My colleague Adeeb Mahmud and I just returned from a week in Mexico, conducting research for a client on the diabetes crisis in the country and the landscape of response efforts. I thought I’d share a couple of highlights from our trip.
The State of the Problem
While we were aware of the problem of diabetes in Mexico, it was alarming to learn about the need on the ground. A staggering 70% of Mexicans are overweight, the country is first in the world in childhood obesity, and the latest government health surveys peg adult diabetes rates at 14%. The culprits? We heard diverse explanations: from overconsumption of foods high in fats and sugar, to a lack of cultural promotion of exercise. As an example of the former, Mexico is the world’s largest markets for Coca Cola products: per-capita consumption is around one and a half two-liter bottles per person per week.
The outcomes for patients with diabetes are also incredibly poor: an estimated 50% of patients don’t know they have diabetes, and only 20% of patients have good control over the disease by international standards—compare to 31% in the rest of Latin America, and around 40% in the US and Europe. The impact of diabetes on Mexico’s economic productivity in the next few years could be crippling: 75,000 Mexicans die each year from diabetes, rates of complications from the disease are high, and diabetes treatment costs the Mexican health care system $5 billion annually.
Efforts to Address the Crisis
In the face of this crisis, Mexicans are responding with several innovative approaches to prevention, diagnosis, and treatment. Here are just two of the groups we got to know:
ABC Hospital is a high-end nonprofit health care facility located in Santa Fe, one of the most economically divided sections of Mexico City. ABC operates a suite of comprehensive health services to underserved patients in a five-kilometer radius around the hospital. By deploying a range of interventions—door-to-door testing, a mobile clinic, centralized education and treatment efforts in the hospital, and a health promoter model using local community leaders in each neighborhood—they are working to radically change the comprehensiveness of care for low-income patients with diabetes.
La Universidad Panamericana (Panamerican University) partners with local foundations and NGOs to operate community clinics that target the rural poor. One such clinic is in the village of Toxi in Atlacomulco, 90 minutes outside of Mexico City. It is staffed by “pasantes” from the university’s medical school—young doctors and nurses who provide a year of community service as a graduation requirement of their medical programs. The clinic provides comprehensive services to individuals at risk for diabetes, from training in basic hygiene and blood testing to insulin provision and assistance with income generation. This model aims to identify a sustainable way of caring for patients in these challenging settings, so that the model can be replicated elsewhere.
The diabetes crisis in Mexico is dire, but pockets of innovation are providing hope. Entities that have historically been siloed are beginning to work together more productively. The government is also beginning to put financial resources behind the problem through efforts like a new low-income health insurance scheme (Seguro Popular). While more efforts are needed on all these fronts, we’re excited that NCDs in Mexico—as elsewhere—are finally demanding attention.