Treating the Indonesian Diabetes Pandemic: A Case Study from Novo Nordisk

Danish pharmaceutical company Novo Nordisk has released a new case study that examines the challenges for diabetes care in Indonesia. The study reflects the company's work to provide diabetes care across Indonesia, a country where millions of people have diabetes but less than one per cent receives proper treatment.

"If action is not taken, demand for healthcare will outstrip Indonesia's ability to provide it," said Charlotte Ersbøll, a corporate vice president at Novo Nordisk in charge of global stakeholder engagement. "In the end, it will be people with diabetes and their families that will carry the highest cost."

Last year, Novo Nordisk sold more than $60 billion worth of diabetes products worldwide, all while achieving some of the most prestigious corporate social responsibility accolades, including earning the top ranking on Corporate Knight's list of Global 100 Most Sustainable Corporations.

The case study, published last week as the fifth installment of Novo Nordisk's Blueprint for Change series, examines the barriers that limit the accessibility of quality diabetes care and identifies opportunities to address them.

According to the analysis, Indonesia suffers from a lack of awareness about diabetes. Many of the 7.6 million Indonesians who have diabetes are unaware that the disease exists, and 59 percent of cases go undiagnosed. Only one in eight of those suffering from diabetes receive insulin treatment.

Indonesia is a country in transition. The economy has grown by nearly 6 percent for the last decade, and economic opportunity is expected to bring some 32 million rural Indonesians to the city by 2030. City life often means less exercise and poorer diet, both of which can contribute to higher rates of diabetes.

To meet this challenge, the Novo Nordisk study recommends across-the-board investments in diabetes awareness and training, both for the general population and health care professionals. Novo Nordisk estimates that if its recommendations were adopted, more than 400,000 diabetes-related kidney failures could be prevented and nearly $6 billion USD could be saved in treatment costs.

"Novo Nordisk is committed to working together with local authorities, investors and NGOs to build trust and confidence among patients, healthcare practitioners and policy makers," said Sandeep Sur, general manager of Novo Nordisk Indonesia. "We must leverage all our joint capabilities and competences if we want to improve knowledge, treatment and better care."

To that end, Novo Nordisk launched its INSPIRE program in 2010 to train Indonesian internists about diagnosing and treating diabetes. By the end of 2012, Novo Nordisk trained 1,200 internists, and the company hopes to train another 1,280 during 2013.

In 2012, Novo Nordisk expanded its INSPIRE program to begin training general practitioners. The company estimates that the average Indonesian general practitioner receives only two hours of diabetes education during medical training, hardly enough to provide the skills necessary to screen for diabetes, manage its complications, or advise patients on proper nutrition. Novo Nordisk has found that its training of general practitioners has been even more effective than its training of internists.

Sidartawan Soegondo, President of the Indonesian Diabetes Association, lauded the investments Novo Nordisk has made to bring diabetes education to his country.

"Everything started with Novo Nordisk," said Seogondo. "We would not have existed without the partnership from Novo Nordisk. Their first investment was the salary of a nurse, and thereafter the ball got rolling."