Diabetes is already a major public health problem in the developing world and regarded as a major cause of premature mortality and morbidity. It is amongst the leading causes of blindness, renal failure, heart attacks, strokes and limb amputations. Due to a compromised immune system, bacterial and fungal infections are also common and pose a health hazard for people with diabetes. Poor and disadvantaged people tend to be diagnosed later, have less access to treatment and consequently suffer more acute and late complications, limiting productivity and increasing economic burden. Effective intervention reduces the health and economic burden of diabetes. This requires focus on prevention – primary prevention – promoting healthy living, and secondary prevention - reducing the burden of complications by early diagnosis and proper care.
There is an urgent need for a multi-sectoral approach in which governments, non-governmental organizations (NGOs), the health industry, national associations, healthcare providers and people with diabetes can play a role in providing at least minimum standards of care that would help those affected maintain the best possible quality of life. This is precisely what the World Diabetes Foundation (WDF) is aiming for.
Developing sustainable solutions for diabetes care in the developing countries
The World Diabetes Foundation aims to address and potentially limit the diabetes epidemic by bringing diabetes higher on the global healthcare agenda as well as fund sustainable projects in awareness, primary prevention, building healthcare capacity, and improving access to diabetes care in the poorest countries. The World Diabetes Foundation acts as a catalyst to build sustainable relations between different stakeholders to ensure that individual project initiatives live on even after the specific project funding has ceased.
The World Diabetes Foundation focuses on the following areas:
• Awareness about diabetes
• Prevention of diabetes and its complications
• Education and training for people with diabetes and healthcare professionals
• Access to essential medicines in diabetes
• Detection, treatment and monitoring of diabetes
A catalytic partner It is very important to the World Diabetes Foundation that its funds are directed to people with the greatest burden and most need: namely for diabetes projects in the developing countries. The strategy is to act as a catalyst - help others do more - making a much greater impact than the Foundation’s size would suggest. The WDF seeks partnerships with established organizations in the areas of health, diabetes and development aid to build on existing structure and resources that help bring diabetes higher on the global healthcare agenda. Through these partnerships we aim to raise global awareness of diabetes and help find the resources to address and potentially limit the epidemic. WDF has established project-related partnerships with organizations such as the World Health Organization (WHO), International Diabetes Federation (IDF), Danish International Development Assistance (DANIDA), The Insulin Foundation, the German NGO Humanitäre CubaHilfe, the Spanish foundation Fundación para la Diabetes, local diabetes associations, the Ministries of Health in various countries, leading diabetes research institutions and WHO collaborating centres. WDF, established in 2002 through a commitment of 500 million Danish Kroner over ten years by Novo Nordisk A/S, is registered as an independent trust and governed by a board of six experts in the field of diabetes, access to health and development assistance. The Foundation is currently chaired by Professor Pierre Lefèbvre, who is also President of IDF. WDF raises funds from other sources to support specific projects ensuring a multiplier effect; for every dollar spent the Foundation is able to raise approximately three US dollars in cash or kind from other sources. The World Diabetes Foundation supports Diabetes Action Now, a global collaboration project between WHO and IDF. The initiative represents the major part of the future WHO diabetes programme. Working with WHO at a national level, we have launched a diabetes project in Vietnam. Based on a community approach to prevention, control and management of diabetes, the project aims to improve the quality of diabetes care in Vietnam. There are also a number of projects with IDF to build capacity and raise awareness of diabetes. One example is the Clinical Practice Guidelines in sub-Saharan Africa. The project aims to provide and promote standardized clinical guidelines for diabetes care to improve the quality of care given to people living with diabetes in Sub-Sahara Africa. The guidelines have been finalized and will soon be distributed and implemented throughout the region. The Memorandum of Understanding that was signed with DANIDA in 2002 materialized into collaboration on three projects. WDF currently supports 86 projects in the developing countries. The projects funded by the Foundation will in the coming 3-4 years directly influence the diabetes treatment, awareness and advocacy of potentially 35,840,000 people in the developing countries
Follow up to ensure success The World Diabetes Foundation has developed a number of general procedures for monitoring and evaluating the projects. The monitoring process is now organized into a system, which determines the need for precise monitoring activities for each individual project done on the basis of assessment of the project’s size, complexity and duration. It is important for us to have realistic expectations regarding the results and outcome of the projects. Experience shows that not all projects will fare as planned and hoped for - not out of ill will, but often due to factors beyond the control of project management and WDF. These factors include - but are not limited to - the political and personal commitment to the activities, transfer of trained staff, changes in policy or unrest in the country in question. These and other such factors will affect and hamper implementation and sustainability of our projects despite our comprehensive efforts to pre-qualify projects before granting support. In order to minimize chances of failure and maximize the likelihood of success and sustainability, we ensure strong local commitment to the activities; we work with highly competent organizations and project leaders; we focus on close dialogue in our partnerships.