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Background of Diabetes in Numbers:

India is the World Diabetes Capital: 65 MillionDiabetics (1/5thof global

diabetics)

Undiagnosed Diabetics in India: 50%

Diabetes Share of Global Health Spend: 12%or $ 548 Million

(Global Average $ 450per diabetic patient)

Indias Diabetes Spend as part of the Global Health Spend: 1%

(Global Average $ 84per diabetic patient)

Growth & Prevalence of diabetes in Mumbai: 1959: 0.7% |2001: 7.5% -

9.3% | NO RECENT DATA!

Diabetes related deaths in India each year: Over 1 Million

Deaths under the age of 60: >50%

Death under the age of 50: > 33%

The size and costs of the diabetes epidemic in India and Mumbai are no longer in dispute.In the recent past, there has been an alarming rise in diabetes in Mumbai and the rest of urban

and rural India. Diabetes inflicts considerable personal suffering and affects a large magnitude of people from all populations and strata of society and it is one of the most important

lifestyle disease today.

High healthcare expenditure, loss of labour productivity and decreased rates of economic growth are directly and indirectly related to diabetes. The economic impact is especially great inIndia, where diabetes strikes a decade earlier than in Europe and USA due to genetic predisposition, increasingly sedentary urban lifestyles and unhealthy dietary intake.

Diabetes is both preventable and can be managed better. Despite its great socio-economic burden and the associated complications and co-morbidities, diabetes is unfortunately not

considered a high-profile illness.

There is an urgent need to raise the profile of diabetes in India and Mumbai through a concerted multi-stakeholder effort. The human and societal cost of acting now will be a minute

fraction of the cost of ignorance and procrastination in this matter.

Planned investments in diabetes will bring tangible health gains. It will also impact other non-communicable diseases areas like hypertension, cardiovascular disease, chronic respiratory

diseases and cancer as well as communicable diseases TB, HIV/AIDS, and malaria that have shared determinants for susceptibility and mortality.

Technological and medical advancements are contributing to improving the quality of life for diabetics and extending their lifespan. At the same time, several low cost treatment and

management solutions have also emerged. These need to be carefully considered and made accessible and available to all.

The burden of diabetes cannot be borne by the government alone. To make a significant impact in prevention, care and management of diabetes, strong partnerships will need to be

forged between governments, the private sector and the community sector including citizenry. If all the stakeholders in the diabetes universe unite, great results can be expected

including savings in the health system, increased productivity and better health outcomes and improved quality of li fe for all Mumbaikars.

We, gathered here on 26 July 2014 at the Observer Research Foundation Mumbai, do unanimously agree that

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Diabetics in Mumbai have the right to:

access affordable medication, supplies and medical care irrespective of

income or location

an early opportunity to be diagnosed followed by education, counselling and

support

minimise risk of complications with recommended, periodic tests ataffordable costs

have access to latest tools such as Continuous Glucose Monitoring and insulin

pumps

have access to affordable and comprehensive health insurance coverage

be treated as equal citizens and be free from discrimination at all times

have convenient access to footpaths, parks and open spaces for exercise and

walking

Diabetics in Mumbai have a responsibility to: plan, monitor and implement their treatment goals

be regular with follow-up visits and testing regimen

promptly notify family, friends and educational institutes (for students) of

their diabetic condition so that they can be supportive in general and

prepared for emergency situations

Educational Institutions have the responsibility to:

ensure that young diabetics are fully supported in all activities

strictly disallow all junk food in the cafeteria

make allowances for diabetic children to access and consume food according

to diet schedule and especially during emergency situations, like

hypoglycaemia

involve parent teacher associations and school management committees in

imparting diabetes awareness and nutritional education to students, teachers

and cafeteria staff

All Mumbaikars have the responsibility to:

make themselves aware and become agents of awareness

encourage family, friends and co-workers with risk factors to get tested

follow a healthy lifestyle through diet and exercise to prevent from

developing risk-factors

never discriminate against a diabetic and discourage discrimination by others understand and recognise a diabetic emergency and help a diabetic in need

National, State and Local Governments have the

responsibility to:

Raise the profile of diabetes in Mumbai and India

establish a screening programme for high risk groups

use IEC to raise societal awareness on the risks of diabetes and encourage :

o non-diabetics to prevent the onset of risk factors

o

pre-diabetics with abdominal obesity, advanced age, genetic

background and low activity levelsto work towards risk reduction

o diabetics to prevent development of complications

impart health and physical education across all educational institutes

create and disseminate suitable food-guides which cater to prevailing food

preferences and are sensitive to age, economic status, culture and religion

ensure availability and affordability of a complete spectrum of diabetes

medicines and supplies throughout the city

establish a robust data collection and records maintenance system to monitor

prevalence and efficacy of treatment options

provide access to fitness through safe and vibrant public places includingparks and playgrounds that are accessible and open at convenient hours and

ensure that all footpaths in the city are unbroken, levelled and pedestrian

friendly

Regulate through policy, the manufacturing, advertising, marketing and sale

of unhealthy foods, particularly to children

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Public and Private Healthcare providers have the

responsibility to:

be sensitive towards diabetic patients and their families and help them devise

an appropriate strategy to plan and manage their condition and recommend

counselling where appropriate to continuously upgrade their skills and knowledge for optimal management

of diabetes and provision of quality healthcare

provide seamless integration, from primary care to specialist and tertiary

care across private and public settings

prescribe affordable/ generic medicines to economically-deprived patients

Employers have the responsibility to:

ensure that workplaces support diabetics

provide healthy food options in cafeterias

introduce sustained awareness to encourage healthy lifestyles

The Pharmaceutical Industry has the responsibility to:

adhere to good manufacturing practices to ensure universal and consistent

efficacy of drugs

ensure availability of diabetes medicines to all Mumbaikars at convenientlocations across the city

create partnerships across stakeholder groups for prevention, control and

management of diabetes in Mumbai

NGOs have the responsibility to:

facilitate the creation of community-based support groups for diabetics

to lobby for the needs of diabetics across stakeholder groups

proactively identify high risk categories and educate them in prevention

encourage diets that are diabetes-friendly in homes and during community

festivals, and promote exercise as a part of daily living.

Industry has the responsibility to:

recognise and prioritise diabetes as a serious health condition and work

towards bridging the large financial gap in diabetes expenditure through CSR

and other resources

create awareness through its network including clients, vendors and contract

workers

Media has the responsibility to:

design and lead sustained campaigns to create a mass awareness

highlight diabetes services and infrastructure available to citizenry from time

to time