About 40% of people living with diabetes globally go undiagnosed, according to new research.
Most people who are not diagnosed live in Africa (60%), followed by south-east Asia (57%) and the western Pacific region (56%), says the 2023 diabetes global industry overview, the largest survey of its type to date.
Half of those who are diagnosed do not receive treatment, said the report. Three in four people with the condition live in low and middle-income countries where people cannot always access healthcare services.
The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.
NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.
Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.
In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.
'A common condition' is a Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
Sasha Korogodski, the report’s lead researcher, said more than 530 companies were found to be specialising in diabetes diagnostics around the world but only 33 were located in Africa, south-east Asia and the western Pacific.
“Limited healthcare infrastructure, including a shortage of healthcare professionals and diagnostic equipment, can impede the early diagnosis of diabetes,” Korogodski said.
The research, published on Thursday, looks at more than 2,800 companies, 1,500 investors and 80 research and development hubs focused on the condition.
The report said the “stark disparity” in treatment “highlights the pressing need to improve access to diabetic care on a global scale”.
Caroline Mbindyo, the chief executive of Amref Health Innovations, part of the NGO Amref Health Africa, said half of all Africans do not have access to the healthcare they need. People living in remote areas can live hours or days from a facility.
“The reality is that the time and expense to make this journey means that it isn’t even an option for many in these communities. It is impossible for them to get to these services,” she said.
In 2021, nearly 7 million deaths around the world were the result of diabetes despite more than $970bn (£794bn) spent on treatment, according to the research. Most of the organisations in the report are located in the US.
More than 70 companies producing diabetes drugs (55%) are in the US with 17% in Europe. The global diabetes market is mainly divided into four giant monopolies, said the research: Novo Nordisk, Sanofi, Eli Lilly and Merck. Together they account for about 72% of the market.
Diabetes is on the rise. Rapid urbanisation and the effects of the climate crisis on harvests have led to an increase in cheap processed food, which has replaced more traditional food sources in diets.
“Combined with the move to more sedentary lifestyles, particularly in urban centres, this leads to increased risk of developing type 2 diabetes, hypertension and certain cancers,” said Mbindyo.
