Paul Zimmet Sydney
You could be forgiven for thinking communicable illnesses, like HIV/AIDS, and the newly feared bird flu, are the major disease threats for Asia in the next and coming decades.
After all, an APEC meeting has been called to focus on bird flu, scientists are fretting over a bird flu vaccine, and Asian bird flu casualties are being cited as early signs of a potential pandemic.
Every year we hear the increased Asian death forecasts for HIV/AIDS, as the disease continues its relentless march of devastation in the region.
It would be foolish in any way to discount the potential impact of these diseases. But a much greater health concern looms on the horizon and risks being overlooked.
It is diabetes and it is far more certain than bird flu to prematurely claim millions of lives. Similarly diabetes-related deaths in Asia over the next few decades will dwarf those caused by HIV/AIDS.
Sound like a stretch?
Not according to the World Health Organization (WHO), which has just released a report claiming chronic diseases, dominated by diabetes, now cause twice the number of deaths than infectious diseases (including HIV), maternal/perinatal conditions, and nutritional deficiencies combined.
The report, Preventing Chronic Diseases: A Vital Investment claims this trend will continue.
In the next decade, the number of global lives claimed by diabetes is set to grow by a quarter, driven by rising obesity and inactivity. It could cause the first life expectancy reduction in more than 200 years. And nowhere is the problem more serious than in Asia.
In Asia there are now 90 million people with diabetes. Asia is home to four of the world's five largest diabetic populations -- India, 33 million people with diabetes; China, 23 million; Pakistan, 9 million; and Japan, 7 million.
Globally the WHO estimates the global diabetes population will grow to more than 200 million in 2010 and 330 million in 2025. The burden in Asia will increase -- in less than a decade 60 percent of all diabetes cases globally will be owned by Asia.
Asia should be in a state of panic. While diabetes can be treated, with limited access to treatments a majority of people affected will die prematurely.
Even with treatments diabetes kills people prematurely, as well as rob them of their quality of life, and put significant strain on resources.
There is a common misconception diabetes is not lethal, with deaths often attributed to complications rather than the disease itself. But diabetes puts people at risk of many diseases, and premature death, as it causes damage to many body tissues, and progresses to strokes, heart disease, kidney failure, blindness, susceptibility to serious infections, and amputations due to loss of circulation.
Diabetes has crept up on Asia with progressive westernization or "Coca-Colonization" of its countries, that has seen the adoption of fatty food diets and sedentary lifestyles. Disturbingly the non-insulin dependent variety of diabetes (type 2), with typical onset in late adulthood in most parts of the world, is surfacing in children in Asia.
With scare health resources Asia is ill-prepared to tackle diabetes effectively and is likely to be distracted by more immediate threats such as bird flu, which it is being asked by countries outside the region to address.
There is also a lack of recognition of the problem with many governments and public health planners in Asia remaining largely unaware of the future potential for increases in obesity and diabetes and its serious complications.
Unless this situation is rectified, there will be a huge economic burden on Asia -- both from direct healthcare costs plus indirect costs from a decline in workplace productivity. In addition there will be losses from premature morbidity and mortality.
Diabetes could cripple the budgets of Asian nations, particularly in developing nations. Diabetes is expected to cost the larger Asian economies up to US$500 billion each in the next decade due to lost productivity and premature deaths.
At the 6th International Diabetes Federation conference for Asia in Bangkok this week I will predict when the history of this century is written it will be diabetes, not bird flu or HIV/AIDS, that will have had the most devastating impact on the Asia Pacific.
There is no doubt that if bird flu is serious enough to warrant an APEC meeting later this year, a similar meeting on diabetes is long overdue.
Diabetes has to be addressed in a significant way in Asia. It is not the bird flu or HIV/AIDS. But it is the killer disease that we are not prepared for, with the potential to claim millions of lives.
Prof. Paul Zimmet is Director of the International Diabetes Institute and Head of the World Health Organization Collaborating Center for the Epidemiology of Diabetes.