In some Pacific Islands as many as one in three adults have type 2 diabetes. Photo: Getty.
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Where's the public outrage at the diabetes epidemic?

Worldwide, diabetes kills almost as many people a year as HIV/Aids, and the number of cases of Type 2 diabetes is set to increase by 50 per cent in the next decade. Why is so little being done to contain the epidemic? 

Over a third of adults in England are at risk of developing Type 2 diabetes, according to a study published in the British Medical Journal earlier this week – and the number of people at risk of suffering from diabetes has trebled in just ten years.

A few more worrying figures: there are currently 3.2 million people in the UK with Type 2 diabetes. A tenth of the NHS budget goes to treating the condition, according to the charity Diabetes UK. Type 2 diabetes can cut short your life expectancy by ten years. If not properly managed, it can lead to a range of complications including heart disease, blindness, kidney damage and nerve damage.

So are we doing enough to fight the disease? The obvious answer is no. We’re not even coming close.

Let’s look at the global problem too. The World Health Organisation (WHO) reports that 1.5 million people die of diabetes a year, making it the eighth most common cause of death worldwide, and almost as deadly as HIV/Aids (which kills 1.7 million a year). Diabetes is often thought of a rich country disease, but it isn’t just that: 80 per cent of diabetes deaths are in low or middle income countries.  In some Pacific Islands over a third of adults are diabetic, and in several Gulf countries over a quarter are. In American Samoa, a staggering 47 per cent of adults are diabetic. 

We’re facing a global health crisis and yet there’s little sense from government that it’s being treated as one.  Last year the all party parliamentary group for diabetes reported on the current state of healthcare provision and concluded, in the words of the chair Adrian Sanders, that "diabetes is one of the greatest challenges we face, yet diabetes healthcare is poor, patchy and expensive, and too many people with the condition are not getting the care or support they desperately need.”

In April, a doctor writing in the Spectator wrote that “medically speaking, I’d rather have HIV than diabetes.” His reasoning: thanks to advances in the treatment of the disease, the life expectancy of someone in the UK who is HIV positive is not all that different from someone that of someone without the condition. Those who are HIV positive and receive the right treatment (usually those in richer countries) are unlikely to suffer complications, and anti-retroviral drugs are now administered in tablet form. In contrast, most people with Type 2 diabetes face daily injections.

And, the good news is that globally, rates of HIV transmission are declining. According to the Global Fund, there were 2.3m new HIV infections registered in 2013 – which is still a lot, and the actual figure for HIV infections could be higher – but is nevertheless down 33 per cent since 2001. In contrast, WHO predicts that in the next decade, global cases of diabetes will increase by 50 per cent

When it comes to the battle to contain the spread of HIV/Aids, it has helped that on an international scale, there are now huge multi-government funded agencies such as the Global Fund. This was set up in 2002 and by 2013 had distributed $16bn to various donors, from governments to NGOs to international development agencies, to combat the disease. UN Aids was set up almost a decade earlier, to co-ordinate the many different UN agencies working to combat the disease and tackle related problems from gender equality, to gay rights and legal protection for sex workers.  The global effort to fight diabetes doesn’t come close.

Plus, long before these international co-ordinated efforts, we have to be grateful for the community activists of the 1980s who forced HIV/Aids on to national agendas, providing the initial impetus for the public awareness campaigns, charity outreach work, and medical research helping to contain the spread and impact of the illness. It’s time to get angry about diabetes in the UK, not only because at least 3.2 million people in the country are at risk of dying young, but because we know from the history of HIV/Aids how big a difference ordinary people getting angry can make. 

Much like HIV, a significant proportion of new diabetes cases can be prevented. You can be unlucky, but there are ways of reducing the likelihood of developing the illness. The rise of Type 2 diabetes has been linked to rising obesity in the UK, so tackling under-nutrition and sedentary lifestyles is key.

And again, much like HIV, tackling diabetes is not just a medical issue – you need to look at the social context. There’s also a strong link between poverty and diabetes in Britain: those in the lowest income bracket are two and a half times more likely to develop diabetes than average. This is because those on lower incomes are more likely to be obese, to smoke, to lack exercise and to suffer from high blood pressure.

There will be no easy way of preventing the rise of diabetes. Just as with HIV/Aids, we have to hope for (and fund) the development of new life-lengthening and life-improving treatments. But it will also involve changing modern diets and lifestyles – and that’s not just a matter of changing behaviour, which is hard enough already, but tackling the deprivation that is so often a cause of bad health.

There’s no miracle cure, but there is one sure-fire way of ensuring that millions of people in the UK and globally die younger than they should, and that’s carrying on exactly as we are now. As things stand, the charity Diabetes UK estimate that by 2025 five million people in the country will have Type 2 diabetes. It doesn't have to be like this. Aren’t you a little bit angry?

Sophie McBain is a freelance writer based in Cairo. She was previously an assistant editor at the New Statesman.

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How the row over Jackie Walker triggered a full-blown war in Momentum

Jon Lansman, the organisation's founder, is coming under attack. 

The battle for control within Momentum, which has been brewing for some time, has begun in earnest.

In a sign of the growing unrest within the organisation – established as the continuation of Jeremy Corbyn’s first successful leadership bid, and instrumental in delivering in his re-election -  a critical pamphlet by the Alliance for Workers’ Liberty (AWL), a Trotskyite grouping, has made its way into the pages of the Times, with the “unelected” chiefs of Momentum slated for turning the organisation into a “bland blur”.

The issue of contention: between those who see Momentum as an organisation to engage new members of the Labour party, who have been motivated by Jeremy Corbyn but are not yet Corbynites.

One trade unionist from that tendency described what they see the problem as like this: “you have people who have joined to vote for Jeremy, they’re going to meetings, but they’re voting for the Progress candidates in selections, they’re voting for Eddie Izzard [who stood as an independent but Corbynsceptic candidate] in the NEC”.  

On the other are those who see a fightback by Labour’s right and centre as inevitable, and who are trying to actively create a party within a party for what they see as an inevitable purge. One activist of that opinion wryly described Momentum as “Noah’s Ark”.

For both sides, Momentum, now financially stable thanks to its membership, which now stands at over 20,000, is a great prize. And in the firing line for those who want to turn Momentum into a parallel line is Jon Lansman, the organisation’s founder.

Lansman, who came into politics as an aide to Tony Benn, is a figure of suspicion on parts of the broad left due to his decades-long commitment to the Labour party. His major opposition within Momentum and on its ruling executive comes from the AWL.

The removal of Jackie Walker as a vice-chair of Momentum after she said that Holocaust Memorial Day belittled victims of other genocides has boosted the AWL, although the AWL's Jill Mountford, who sits on Momentum's ruling executive, voted to remove Walker as vice-chair. (Walker remains on the NEC, as she has been elected by members). But despite that, the AWL, who have been critical of the process whereby Walker lost her post, have felt the benefit across the country.

Why? Because that battle has triggered a series of serious splits, not only in Momentum’s executive but its grassroots. A raft of local groups have thrown out the local leadership, mostly veterans of Corbyn’s campaign for the leadership, for what the friend of one defeated representative described as “people who believe the Canary [a pro-Corbyn politics website that is regularly accused of indulging and promoting conspiracy theories]”.

In a further series of reverses for the Lansmanite caucus, the North West, a Momentum stronghold since the organisation was founded just under a year ago, is slipping away from old allies of Lansman and towards the “new” left. As one insider put it, the transition is from longstanding members towards people who had been kicked out in the late 1980s and early 1990s by Neil Kinnock. The constituency party of Wallasey in particular is giving senior figures in Momentum headaches just as it is their opponents on the right of the party, with one lamenting that they have “lost control” of the group.

It now means that planned changes to Momentum’s structure, which the leadership had hoped to be rubberstamped by members, now face a fraught path to passage.

Adding to the organisation’s difficulties is the expected capture of James Schneider by the leader’s office. Schneider, who appears widely on television and radio as the public face of Momentum and is well-liked by journalists, has an offer on the table to join Jeremy Corbyn’s team at Westminster as a junior to Seumas Milne.

The move, while a coup for Corbyn, is one that Momentum – and some of Corbyn’s allies in the trade union movement – are keen to resist. Taking a job in the leader’s office would reduce still further the numbers of TV-friendly loyalists who can go on the airwaves and defend the leadership. There is frustration among the leader’s office that as well as Diane Abbott and John McDonnell, who are both considered to be both polished media performers and loyalists, TV bookers turn to Ken Livingstone, who is retired and unreliable, and Paul Mason, about whom opinions are divided within Momentum. Some regard Mason as a box office performer who needs a bigger role, others as a liability.

But all are agreed that Schneider’s expected departure will weaken the media presence of Corbyn loyalists and also damage Momentum. Schneider has spent much of his time not wrangling journalists but mediating in local branches and is regarded as instrumental in the places “where Momentum is working well” in the words of one trade unionist. (Cornwall is regarded as a particular example of what the organisation should be aiming towards)

It comes at a time when Momentum’s leadership is keen to focus both on its external campaigns but the struggle for control in the Labour party. Although Corbyn has never been stronger within the party, no Corbynite candidate has yet prevailed in a by-election, with the lack of available candidates at a council level regarded as part of the problem. Councilors face mandatory reselection as a matter of course, and the hope is that a bumper crop of pro-Corbyn local politicians will go on to form the bulk of the talent pool for vacant seats in future by-elections and in marginal seats at the general election.

But at present, a draining internal battle is sapping Momentum of much of its vitality. But Lansman retains two trump cards. The first is that as well as being the founder of the organisation, he is its de facto owner: the data from Jeremy Corbyn’s leadership campaigns, without which much of the organisation could not properly run, is owned by a limited company of which he is sole director. But “rolling it up and starting again” is very much the nuclear option, that would further delay the left’s hopes of consolidating its power base in the party.

The second trump card, however, is the tribalism of many of the key players at a local level, who will resist infiltration by groups to Labour’s left just as fiercely as many on the right. As one veteran of both Corbyn’s campaigns reflected: “If those who have spent 20 years attacking our party think they have waiting allies in the left of Labour, they are woefully mistaken”. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.