East Africa is facing a health time bomb with diabetes having an increasing impact on people of working age, signalling a threat to the region’s economic development.

According to the 2013 Global Diabetes Scorecard, more than three quarters of the diabetes-related deaths that occurred in the region last year — that is more than 80,000 — were of adults aged between 20 and 60 years.

The scorecard notes that East African governments need to strengthen their existing health systems to improve health for people living with diabetes in order to prevent the projected almost twofold increase in the prevalence of the disease over the next two decades.

“Although the East African countries are beginning to make progress in responding to diabetes, they need to take a stronger strategic approach to diabetes,” notes the scorecard by the International Diabetes Federation.

Building on the United Nations Summit of 2011, global leaders have now signed up to an historic commitment to reduce premature deaths from diabetes and other non-communicable diseases (NCDs) by 25 per cent by 2025.

They have also agreed on a Global Action Plan designed to achieve a range of measurable targets on diabetes and NCDs, including halting the rise in diabetes and obesity as well as promises of action on prevention and care.

According to the report,  Kenya is taking some significant action across all areas of diabetes prevention including the quality of self-management education, efforts to raise awareness and the national diabetes programme, with services being devolved to bring them closer to people.

“However, the low level of diabetes-related health expenditures in Kenya has prevented a very small proportion (0.3 per cent) of diabetes-related deaths,” said the report.

Kenya has a fully implemented inter-ministry diabetes plan. An NCD plan exists but has not been implemented. A range of policies on nutrition exist: Those for saturated and trans fats have been fully implemented but those on the production of and access to healthy food, only partially.

Also, only 50 per cent of health costs are covered via cost-sharing in public hospitals and there is limited availability of self-management education.

Tanzania on the other hand is making some progress, especially on monitoring and surveillance. The government is responding to the diabetes challenge through the health system but the funding allocated does not meet the needs.

The low level of diabetes-related health expenditures has prevented a very small proportion (0.2 per cent) of deaths in the country.

Tanzania has partially implemented national diabetes and NCDs plans; the NCD Strategy developed in 2008 is now being revised. There are no policies in the country on nutrition and the regulation of marketing to children is in development.

The scorecard indicates that Uganda needs to make progress in a range of areas if it is to respond effectively to the challenge of diabetes.

Relevant experts and policy officers in the Ministry of Health have drafted an NCD plan that is awaiting to be debated in Parliament.

The low level of diabetes-related health expenditures has prevented a very small proportion (0.3 per cent) of diabetes related deaths.

A national diabetes plan plus a set of policies on nutrition, regulation of marketing and physical activity are also in development.

The health system provides a full range of diabetes care and prevention services – but not universally. Self-managed education is provided on a limited basis. Less than 50 per cent of the costs are covered, as the government’s health spending priority is communicable diseases.

Rwanda’s best performance is in policies relating to health systems and access, while other areas — especially monitoring and surveillance — are weak.
A range of activities and initiatives on NCDs have been developed, but an appropriate national policy is lacking.

“The government needs to make progress on relevant plans and ensure appropriate monitoring and surveillance,” notes the scorecard. “The low level of diabetes-related health expenditures has prevented a very small proportion (0.6 per cent) of diabetes related deaths.”

Policies exist to promote access to healthy food and physical activity but are only partially enforced. Regulations on marketing to children are in development.