Few people realise that in Africa, more than any other continent, there are interactions between diabetes, tuberculosis (TB), and HIV/Aids, and that their various treatments increase the negative impact of all three conditions.
According to research, presented at the Diabetes Leadership Forum Africa 2010 in Johannesburg, people with diabetes are eight times more likely to contract TB; diabetes treatment interferes with TB management; and TB treatment interferes with blood glucose management. Diabetes-related complications and mortality also increase in the presence of TB. Furthermore, for people with both diseases, their TB is more infective, which has major implications for the spread of TB.
In sub-Saharan Africa the preferred antiretroviral treatment (ART) for HIV/Aids has been linked with an increase of pre-diabetes, which could lead to diabetes if undetected. Because of the great number of people living with HIV/Aids, this effect is becoming a major influence on the growth of diabetes in Africa.
It is therefore important that African countries adopt an integrated public health care plan that can detect and treat multiple diseases simultaneously, rather than just focus on a few conditions.
"To date, policy makers have focused mainly on preventing the spread of infectious diseases, because of their acute nature, but this has left millions of people with diabetes and other NCDs under-serviced by the healthcare system," Dr Anil Kapur, Managing Director of the World Diabetes Foundation, told delegates at the Diabetes Leadership Forum.
"To alleviate the burden of disease, it is time for all partners to start seeing communicable and non-communicable diseases as two related areas and to explore joint strategies for detection, prevention and management, building on the same infrastructure and health care capacity," Kapur said.
The World Diabetes Foundation recommends, for example, early screening for diabetes, carried out when people are seeking treatment for other conditions would improve early detection and treatment of diabetes.
"If we fail to implement an integrated strategic plan for the management of diabetes and related health risks in all of the countries of the African Union, Africa’s healthcare system could simply collapse under the load," Prof Jean-Claude Mbanya, President of the International Diabetes Federation, warned.
In September 2011, the United Nations held its first ever summit on Non Communicable Diseases (NCDs) including diabetes. Over 100 countries indicated that NCDs had become a global priority for world leaders and a core development issue on the global agenda.
"The UN Summit on NCDs is a key opportunity to put in place change that will save millions of lives now and set in place a better future for our children and grandchildren - an opportunity that we can’t afford to lose," Mbanya said.
- (Birgit Ottermann, Health24, updated November 2012)
(World Diabetes Foundation, International Diabetes Federation, Novo Nordisk, Diabetes South Africa, Diabetes: the hidden pandemic and its impact on Sub-Saharan Africa – Document prepared for the Diabetes Leadership Forum Africa 2010 - Edited by Prof Ayesha Motala and Dr Kaushik Ramaiya, 2010)