TOO MUCH TORTILLA
According to the BMI's Burden of Disease Database (BoDD), a few years ago diabetes represented 6% of all disability-adjusted
life years (DALYs) in Mexico. This figure will continue to rise until more than 1.5 million DALYs are lost to the disease
less than fifteen years from now. Local data indicates that more than a third of Mexicans who have diabetes are unaware that
they are suffering from the disease. As it stands, diabetes represents about 35% of all Mexico's public health spending, and
data published suggests that there will be more than 13.5 million sufferers by the year 2025.
Diabetes is clearly Mexico's biggest current health problem, which may be explained by the fact that Mexico is currently top
in the world for child obesity, and number two for adult obesity. Although looking at increasingly popular eating habits in
Mexico, the problem most likely isn't too much tortilla. It is the highly westernized diet that has crept into Mexican society
in the form of too many processed foods and far too many sugar-filled sodas.
Joel Durán, Marketing Director, Novo Nordisk Mexico
Joel Durán, director of marketing at diabetes specialist Novo Nordisk in Mexico, suggests that due to the sheer size of the
problem, a solution backed by all stakeholders in the market needs to be found.
"Given the speed at which diabetes is rising we need stronger collaborations and partnerships in order to change the mentality
of the Mexican people. If we do not do this, we will not achieve the common goal of changing the face of diabetes and tackle
the problem in the most effective way. We should beat diabetes before it beats us. That is our main concern—how can we make
a change and how can we participate and provide knowledge, expertise, education, and be a factor of change in terms of finding
a solution, to ultimately beat diabetes."
Not many people can disagree with that stance, but it may be easier said than done.
Carlos Baños, President and General Director, Lilly Mexico
The three largest social security institutions in Mexico; IMSS, ISSTE and Seguro Popular, run specific diabetes programs that
include nutritional education and psychological support. They are also trying to include a wider selection of pharmaceutical
treatments in an attempt to provide more comprehensive care. But are these enough?
If combating diabetes requires a complete change in mentality for Mexicans, then it certainly is a tall order. It is far more
achievable if the pieces of the current mentality puzzle can be put together and understood. Many people say that there is
a social stigma surrounding diabetes and a dislike of anybody knowing that you have the disease. This would probably explain
the high percentage of undiagnosed sufferers. Durán believes there is a strong emotional connection with food in Mexico because
of the high proportion of family events that involve eating, and the thought of treatment might drag patients away from being
able to participate.
"This emotional connection is preventing a lot of patients from making small but crucial changes in diet and lifestyle habits
that would enable better treatment compliance," he explains.
Carlos López Patán, General Director, Medix
If mentality is the underlying cause of both under-diagnosis and non-compliance with treatment, it becomes even more important
to break down barriers and to start to tackle this elephant of a problem. Carlos Baños, president and general director of
Eli Lilly in Mexico believes, along with the majority of the industry, that education is essential for treatment compliance.
This not only involves telling people about the disease and what they need to do, but tailor-making real educational solutions
"In Mexico the average person reads fewer than two books a year. This is a big challenge because we can produce the most beautiful
material about how to manage diabetes, but achieve nothing because the materials have not been read." One of Eli Lilly's solutions
to the problem is an educational tool called Diabetes Conversations Maps.
"This tool was developed globally and adapted locally to adjust to the culture of Mexico. It is a game, similar to Monopoly,
which helps teach people living with diabetes and their family all they need to know on the disease and how to care for themselves."
When it comes to diabetes treatments, the sharp increase of competition in the field has made brand loyalty more important
than ever. Increasing compliance and making the physician's life easier is essential. Education to ensure brand loyalty can
often be seen in Mexico in the form of a trained nurse who spends more time with the patient than the doctor in the patients'
own homes, to show them how to use the treatment equipment, how to clean it and store it properly. A big investment on the
part of the pharmaceutical companies, but brand loyalty for chronic illnesses seems to be worth it.
Carlos López Patán, general director of Medix, the Mexican specialists on obesity, explains that for him, the key to success
in providing obesity treatment lies in the provision of an entire catalogue of individualized services and products.