Tashkent, Uzbekistan (UzDaily.com) -- In a special ceremony at UN City in Copenhagen the day after World Diabetes Day, the World Diabetes Foundation signed an agreement granting WHO/Europe over US$ 900 000 for a 3-year project to improve access for the prevention and control of noncommunicable diseases (NCDs) in primary care in Kyrgyzstan and Uzbekistan. The main beneficiaries of this project will be people with diabetes and their families and carers, particularly those of a lower socioeconomic status.

“This project will allow WHO and the Foundation to build on work that we have both been doing for some years in this region, to build capacity among health-care professionals. We are certain that it will support people living with NCDs, and those at risk. It will be a driver for greater investments in the health of the citizens of these countries and a model for replication in other countries,” said Dr Anil Kapur, Chairman of the World Diabetes Foundation.

“We are thrilled to be able to continue the battle against noncommunicable diseases in Kyrgyzstan and Uzbekistan,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Diabetes results in a tragic loss both for people and economies. This project represents a major step forward and its impact will be seen not only in the 2 countries, but across the Region, as its progress is charted, disseminated and hopefully replicated.”

Kyrgyzstan and Uzbekistan, both lower-middle income countries in central Asia, face similar challenges: a high rate of diabetes of up to 11% of the population with many yet undiagnosed, and a high rate of premature deaths from NCDs. Access to care for people with diabetes is unequal and fragmented, with significant gaps in provision. There is a lack of clinical training in preventing and treating diabetes and its complications, a lack of diagnostic tools, and patient education and involvement is not given priority. Nurses’ roles are limited.

However, both countries have worked for some years with the support and expertise of WHO/Europe to pursue health reforms towards universal health coverage. For example, with its support, Kyrgyzstan has developed a basic but standardized database used by every family medical centre and coordinated by the eHealth Centre. It was found that 8 times as many people were going undiagnosed as were on official registers, and that the care provided was often inadequate. Through training and in partnership with health-care professionals the aim now is to improve the care and treatment in a coordinated and systemic way, achieve earlier diagnosis and increase awareness that type 2 diabetes can be largely prevented.

The project funded by the World Diabetes Foundation will have 3 main objectives:

• The first is to pursue universal health coverage by improving clinical practice in controlling and preventing complications for NCDs in primary care and enhancing the quality of integrated care. This will involve working closely with health professionals in workshops, courses and meetings, to improve the quality of care, and setting up individual integrated pathways, diabetic retinopathy screening programmes and diabetes registers.
• The second is to improve the self-management of NCDs and chronic conditions by providing therapeutic patient education. Nurses will undergo specific training sessions on managing chronic patients, helping them to understand and manage their conditions in a more patient-centred way. Each patient will have a tailored care plan to include, for example, monitoring and follow-up, lifestyle changes and making sure they can stick to their therapy.
• The third aims to implement evidence-based policies and establish a system-approach to clinical practice and quality improvements, developing a roadmap to prevent complications among people with diabetes, with a focus on cardiovascular disease, eyes and feet, and ensuring that evidence informs policy so that proven effective interventions are scaled up. This approach yields benefits in both health and financial terms.

The overall aim is to further progress towards the Sustainable Development Goals (SDGs), particularly SDG 3.4, which is to reduce premature mortality from NCDs by a third by 2030, through prevention and treatment, and promote mental health and well-being.

Some of the activities of this project will have a national scope, whereas others will be implemented through demonstration projects in targeted areas: the Chui Region of Kyrgyzstan and the Syrdarya Region in Uzbekistan. In these pilot areas, the aim is that all nurses will be trained in diabetes foot care and prevention of complications, and there will be a minimum 10% increase in the enrolment of diabetes patients. At least once a year, all eligible patients will have foot examinations and will be screened for diabetic retinopathy, and all type 2 diabetes patients will receive training on self-care.

The WHO Global Diabetes Compact, agreed in April 2021, will help guide this project in its determination to boost efforts to prevent diabetes and bring equitable, comprehensive, affordable and good-quality treatment and care to all who need it, decreasing inequity in access to diagnosis and treatment in primary care.

The World Diabetes Foundation is a leading global funder of diabetes prevention and care projects in low- and middle-income countries. Its vision is to alleviate suffering related to diabetes among those in greatest need.