with Amazon. I'll pay a bit more for good service any old day and I'll do without if it means dealing with attitudes.

If I had known that India was down yesterday, I might have spent a portion of the day calling tech support, Amazon and a few others just to have the refreshing opportunity to talk with someone without an accent.

I have yet to talk to someone from India who talked to me like I was not a bug they wanted to flick off their shoulder. I KNOW there are some great people in India, I have a good friend who originally hails from there. Love her, she's great people. Had a couple of doctors from India some years back, no problems.

I think these companies just hire snippy people. Could be a factor of how much they're being paid, too. Somehow it's cheaper for Amazon and other companies to pay long distance phone bills and pay the people than it is to hire folks here in the good ol' USA.

Wonder how the outage is affecting the financial markets here, and in the Middle East and Asia?

Here's an irreverent thought that will probably have folks yelling at me... Cows are sacred in India. I bet you won't find McDonald's, Burger King or any other meat selling company outsourcing to India .

India works to resume Internet services
NEW DELHI - Bandwidth providers said they expected India's Internet service to be back to about 80 percent of its usual speed by the end of Friday, a day after Internet service across a swath of Asia and the Middle East was disrupted.
http://news.yahoo.com/s/ap/20080201/ap_on_hi_te/internet_outages

Hard lesson learned re: Amazon

My husband has surgery earlier this month and was still unable to be left alone for long periods of time. I have shopped on-line before, love having packages just show up on my front porch. When Greg's daughter-in-law sent a list for the grandkids with the suggestion that I shop on Amazon I thought it was a GREAT idea!

I popped over, found the things we wanted and ordered. Voila, done without any hassle. They guaranteed arrival before Christmas, we had 8 full days so there was a fudge factor allowance in case there was a glitch.

One of the books arrived on the 20th. Checked email and found a note saying that they'd split the shipment, the rest would arrive by the 24th. Cutting it close as that's Christmas Eve and that's when the grandkids were coming, but they promised.

On the 22nd I called as it hadn't arrived. On-line tracker showed only that the carrier had been notified to pick up. I was starting to do a mini-panic.

The person I talked to (from India I believe based on accent), was rather abrupt. He said they were getting a lot of calls and that my shipment was like everyone else's and it would arrive by Christmas. The carriers were very busy and they were not all scanning the items thus it was not showing on their tracker that it been picked up but it would arrive. Basically he said I was wasting his time calling. Frustrating as it seemed he didn't even bother to check anything, just spouted his standard lines.

Christmas eve day... no packages. But the mail was running behind, we saw trucks zipping up and down the road delivering packages and knew they worked late to make sure the packages arrived.

The kids came. The kids left. No Christmas presents from Amazon. The grandkids were so good about it (probably because the parents had warned them on the way over that their Christmas presents might not have made it to our doorstep). Disappointed but good. I was so frustrated. We must have sneaked outside 20 times to see if maybe the packages had been delivered.

What a rip. That is the last time I will order presents on-line from Amazon. I know that only allowing a week for delivery at Christmas is a risky proposition. However, I think if when I called their so-called help line someone should have done some cursory checking. It they had followed up, the presents would have been found and delivered. I used to manage an area where we dealt with similar situations. I am well aware of what COULD have been done.

I'm not giving up on ordering on-line. I just won't be shopping Amazon anymore. If it hadn't been for my recovering husband, I wouldn't have allowed Christmas to sneak up so quickly. I'll know in the future to shop earlier...

I sent Amazon an email, not yelling, not nasty, but definitely to the point, regarding the shipment. It's been 12 hours. I haven't heard back from them yet. They're going further and further in the dog house with me.