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Message from the WHO Regional Director for Africa, Dr Matshidiso Moeti
The international community commemorates World Diabetes Day on 14 November every year, to raise awareness of the growing burden of this disease, and strategies to prevent and manage the threat.
This year’s theme is again “Access to diabetes care”, as it was last year, and will be again in 2023, highlighting the importance of prevention and response efforts.
Africa’s diabetes statistics illustrate the depth of the challenge: 24 million adults are currently living with diabetes, with that number predicted to swell by 129% to 55 million by 2045. Last year, Diabetes mellitus took the lives of 416 000 people on the continent, and is forecast to become one of the leading causes of death in Africa by 2030.
Importantly, diabetes is the only major noncommunicable disease (NCD) for which the risk of dying early is increasing, rather than decreasing.
Known risk factors include family history and increasing age, along with modifiable risk factors such as overweight and obesity, sedentary lifestyles, unhealthy diets, smoking and alcohol abuse. Unfortunately, these modifiable risk factors are on the rise across all countries in the WHO African Region.
Response efforts are constrained by the fact that more than one in every two people in Africa living with Diabetes mellitus have never been diagnosed. Increased access to diagnostic tools and medicines, particularly insulin, is one of the most urgent areas of work.
Left unchecked, and without management and lifestyle changes, diabetes can lead to several debilitating complications. These include heart attack, stroke, kidney failure, lower limb amputation, visual impairment, blindness, and nerve damage. People with diabetes are also at higher risk for severe COVID-19 symptoms.
To accelerate progress on diabetes and other NCDs, WHO developed the Global Diabetes Compact. Its vision is to reduce the negative impacts of the disease, and ensure that everyone living with diabetes has access to equitable, comprehensive, affordable, and quality treatment and care.
During the 75th World Health Assembly in May this year, WHO Member States supported the creation of the first global targets for diabetes by 2030, as part of recommendations to strengthen and monitor diabetes responses within national NCD programmes. These include that 80% of people living with diabetes will be diagnosed, and have good control of their glycaemic levels and blood pressure; 60% of those older than 40 will be receiving treatment with statins; and 100% of people with Type 1 diabetes will have access to affordable insulin and blood glucose self-monitoring.
At the 72nd WHO Regional Committee for Africa in August 2022, efforts to improve services to prevent and manage diabetes care, and achieve Universal Health Coverage, saw Ministers of Health from the continent adopt the PEN-Plus regional strategy. This is focused on integrating outpatient care for severe and chronic NCDs at first-referral level health facilities.
As such, the strategy calls for the strengthening of capacity at these facilities to diagnose and manage Type 1 diabetes, and other severe NCDs. Its implementation will reduce the number of deaths, and improve the quality of life of Africa’s children living with Type 1 diabetes.
Today, as we mark World Diabetes Day, I want to take this opportunity to appeal to governments of Member States to prioritise investment in essential products, such as insulin, glucometers and test strips. This is critical to ensure equitable accessibility for everyone living with diabetes, no matter where on the continent they are.
As WHO in the African Region, we commit our full support to the requisite training of health workers in the prevention and management of NCDs at district and community level, to improve availability of these services.
I would also like to urge African governments to adopt and customise the global targets for diabetes, as part of recommendations to strengthen and monitor diabetes responses within their national NCD programmes.
To Africa’s people, I cannot overemphasise the importance of healthy and balanced diets, combined with regular exercise, not smoking, maintaining a healthy weight, and limiting alcohol consumption. This will go a long way to protecting individuals from Type 2 diabetes and other NCDs.
Finally, to our partners, let’s join forces to support African governments to accelerate the implementation of WHO’s Package of Essential Noncommunicable (PEN) disease and healthy lifestyle interventions, and PEN-Plus, and to improve access to diabetes care across the continent.
Let’s all unite and do our part to prevent unnecessary suffering, and save lives.
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Lusaka — African health ministers and partners are calling for increased investment in integrated health services to address the growing burden of severe noncommunicable diseases (NCDs), particularly those affecting women and underserved populations across the region. At a high-level side event during the Seventy-fifth session of the WHO Regional Committee for Africa, delegates emphasized the urgent need for equitable access to prevention, screening, treatment, and rehabilitation across the continuum of care for NCDs. Disparities are especially pronounced in rural areas, where health infrastructure and services remain inadequate. Breast and cervical cancers are among the leading causes of cancer-related deaths among women in sub-Saharan Africa—particularly cervical cancer, which is both preventable and treatable. It remains the most common cause of cancer death for women in the region. In 2022, Africa accounted for nearly a quarter (23%) of the 76 000 global cervical cancer deaths. Meanwhile, severe NCDs such as Type 1 diabetes, sickle cell disease, and heart conditions claim more than half a million lives annually, including among children, adolescents, and young adults in some of the continent’s poorest communities. Inequitable access to health services continues to hinder efforts to reduce this burden. To improve cervical and breast cancer care in the region, urgent investment is needed in leadership, governance, and financing. Strengthening these foundations is critical in the current funding landscape. Advancements in strategic planning, healthcare infrastructure, workforce training, and—most importantly—equitable access to screening, diagnostic, and treatment services are essential. To address these challenges, WHO and its partners showcased successful integrated models such as the Women’s Integrated Care for Cancer Services (WICS), the BEAT Breast Cancer Project, and the PEN-Plus Strategy. WICS strengthens early detection, treatment, and integration of women’s cancer services into primary health care systems in Côte d’Ivoire, Kenya, and Zimbabwe. The BEAT Breast Cancer Project is a transformative multi-year initiative aimed at reducing breast cancer mortality among women in Tanzania and Ghana through early detection, timely diagnosis, and comprehensive treatment access. “PEN-Plus, WICS and the BEAT Breast Cancer Initiative are models for a new standard of care, rooted in equity, access and health justice. I urge countries to prioritize policies that embed these models into broader health system strengthening, said Dr Mohamed Janabi, WHO Regional Director for Africa”. Côte d’Ivoire offers a compelling example of progress, combining high HPV vaccination coverage—reaching over three million girls (91.4%)—with WICS-supported community-based screening campaigns to strengthen cervical cancer prevention. In Kenya, cervical cancer screening has been successfully integrated into national health services. “This gathering marks a pivotal moment to accelerate action for breast cancer prevention in Africa. We deeply value the leadership of the Ministries of Health of Ghana and Tanzania, and the steadfast support of the Pfizer Foundation in helping us achieve this milestone. The side event builds momentum for the policy prioritization of women’s cancers, partnerships to strengthen the broader women’s cancer ecosystem, and advance a health-systems approach to breast cancer prevention and management”, said Dr Somesh Kumar, Senior Director, Jhpiego. PEN-Plus expands access to care for severe NCDs at the district hospital level. Since its implementation, 20 countries in Africa have increased access to services for severe NCDs. Over 15 000 people are currently receiving treatment for chronic conditions such as sickle cell disease and Type 1 diabetes through PEN-Plus clinics.
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