16 November 2018

Nigeria: Diabetes and the Family

editorial

November 14, every year, is recognised by the international community as World Diabetes Day. In marking the day, campaigners against the deadly but preventable and treatable disease seek to generate, primarily, global awareness with focus on diabetes mellitus as it is believed that more than 400 million people live with it worldwide, and the prevalence is predicted to continue rising if current trends persist. It was the seventh leading cause of death in 2016.

The International Diabetes Federation (IDF), which coordinates all activities related to the event, is worried that the number of patients suffering from the non-communicable disease is rapidly increasing worldwide. And to emphasise the impact of the disease in the family, it chose an apt theme for 2018: The Family and Diabetes - diabetes concerns every family.

It is already known that the disease comes in different types and forms. Type 1 Diabetes is not preventable but can be managed with insulin injections. The programme for the campaign do last throughout the year. During that period, relevant topics are chosen to highlight the dimensions of the disease ranging from diabetes and human rights, lifestyle, obesity, diabetes in the disadvantaged and the vulnerable, and diabetes in children and adolescents.

Historically, World Diabetes Day, as an event to put on the world stage the urgency of plans, policies and programmes to combat the killer disease, was launched in 1991 by the IDF and the World Health Organisation (WHO) in response to the rapid rise of diabetes.

Impressively, the world keyed into this effort to save lives threatened by the disease and by 2016, the Day was being commemorated by over 230 IDF member associations in more than 160 countries and territories, as well as by other organisations, companies, healthcare professionals, politicians, celebrities, and people living with diabetes and their families. Activities include diabetes screening programmes, radio and television campaigns, sports events and others.

This year, WHO joins partners around the world to highlight the impact diabetes has on families and the role of family members in supporting prevention, early diagnosis and good management of diabetes. Diabetes is, without doubt, a major cause of premature death, blindness, kidney failure, heart attack, stroke and lower limb amputation.

The world body is concerned that besides the economic burden on the health-care system and national economy, diabetes can impose a large economic burden on people afflicted by it as well as their families in terms of higher out-of-pocket health-care payments and loss of family income associated with disability, premature death, and caring for disabled family members. Expenditure on medications and treatments are a major source of household expenditure on diabetes healthcare. This was the focus of the campaigners against the disease in Nigeria who used the occasion of the event to cry out over what is perceived as high import duty on medications.

This worrisome economic policy was adopted as a point of reference in the drive to ameliorate the impact of the disease in Nigeria because it was realised that complications of diabetes can be avoided or delayed with medication, regular screening and treatment. This process will be hampered if the cost of the medications becomes prohibitive on account of government policy which may not have been intended to have the undesired impact just observed.

Although diabetes can be managed with generic medicines, expenditure on the more expensive branded, patented medicines is increasing. Their price is in large disproportion with what is known about their health benefits. Because of the potential to incur catastrophic personal expenditures by people without financial protection, both patients and policy-makers need to be aware of the health impact which can be expected with their use. It is to achieve this that WHO issued guidelines on the selection of medicines for the control of blood glucose in which it recommended the use of generic medicines and human insulin.

WHO also, in response to growing concerns about the health and economic threat posed by diabetes, may have persuaded the United Nations Organisation (UNO) to make the Day an official UN day in 2006. The World Diabetes Day 2018 campaign is geared towards promoting universal health coverage for affordable and equitable access to diabetes management, including improving the knowledge and capacities of people with diabetes and their families to take charge of their own care, to reduce economic hardship in households which have few strategies for coping with the economic burden of diabetes.

This newspaper, therefore, joins the campaigners against diabetes in Nigeria in urging the government to review the Import Adjustment Tax which placed 20 per cent tax on imported medicaments. We appreciate the government's policy aim which was to discourage importation and encourage local manufacture of the drugs, but it is beginning to have the unintended effect on the poor and the vulnerable who need these drugs at all cost.

Nigeria

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