Pan European Networks - Horizon 2020 - page 184

H O R I Z O N 2 0 2 0 P R O J E C T S : P O R TA L
H E A L T H : D I S E A S E R E S E A R C H
This is undoubtedly positive, as national policy
frameworks are a prerequisite for effective
policy action and the delivery of high quality
diabetes care on the ground.
Following up effectively
Yet, implementation and evaluation appear to
be major weaknesses of these plans and
policies. The Czech Republic is the only country
in the EU that includes a strong monitoring and
evaluation system in its national plan for
diabetes. It is also the only country to assess
the cost effectiveness of the measures within
its plan. The same goes for prevention policies:
Greece is the only country that reports
monitoring and measuring the impact of its
prevention policies, as well as assessing their
cost effectiveness.
In the current context where politicians across
Europe repeatedly stress the need to reduce
health expenditure and make healthcare
systems more sustainable, it is alarming to see
that cost effectiveness analysis of policies is
almost absent.
Overall prevention also remains poorly
funded throughout the EU. This is a lost
opportunity, as over 70% of Type 2 diabetes
cases can be prevented or delayed by adopting
healthier lifestyles.
A new Commission
Within this context, the new European
Commission will be faced with many challenges
when it comes to tackling diabetes and chronic
diseases, as well as promoting and protecting
the health of EU citizens. In their quest to
reinstate jobs and growth, Jean-Claude
Juncker and his team of commissioners must
not forget that the health of their citizens is a
prerequisite to a productive workforce and
economic prosperity. During the next five years,
efforts need to focus on improving access to
quality diabetes care, reducing health
inequalities among EU member states and
is now undisputable that diabetes is a major public health
issue. According to the latest estimates, more than 52 million
people in Europe are living with diabetes; that is approximately
8% of the adult population in the region. By 2035, estimates indicate
that more than one in ten adults in Europe will be living with diabetes.
The condition takes a devastating toll on health, lives and healthcare
costs. At the end of 2014, a quarter of the total expenditure for diabetes
care worldwide – around €115bn – had been spent in Europe.
Type 2 diabetes is by far the most common form of diabetes, comprising
more than 90% of cases. It is often associated with unhealthy eating,
physical inactivity, obesity and being overweight. The disease usually
occurs in adults, but is increasingly seen in children and adolescents. Its
symptoms, which can include excessive urination, thirst, constant hunger
and fatigue, are usually less marked than for Type 1 diabetes. As a result,
the disease may not be diagnosed until several years after it has
appeared, when disabling complications including cardiovascular
disease, kidney failure and vision problems have already developed.
Worryingly, estimates show that one in three adults with diabetes in
Europe is undiagnosed. This means that many people already have at
least one complication by the time they are diagnosed. In addition, the
number of people with impaired glucose tolerance, or pre-diabetes, is
also on the rise. More and more EU citizens are therefore at high risk of
developing Type 2 diabetes.
Cause for concern
These trends, as well as the EU’s ageing population, present an alarming
scenario for healthcare systems across the region. Over the past decade,
ageing populations, obesity and sedentary lifestyles have been key drivers
of the diabetes epidemic – and of the chronic diseases epidemic as a
whole – in the EU. This issue shows no signs of abating, as by 2020
more than a quarter of Europeans will be over 60 years of age.
Tackling the diabetes epidemic will therefore require co-ordinated efforts
to develop and implement comprehensive policies to improve prevention
and early diagnosis, ensure access to quality diabetes care, but also
support research for finding new and more effective treatments.
At policy level, there is clearly a growing awareness of the need for action.
The Joint Action on Chronic Diseases, which has a dedicated work
package on diabetes, and the EU Summit on Chronic Diseases held in
April 2014 are evidence of the political commitment to act on diabetes.
This is echoed at national level, as more than half of EU countries have
a national plan covering the condition, and almost all of them have put
in place prevention policies on the major risk factors of diabetes, including
obesity and lack of physical activity.
Diabetes: the challenges ahead
João Manuel Valente Nabais,
president of the International Diabetes
Federation Europe, reflects on the present – and future – challenges around
diabetes in Europe
João Manuel
Valente Nabais
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