The cost of preventing and treating diabetes and related chronic diseases may be high, but the cost of neglecting them will be vastly higher. That was the judgment of a two day meeting held last week in Oxford's Magdalen College. But more impressive than this predictable conclusion was the determination of participants to act on it. So too was their optimism.
Oxford Vision 2020 is a collaboration between the university, the World Health Organization, the Institute for Advanced Futures, a non-profit research and educational organisation, and the Danish pharmaceutical company Novo Nordisk. Lars Rebien Sørensen, the president of Novo Nordisk, explained that the project grew out of a study commissioned to examine possible future implications of diabetes. The scenarios that emerged prompted him and his colleagues to seek partners willing to work for change.
On current trends, the global figure for people with diabetes will reach 300 million within the next 25 years. The developed world is most affected, but the disease is also increasing in developing countries. The poor diet and lack of exercise that promote it are also risk factors for obesity, hypertension, and cardiovascular disease. Success in preventing diabetes would pay wider dividends.
“It is naive to assume that science and technology, or the miracle drugs of the future, will provide the total solution,” Mr Sørenson points out. Hence the presence at the Oxford meeting of economists, policy makers, and food industry representatives, as well as doctors and public health specialists.
With respect to diet, the organisers of Oxford Vision 2020 say that change cannot succeed without the cooperation, willing or otherwise, of the food industry. But Dr Derek Yach of WHO, another of the Oxford speakers, is undaunted. Food companies, he says, often respond to public opinion and know that it makes business sense to change voluntarily before being forced to do so.
David Matthews, professor of diabetic medicine at Oxford, concedes that a successful plan for reducing the prevalence of diabetes will depend on huge numbers of people altering the way they live. But he views this less as an obstacle than a virtue. The task, he argues, cannot simply be allocated to some other person or organisation and then forgotten. Change will come more easily if everyone is involved.
He admits the difficulties. Whereas campaigns against, for example, HIV or tobacco involve an easily identifiable change—practising safe sex, stopping smoking—reducing the risk of diabetes cannot be done by a single action or simple message.
HIV began being taken seriously when there was a general realisation of its extent and impact. The effects of diabetes and related illnesses are already huge but make less of a mark on public consciousness. Dr Yach is confident that awareness will dawn—but concedes that things will probably get worse before they get better. Meanwhile, he says, the Oxford meeting was simply the first step in a process intended to develop a new and comprehensive strategy.