Diabetes Care May Suffer Lack of Political Attention

Clinics to tackle diabetes and hypertension may face shortages because the diseases have been left out of the donor and political spotlight.

In urban areas, 4.3 percent of people over the age of 25 were diagnosed with diabetes, compared to 1.2 percent in rural areas, according to a 2010 report by the Health Ministry and World Health Organization. About one in four diabetic patients took traditional remedies and about 14.5 percent used insulin treatment, it showed.

But Prak Piseth Raigsey, director of preventive medicine at the Health Ministry, said clinics lacked funds to offer incentives to physicians and buy medication.

“We opened clinics in the prov-inces, but right now there is a shortage of drugs to treat patients. It is still a problem,” she said.

Dr Piseth Raigsey said the government budget for noncommunicable diseases was lower than that for infectious diseases like HIV/AIDS. “It’s not a priority like maternal and child health.”

However, Sok Kong, deputy director of the ministry’s noncommunicable disease office, denied that there were drug shortages at the nine diabetes clinics nationwide—some of which charged small fees as salary supplements for doctors.

“We sometimes face problems with drugs if they go out of stock or are transferred a bit late,” Dr Kong said.

Chheang Sena, vice president of the Cambodian Diabetes As-sociation, said that the World Diabetes Foundation last year stopped providing drugs and incentives to clinics in five prov-inces. “That’s the responsibility of the government now,” Dr Sena said, noting that diagnostic tests were the only shortage.

Nasir Hassan, a WHO environmental health adviser, said that noncommunicable diseases were an increasing health burden in developing countries such as Cambodia.

“There is a lack of infrastructure for [diabetes] testing and information in rural areas,” Dr Hassan said. “It’s a huge problem, but also applies to other noncommunicable diseases like hypertension and cancer.”

Cambodia has a relatively low level of diabetes compared to other Asian countries, but risk factors like alcohol and smoking were higher, he added.

Nearly 8,000 deaths were attributed to diabetes in Cambodia last year, according to the Internation-al Diabetes Federation.

Maurits Van Pelt, director of the NGO Mopotsyo, said most donors viewed diabetes as a “black hole”, and exclusively fo-cused efforts on diseases like tuberculosis and HIV/AIDS.

Less than 1 percent of health sector donations were devoted to noncommunicable diseases, compared to about 60 percent for in-fectious diseases, he said.

“For diabetes there is no mo-ney available,” Mr Van Pelt said, noting that the NGO set up networks for diabetic patients to educate each other.

“What are we going to do ex-cept sort out our own problem?” he said.

(Additional reporting by Cheng Sokhorng)

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