By Dr Arvind Mathur, WHO Representative
DILI, 14 november 2024 (TATOLI) – Imagine a young mother forced to abandon her hopes and the life she once knew as diabetes quietly drains her health and energy. The endless fatigue, the exhausting demands of managing her illness, and the emotional toll leave her feeling isolated and overwhelmed. This is the difficult reality for countless Timorese families, as diabetes silently spreads through communities, fueled by rapid urbanization and shifting lifestyles.
Nearly 4% of adults have raised fasting blood glucose levels—a key marker for diabetes risk. However, the crisis is particularly acute for women of Timor-Leste, who face a death rate from diabetes that is four times higher than men. This gender disparity calls for targeted interventions to improve women’s diabetes care urgently.
The consequences of diabetes extend far beyond elevated blood sugar levels. It is a gateway to a host of other debilitating conditions, including heart disease, kidney failure, and nerve damage. Adults with diabetes face twice the risk of heart disease or stroke compared to those without it. Moreover, in this country, individuals with diabetes are especially vulnerable to infections like tuberculosis, often facing poorer health outcomes due to delays or barriers in accessing care.
A significant challenge in combating diabetes in Timor-Leste is the late diagnosis of the disease. Due to low public awareness, subtle symptoms, and limited access to diagnostic resources, many remain undiagnosed till diabetes has progressed to complications, adding to the health and economic strain on individuals and their families.
The theme of this year’s World Diabetes Day—Breaking Barriers, Bridging Gaps—resonates deeply with Timor-Leste’s fight against diabetes. It is time to confront that diabetes is not merely a pressing health imperative; it is a societal, economic, and educational one.
Managing diabetes in Timor-Leste presents numerous challenges. Access to healthcare services remains limited, particularly in rural areas where facilities are limited. The country’s reliance on imports for essential medicines and diabetes management supplies, often with delays, leaves patients vulnerable to complications. Crucially, a big percentage of the healthcare workforce needs re orientation training on the latest treatment protocols in diabetes management.
This is why this battle calls for a new strategy—one that involves united approaches to tackle interlinked diseases, strengthens capacity and engages communities in the effort. Importantly, the Government of Timor-Leste has begun taking steps in this direction- the Integrated Health Program (PROGRAMA INTEGRADU BA SAÚDE (PIS) aims to offer seamless integrated specialist health services to community care and with efficient referral pathways.
The Ministry of Health has adopted and implemented WHO’s Package of Essential Non-Communicable Diseases (PEN) protocol across the country. It offers a cost-effective approach for the early detection and management of diabetes, cardiovascular disease, and other life-threatening noncommunicable diseases—knowing that controlling any of these conditions can create a positive ripple effect in managing them collectively.
The Ministry’s initiative of ‘50X25’ aims to place 50,000 people with hypertension and or diabetes on standard treatment protocols by 2025. The Ministry of Health and WHO, with the World Diabetes Foundation, are accelerating diabetes and hypertension diagnosis and management in Dili and Aileu municipality.
WHO’s HEARTS program, adapted to Timor-Leste’s primary care as “Timor Hearts”, focuses on lifestyle counseling, evidence-based treatments, access to essential medicines, team-based care, and regular monitoring.
Tuberculosis patients are now routinely screened for diabetes under an integrated health approach, while community screenings for hypertension and diabetes are planned during outreach through the Integrated Health Program.
When it comes to diabetes care, with its close ties to lifestyle and exercise, the approach needs to go beyond clinics and reach into the community itself. Reflecting this vision, WHO has helped MOH establish 64 open gyms across the country, creating spaces that encourage physical activity and continue with signature “Walk the Talk” events in Dili and other municipalities.
It cannot be stated enough that addressing diabetes requires system-wide changes. Expanding diabetes education for providers, consistent availability of medications and diagnostic tools are crucial to that change. Campaigns that promote healthy lifestyles, awareness of symptoms and encourage early testing can and are making a difference. Schools and workplaces can also help foster environments where prevention is prioritized, and diabetes resources made accessible.
As Timor-Leste navigates the complexities of diabetes care, it is clear that every step—from policy to community engagement—counts in bridging the gaps. By prioritizing the three pillars of prevention, diagnosis and care, the nation can stop the silent burden of diabetes.
TATOLI
Source: WHO
