Seize the momentum
The diabetes community urges governments to ensure access to diabetes medications and devices is equitable across the country. istock.com
Diabetes community calls for implementation of the Diabetes Framework with funding and concrete action this spring
It was a milestone celebrated throughout Canada’s diabetes community. The Framework for Diabetes (the Framework), tabled in Parliament on October 5, 2022, capped more than six years of collaborative work by Diabetes Canada and more than 100 allied organizations and individuals. Here was a policy roadmap for all sectors of society to take concrete actions to stem the surge in diabetes across the country – a direction endorsed by parliamentarians of all parties.
Diabetes Canada and its partners are eager to see progress continue. The release of the Framework was not the endgame, they stress; the plan needs to be brought to life with firm commitments of financial and human resources – starting with the 2023 spring budgets of the federal and provincial governments.
“The case for beginning to implement the Framework is one of urgency,” says Laura Syron, president & CEO of Diabetes Canada. To put in perspective the cost of inaction, Ms. Syron highlights the unrelenting pace of the epidemic’s growth.
“By the time federal Finance Minister Chrystia Freeland rises in the House of Commons to read her budget speech in early to mid-March, almost 70,000 people across Canada are estimated to have received a new diagnosis of diabetes since the Framework was tabled,” she says.
“Every three minutes in Canada, someone receives a diagnosis of some form of diabetes; that’s 480 people each day. It’s a staggering number, but we know what we can do to help stem the tide.”
Through pre-budget submissions and other advocacy efforts, Diabetes Canada has pressed its case for implementation, confident that the Canadian public supports the call for timely action to put the Framework into effect.
A national poll conducted by Nanos in November found that nearly nine in 10 Canadians support the federal government committing resources to implement the Framework. Similarly, more than nine in 10 Canadians agree with necessary support from provincial and territorial governments to help implement the Framework.
“We’re committed to keeping the momentum going,” says Ms. Syron. “The Nanos poll results are a compelling signal to all levels of government to follow through and provide budget commitments in 2023 to implement the Framework.”
Diabetes Canada has identified five priority areas for action to begin the implementation of the Framework: access to resources; measurable progress; comprehensive data; education; and research. “While all these areas are important, expanding access to resources and creating a multi-sectoral accountability body to measure progress are particularly urgent,” says Ms. Syron.
“Every three minutes in Canada someone receives a diagnosis of some form of diabetes; that’s 480 people each day. It’s a staggering number, but we know what we can do to help stem the tide. ”
Boost funding to expand access to diabetes testing, treatment and prevention services
Access to diabetes services, medications and devices is inconsistent across the country, dependent on where the person lives and their financial resources. “This uneven approach across jurisdictions to prevention and treatment exacerbates the challenges for those who live with diabetes, and more so for those in health-equity seeking communities who also have a higher rates of diabetes and risk factors relative to the population as a whole,” Ms. Syron says.
To tackle these inequities, Diabetes Canada urges the federal government to commit to sustained funding including innovative mechanisms such as cost-sharing, matching funds and public-private partnerships. Injecting more money into the system will help the provinces and territories, and local communities, build capacity to ensure everyone who needs these vital supports and services can receive them.
Relatedly, a better system needs to be developed for collection and sharing of data – which echoes national calls for a pan-Canadian health data strategy for health care management as a whole, to close the major gaps in reporting on diabetes along with other chronic conditions and enable more precise measurement of health outcomes by policy-makers. “We need good data from across the county to make good health-care decisions. On this point, we see a lot of agreement across the diabetes community,” added Ms. Syron.
Another priority is to increase testing and monitoring for diabetes, says Ms. Syron.
“One in three people in Canada is living with diabetes or prediabetes, and many Canadians in the latter category don’t even know that they are at risk for developing diabetes,” says Ms. Syron. “Testing needs to be expanded, as does public health monitoring and surveillance, so people with diabetes and their health-care providers can track key health indicators associated with diabetes and detect signs, as early as possible, of an increased risk of complications.”
Treating diabetes and related complications represents immense costs to our health-care system, an expenditure of almost $50-million every 24 hours. Diabetes contributes to 30 per cent of strokes, 40 per cent of heart attacks, 50 per cent of kidney failure requiring dialysis, and 70 per cent of all non-traumatic leg and foot amputations. It is also the leading cause of preventable blindness.
A complex challenge that requires a whole-of-society effort
Diabetes Canada also urges the federal government to help create and fund an independent, multi-sectoral oversight body. This body is to include leaders in the public and private sectors, who would develop performance indicators, share best and emerging practices across the diabetes ecosystem, and measure and report annually on the progress of the implementation elements of the Framework.
The work to set up the oversight body should begin right away, so it’s in a position to fulfill the commitment to deliver annual reports to governments and Canadians, “and help inform the mandatory, legislative review of the Framework in five years,” says Ms. Syron.
“The multi-sectoral table will bring a whole-of-society effort – as the Framework stresses – to address the epidemic of diabetes,” she says. “All sectors have a stake in achieving success. It’s not just a government policy issue; we need the private sector, health charities, patient groups, research organizations, affected sub-populations, the labour movement and others to also contribute funding for this “Big Table” endeavour. It will operate outside the day-to-day political realm, which can encourage freer exchanges, innovative ideas for change, and a system-wide and longer-term perspective to combat this disease.”
Harness the energy to act now
The diabetes community is not discounting the great progress that has already been made, says Ms. Syron. “We very much appreciate the work that parliamentarians have done to date, and it’s a testament to what they can accomplish when they work collaboratively in the national interest. They have made diabetes a policy issue, not a partisan issue – recognizing it’s a people issue, not a politics issue. As well, this Framework can be used as a template to support efforts to combat other chronic diseases.” She also noted that several provinces have already announced their own strategies or frameworks and more are expected this year.
Given the anticipation and momentum that has been building over the past several years, the diabetes community “would be deeply disappointed if governments didn’t back that up with financing and implementation steps in their next budgets,” Ms. Syron says.
“There’s great excitement and energy within the community, and support for action is strong. The hard work of making diabetes a nationwide concern has been done, in part, through this Framework. Now there’s an urgent need to address this concern with concrete budget commitments. Diabetes Canada is keen to partner with all stakeholders in the months and years ahead to bring the Framework to life.”
To view this report on The Globe's website, visit globeandmail.com
To view the full report as it appeared in The Globe's print edition: Diabetes - today and tomorrow