On a global level, 422 million people are today affected by diabetes. That’s nearly four times the number affected 30 years ago. In Africa, middle-income countries are those most affected.
“If you tell a 50-year-old person you have to stop putting so much sugar in your tea, that's very difficult," Matthias Arnold explained. He is a PhD candidate at the Institute for Health Economy and Management at the University of Munich. Diabetes, the chronic disease in which the body is not able to regulate its own blood sugar levels, still only affects small percentage of people in Africa, but the numbers are growing.
Accoridng to the World Health Organization diabetes is expected to be the seventh biggest global cause of death worldwide by 2030. And that although the disease is largely preventable through healthier diets and more physical activity. Once diabetes is diagnosed, it must be managed well – a stricter diet, medication or twice daily insulin shots to regulate the blood sugar. If left untreated, it can be the cause of kidney failure, heart attack or blindness.
Arnold was himself diagnosed with diabetes Type 1 at a very early age - Type 1 is the more rare type of diabetes, that affects less than 90 percent of diabetics and is not caused by obesity or lifestyle. "It's easier if you have that at a young age. But when you have done something all your life, and then your doctor tells you, you have to cut down on your sugar, your carbohydrates and eat more vegetables, that's difficult."
While African countries still lie on the low end of the diabetes spectrum , in middle-income countries like Kenya are experiencing a rise in non-communicable diseases like diabetes. "A lot can be attributed to our detection rates getting higher, but obesity is higher and issues to do with alcohol, poor diet and tobacco add to the risk," Dr. Kibachio Joseph Mwangi, who heads the non-communicable diseases division at Kenya's Ministry of Health told DW. According to WHO data, over 2,650 Kenyans between the ages of 25 to 69 die of diabetes each year.
In 2011, Kenya signed the Global Action Plan on non-communicable diseases, which include cancer, heart disease and diabetes, and has set up a strategy to reverse the rise in these diseases. Prevention of the diseases, health promotion and training health personnel are all on the agenda. According to Mwangi, the cost of the treatment has also been addressed: "Insulin used to be quite expensive but the price has stabilized. That has been done with partnerships with the pharma-industry."
The cost of treatment is however still a major burden for those affected with diabetes. The cost for 25 days of treatment is about 1,500 Kenyan Shillings ($14, 80 or 13 euros), which as Jamillah Mwanjisi from the NGO Help Age, points out is too expensive for many Kenyans. The NGO campaigns for the rights and support of the elderly, who in Kenya rarely have a pension or health insurance. "For older people it is almost impossible to pay because most of them have no access to any sort of income." Additionally, the accessibility and costs of getting to a health center that has the available treatment add to the difficulty of those affected.
Wider screening needed
According to Mwanjisi, the level of awareness for diabetes is still very low in Kenya. "Many health facilities do not immediately think and test for diabetes – but instead test for malaria and other common diseases," she said. In an ideal situation, there would be country wide screening, so that people know their blood sugar levels and whether they are at risk.
According to Mwanjisi, the growing urban population is more affected than those in rural areas. "You sit in the office, you use motorized transport, once at home you sit and watch TV," she said. "I think realization that fitness and dietary requirements are actually good for your health are only starting arise now as the population is ageing," Arnold added.