diabetes research and clinical practice 96 (2012) 416–417
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Diabetes Research and Clinical Practice jou rna l hom ep ag e: w ww.e lse v ier .com/ loca te /d iab res
Brief report
IDF’s Global Diabetes Forum: Driving multisectoral partnerships for diabetes Katie Dain Advocacy and Programme Development Co-ordinator, International Diabetes Federation, Belgium
Just three months after the UN High-Level Summit on NonCommunicable Diseases (NCDs) in New York and the adoption of the first ever UN Political Declaration on NCDs [1], IDF convened over 15,000 of the diabetes and global health community at the World Diabetes Congress in Dubai. To maximize this sequence of events, IDF held a unique event immediately prior to the official opening of the Congress. The Global Diabetes Forum brought together a high profile audience to build on the political momentum from New York, explore the implications of multisectoral and whole-of-society approaches that lie at the heart of the Political Declaration, and begin to define the partnerships required to drive change for the 366 million people with diabetes worldwide [2]. IDF’s advocacy in the lead up to the UN Summit was founded on the message that diabetes is everyone’s business [3]. The causes of this one disease are diverse and complex, driven by global patterns of urbanization, globalization and economic development, and its impact is felt by all of society. For this reason no single actor or sector can solve the diabetes epidemic alone, and the response must include all sectors of society and be coordinated to have impact. These messages are strongly stated in the Political Declaration, with an entire section dedicated to whole-of-government and a whole-ofsociety efforts, and commitments to develop multisectoral national NCD plans and collaborative partnerships that go beyond the health sector. This has provided renewed impetus to better define what these somewhat nebulous phrases mean (‘multisectoral’ and ‘whole-of-society’) and how these partnerships need to work in practice to ensure they add value and harness the strengths of their different constituents. IDF’s Global Diabetes Forum brought together representatives from the UN, governments, the private sector and civil society to take the Political Declaration one step further in the practical application of effective partnerships for diabetes.
The main focus of the Forum was to discuss the shared priorities of the three pillars of what IDF has coined ‘Triple P’ partnerships – public, private and the people – and explore in depth the role and expertise of one particular constituent of these partnerships – the private sector. IDF has always maintained that engaging with the private sector in an open, transparent and positive way is central to providing long-term solutions for the global diabetes epidemic, and this sentiment is endorsed in the UN Summit Declaration with a set of commitments directly aimed at the private sector. At the most basic level, as employers the private sector has a clear incentive to invest in health, and as producers, marketers and innovators, the private sector has unique capacity and expertise that improve health outcomes for people with diabetes and prevent the development of future cases. Discussion during the Global Diabetes Forum was focused around four themes – Working Towards Better Health; the Business of Better Health; Investing in Better Health; and Harnessing Private Sector Expertise. Each theme was led by four eminent thought leaders, each from a different sector. Below is a summary of messages that emerged during the Forum, all of which are outlined in more detail in the forthcoming Dubai Blueprint (to be published soon).
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Not ‘if’ but ‘how’
Forum participants were in consensus that we should no longer be discussing if the private sector has a role to play in tackling diabetes and related NCDs, but how? Within certain parameters and safeguards in place, the role of the private sector in delivering healthcare and insurance plans, producing essential medicines and technologies, promoting healthy working environments for employees, and reformulating food
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diabetes research and clinical practice 96 (2012) 416–417
and beverage products to reduce salt, fat, and eliminate transfats are integral to reducing the burden of diabetes worldwide. Discussion at the Forum focused on how to maximize expertise and skills of the private sector.
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underserved yet viable and profitable markets. Delivering diabetes care to the poorest populations offers a new innovation frontier, particularly in redesigning products and distribution channels, and an opportunity for substantial productivity for private and public interests.
The business case for private sector action 5.
Discussion on the business case for private sector action was centre stage at the Global Diabetes Forum. Participants shared views on the most compelling case to prompt action in all sectors, as well as applying pressure on the more ‘health polluting’ businesses to come into line. It was clear that all sectors have an incentive and a responsibility to invest in health, for both humanitarian and economic reasons. The cost of inaction on NCDs is staggering, estimated to lead to a cumulative output loss of USD 47 trillion in over the next 20 years [4]. For this reason, the World Economic Forum recently rated diabetes and NCDs as one of the greatest threats to the global economy, only second to asset price collapse [5]. As employers, the private sector has a particular stake in health. Diabetes and NCDs are increasingly hitting people in their most productive years, causing absenteeism, lost productivity and high healthcare costs across the life course.
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Shifting the discourse to shared values
The UN Summit process catalyzed a healthy dialogue on private sector engagement in global health, with concerns around conflict of interest coming to the fore. Similar concerns have surfaced recently with respect to a Global Fund grant and WHO Reforms [6]. The Global Diabetes Forum tackled these issues head on in a neutral space, with participants voicing the need to shift the dialogue from negative and antagonistic ‘conflicts of interest’ to more constructive ‘commonality of interests’ or ‘shared values’. Many participants voiced the need for the private sector to go beyond corporate social responsibility, and instead embed values and practices that enhance the competitiveness of a company while simultaneously promoting health in the communities they operate in.
Thinking outside the box
Along with the conventional role of the private sector in health and diabetes specifically, Forum participants explored the less obvious private sector skills and expertise that need to be harnessed to have a greater impact on health. Marshaling the financial resources of the private sector for diabetes remains a major priority for IDF, particularly in the absence of a shift in funding priorities of multilateral or bilateral agencies since the Summit. But beyond the immediate priorities of money and medical products, the private sector’s comparative advantage relative to the public sector in management, planning, information infrastructure, logistics, and distribution channels are relatively untapped expertise in the global response to diabetes. Forum participants shared many of the lessons that can be learnt from other health issues, such as HIV/AIDS, where public–private partnerships are more advanced and are testament to the transformative potential of thinking outside the box. The Global Diabetes Forum was a significant step forward in defining practical next steps for the global diabetes community after the UN Summit, as well as progressing the dialogue on multisectoral partnerships that must be the cornerstone of the global response. Only by working together in partnerships that span every level of government, public and private sector will we see sustainable change that will benefit current and future generations. Significantly, Forum participants and the Dubai Blueprint began to establish the rules and shape of these multisectoral partnerships that will drive change in an effective, transparent, equitable and accountable way. This is an exciting time for the global diabetes and NCD community. Together we can make a world of difference for people with diabetes.
references
4. Opportunities for the next wave of innovation and productivity A key theme of the Global Diabetes Forum was innovation. Arguably the greatest unmet needs in the global economy are health, improved nutrition, help for the ageing population, and less environmental damage. In high-income countries, demand for products and services that meet these societal needs is rapidly growing and innovation can generate a competitive advantage to private sectors that are able to get ahead of the game to deliver healthier food and the means to a healthier lifestyle. At the same time, societal needs in lowand middle-income countries are greater, and there lie
[1] A/66/L.1 Political declaration of the high-level meeting of the general assembly on the prevention and control of noncommunicable diseases (2011). [2] International Diabetes Federation. Diabetes atlas, 5th ed., Brussels: International Diabetes Federation; 2011. [3] International Diabetes Federation. A call to action on diabetes. Brussels: International Diabetes Federation; 2010. [4] World Economic Forum, The global economic burden of non-communicable diseases, Geneva (2011). [5] World Economic Forum, Global risks 2010 – a global risk network report (2010). [6] Matzopoulos R, et al. Global fund collusion with liquor giant is a clear conflict of interest. Bull WHO 2012;90.