Writing from the halls of the UN Climate Change COP19 Summit in Warsaw, where I’m tracking negotiations, I’m also marking World Diabetes Day (WDD), which falls on 14 November and represents the intersection of two urgent and interconnected challenges.
Diabetes is one of the major health and development challenges of the 21st century. According to the International Diabetes Federation (IDF), there are currently 371 million people living with diabetes and another 280 million are at high risk of developing the disease. Half a billion people are expected to be living with diabetes by 2030.
Diabetes causes 5 million deaths and costs over 470 billion US Dollars in global healthcare expenditure every year, whilst climate change is on an even greater trajectory in regards to its devastating environmental, economic and human impacts.
Each year, WDD revolves around a diabetes-related theme and this year’s WDD slogan is Protect Our Future; a slogan that also resonates with the youth constituency at the UN climate talks who are pushing governments to recognize the thus far neglected rights and voices of future generations who will face the full injustices of climate change if the necessary action required by the science isn’t taken.
On 14 November, which also happens to be Youth and Future Generations Day at the climate negotiations, it’s important to highlight these two generation defining issues.
How are diabetes and climate change interconnected?
(Source: International Diabetes Federation)
Like many socio-economic issues, health and climate change are deeply interconnected and both its challenges and solutions cannot be separated. Climate change is the largest threat to human health and exacerbates existing health risks including increased morbidity and mortality from non-communicable diseases (NCDs) such as diabetes.
Diabetes and climate change are directly and indirectly interconnected, as the IDF explains, some of these interconnections include:
Extreme climate events: As we have seen with Typhoon Haiyans path of destruction through the Philippines this past week, the increase of extreme climactic events will cause damage to healthcare infrastructure and threaten the delivery of care for vulnerable people with diabetes.
An overheating world: People with underlying medical conditions such as diabetes are more vulnerable to the adverse health impacts of climate change. In hotter temperatures, dehydration and heatstroke increases morbidity and mortality in people with diabetes. People with diabetes are predisposed to cardiovascular events during heat waves and higher mortality from heart attack on days of high air pollution.
Food insecurity and malnutrition: Climate change is exacerbating food insecurity. Climate change threatens agricultural production and the food supply through water scarcity, and drought the destruction of crops by climactic extremes. Both over-nutrition and under-nutrition increase an individuals risk of developing type 2 diabetes and related NCDs.
Obesity and greenhouse gas emissions: The rising burden of type 2 diabetes and its principal driver, obesity, are likely contributing to climate change. Increasing obesity prevalence in a population increases GHG emissions from food production and car travel. It has been estimated that a population in which 40% of people are obese requires 19% more food energy than a population in which there is a normal BMI distribution.
Urbanisation: Fossil-fuel based transport adversely impacts on health and the environment. The IPCC states that 23% of global GHGs are from transport with road traffic constituting 75% of these emissions. The resulting physical inactivity from sedentary lifestyles is one of the four leading NCD risk factors and accounts for nearly a third of type 2 diabetes prevalence.
Global population: The world’s population is predicted to grow to nine billion by 2050, and such major population growth using our current models increases production, industrialisation, energy consumption and GHG emissions, all of which are driving type 2 diabetes and climate change.
A global challenge
Small island developing states at high risk of climate extremes are disproportionately affected by diabetes.
In regards to diabetes prevalence per capita, the highest-ranking countries are Micronesia, Nauru, Marshall Islands, Kiribati and Tuvalu. Including Vanuatu, all these countries are also members of The Alliance of Small Island States (AOSIS) within the UN Climate talks. AOSIS is a coalition of small islands and low-lying coastal countries that are the most vulnerable to the adverse effects of global climate change, and where some of its members face the prospect of extinction.
Two thirds of diabetes is found in low and middle income countries. These countries are already burdened by climate impacts and are the countries that can least afford to deal with the increased pressure on health systems, the added mortality and expenditure of diabetes, as well as it’s related impacts such as blindness and amputations due to diabetic retinopathy and neuropathy.
However that is not to say that climate change and diabetes poses a problem just for low-income countries, but expands across the spectrum. Relatively oil and gas rich countries of Kuwait, Saudi Arabia, Qatar and Bahrain also make up the top 10 in diabetes prevalence per capita, whilst according to the World Bank, these countries also make the top 10 in regards to carbon dioxide emissions per capita. The socio-economic impact of diabetes alone in such countries threatens to undermine wider development and the benefits of achieving of the Millennium Development Goals.
Breaking down the silos
Both of these issues need an interconnected and intergenerational vision that is sustainable and regenerative; this means looking beyond the typical 20-50 year national strategies, and striving for system solutions that can serve and be relevant for citizens in hundreds of years time; not just one generation.
Since social issues such as climate change and diabetes are cross-cutting by nature, one needs multiple stakeholders to effectively address the problem. Neither climate change or health policies actions be addressed in silo as they are largely being done on a local and global scale.
If there is one global constant, it is that the world is in flux. A systems approach is also needed to address climate change, diabetes and its interconnected issues. (Consider the link between climate change, diabetes, energy, food security, and education reform for instance). This collective impact approach is essential within this context to connect and provide links between the community, the private sector, international organisations, NGOs, government institutions, media and academia around solving social, economic and environmental issues.
On Future Generations Day at the UN climate talks, we are reminded that young people are often the ones who serve best as global key stone connectors, and the One Young World Community is a testament of this.