Economic Impact of Diabetes in Africa
- 55 Downloads
Purpose of Review
This review seeks to address knowledge gaps around the economic burden of diabetes in Africa. Africa is home to numerous endemic infections and also prevalent non-communicable diseases including diabetes. It is projected that the greatest increases in diabetes prevalence will occur in Africa. The importance of this review therefore lies in providing adequate knowledge on the economic challenges that diabetes poses to the continent and describe the way forward in tackling this epidemic.
Diabetes contributes to a huge amount of the global health expenditure in the world. There is a dearth of information on the economic burden of diabetes in Africa with very limited number of studies in the area. Predictions do show that Africa has the greatest predicted increase in both the burden of diabetes and associated diabetic complications but yet contributes the lowest in the global annual healthcare expenses with regard to diabetes care. In 2017, the International Diabetes Federation (IDF) estimated the total health expenditure due to diabetes at $3.3 billion. In Nigeria, the national annual direct costs of diabetes was estimated in the range of $1.071 billion to $1.639 billion per year while the estimated monthly direct medical costs per individual in Cameroon stands at $148. In Sudan, the direct cost of type 2 diabetes control was $175 per year which only included the cost of medications and ambulatory care. People with diabetes are likely to experience one or more chronic illness and a significant portion of the costs associated with these complications are attributed to the underlying diabetes.
The growing epidemics of diabetes and associated diabetic complications worldwide poses catastrophic financial costs, especially in Africa where most of the expenses are paid by patients and families. The most common method used for the estimation of the economic burden of a public health problem like diabetes is the cost-of-illness approach. Cost-of-illness studies traditionally divide costs into three categories: direct, indirect, and intangible. The IDF estimated the total health expenditure due to diabetes at $3.3 billion worldwide in 2017. Most of the existing studies in Africa estimated only the direct costs. The medical direct cost of type 1 diabetes was higher than type 2. However, the estimations of costs of diabetes in many countries in Africa may be underestimated due to absence of data on the relative contribution of cost of diabetes complications.
KeywordsAfrica Burden Diabetes Economic
Compliance with Ethical Standards
Conflict of Interest
Clarisse Mapa Tassou, Jean-Claude Katte, Camille Mba Maadjhou, and Jean Claude Mbanya declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 2.• Atun R, Davies JI, Gale EAM, Bärnighausen T, Beran D, Kengne AP, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017;5:622–67 This article provides an up-to-date situational analysis with regards to the diabetes challenges and perspectives for transforming the diabetes landscape in the continent. It further identifies current gaps in economic policies which may serve as landmarks for action.CrossRefGoogle Scholar
- 3.• IDF. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation; 2017. The IDF Diabetes Atlas provides a gross estimate of total health expenditure worldwide. It stands as a useful reference point for global estimates since the data is pooled from the numerous participating countries in the federation. Google Scholar
- 4.Nikolic IA, Stanciole AE, Zaydman M. Chronic emergency: why NCDS matter—Health Nutrition and Population (HPN) discussion paper [Internet]. 2011 [cited 2018 Sep 7]. Available from: http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/ChronicEmergencyWhyNCDsMatter.pdf.Accessed 7 Sept 2018.
- 9.IDF. IDF Diabetes Atlas, 1st edition [Internet]. Brussels, Belgium: International Diabetes Federation; 2000 [cited 2015 Jan 6]. Available from: www.idf.org/diabetesatlas. Accessed 6 Sept 2018.
- 10.The World Bank. Data indicators [Internet]. 2017 [cited 2018 Oct 1]. Available from: https://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD?view=chart
- 11.World Health Organization. Global health expenditure database [Internet]. 2015. Available from: http://apps.who.int/nha/database/ViewData/Indicators/en
- 16.WHO. Global status report on noncommunicable diseases, vol. 2010. Geneva: World Health Organization; 2010.Google Scholar
- 17.WHO. Global status report on noncommunicable diseases, vol. 2014. Geneva: World Health Organisation; 2014.Google Scholar
- 19.Songer TJ, Ettaro L. The economics of diabetes project panel. Studies on the cost of diabetes [Internet]. Centers for Disease Control and Prevention; 1998 [cited 2016 Dec 11]. Available from: http://www.pitt.edu/~tjs/coi/Costofillness.PDF. Accessed 7 Sept 2018.
- 22.•• Kirigia JM, Sambo HB, Sambo LG, Barry SP. Economic burden of diabetes mellitus in the WHO African region. BMC Int Health Hum Rights. 2009;9(6) This article presents a direct view of the cost of diabetes on more than half of the countries in Africa. It is therefore a cardinal picture as to the economic burden of diabetes in the African continent. It further shows the estimated cost of illness (diabetes) per region (country)/year.Google Scholar
- 23.Suleiman IA, Fadeke OF, Okubanjo OO. Pharmacoeconomic evaluation of anti-diabetic therapy in a Nigerian tertiary health institution. Annals of African Medicine. 2006;5:132–137.Google Scholar
- 26.Suleiman IA, Festus JA. Cost of illness among diabetes mellitus patients in Niger Delta, Nigeria. J Pharm Health Serv Res. 2015;6:53–60.Google Scholar
- 28.Abdulganiyu G, Tayo F. What is the cost of illness of type II diabetes mellitus in a developing economy? Int J Pharm Pharm Sci. 2014;6:929–31.Google Scholar
- 34.Okoronkwo IL, Ekpemiro JN, Okwor EU, Okpala PU, Adeyemo FO. Economic burden and catastrophic cost among people living with type 2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria. BMC Res Notes. 2015;8.Google Scholar
- 35.Danmusa UM, Terhile I, Nasir IA, Ahmad AA, Muhammad HY. Prevalence and healthcare costs associated with the management of diabetic foot ulcer in patients attending Ahmadu Bello University Teaching Hospital, Nigeria. Int J Health Sci. 2016;10:219–28.Google Scholar