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Commemorating 100 years of insulin: Reflections of a non-profit leader

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As the WHO commemorates 100 years since the discovery of insulin on April 14, Nalini Saligram, PhD., founder, Arogya World, a global not-profit organisation working to combat NCDs, calls for a commitment to building a movement around healthy living while honouring the spirit behind the extraordinary gesture of the scientists who sold the patent for $1 saying– Insulin belongs to the world, not me

In 2021 as the world reels from COVID related devastation it is important to remember that this is the 100th anniversary of one of mankind’s great achievements, the discovery of insulin. Life-saving insulin belongs right up there in Medicine’s hall of fame, with antibiotics, vaccines, modern-day cancer therapies, antipsychotics, morphine, statins, etc. which have reduced suffering, improved the quality of the life we spend on earth, and even extended our lives. This year we honour Dr Frederick Banting and Charles Best and their co-workers for discovering this miracle, a matter of life or death for people with Type 1 diabetes.

For the rest of the 500 million living with diabetes today, most with Type 2, it is a powerful tool. As the disease worsens over time, doctors add short-acting and long-acting insulin to different classes of oral medications and manage the patient’s blood sugar optimally. This helps to prevent further complications from uncontrolled diabetes such as heart disease, stroke, kidney disease, nerve damage, foot amputations, eye damage, blindness etc. 

Diabetes is one of the Non-Communicable Diseases (NCDs), that also include heart disease, cancer and chronic lung diseases. NCDs represent 7 of the 10 causes of death, are collectively acknowledged to be one of the top health & development challenges of the century and threaten to wipe out the hard-fought gains the world made against the Millennium Development Goals (MDGs).

Prevention – A smart solution 

NCDs are largely preventable. According to WHO 80 per cent of heart disease, 80 per cent of type 2 diabetes and 40 per cent of cancers can be prevented with 3 lifestyle changes – one must eat right, exercise and avoid tobacco. I consider the landmark clinical trial Diabetes Prevention Program as another of the greatest advances in public health and medicine. It showed definitively that exercise and diet can prevent diabetes, and keep it at bay for 10 years. 

A staggering 4 billion people live with NCDs today. You simply can’t treat your way out of this crisis – the problem is too huge. Prevention through healthy living is the smart solution.   I am excited about WHO’s Global Diabetes Compact being launched this week and that they have committed to help governments in meaningful ways to prevent and manage diabetes. I am particularly pleased that “On the prevention side, particular focus will be given to reducing obesity, especially among young people.”

This is good news all around, and we congratulate the WHO for their vision. 

Inaction is not an option

In India 3 out of 4 adults in metros have diabetes or are pre-diabetic, and get the disease 10-20 years earlier than people in the West. The public health burden is alarming. Something must be done. As an NGO health leader, I think about diabetes prevention every day. In COVID times, prevention is even more important and urgent because people with underlying diabetes have more severe disease and negative health outcomes from COVID.

On this 100th birthday of insulin let us honour that magnificent medical breakthrough, and the spirit behind the extraordinary gesture of the scientists who sold the patent for $1 saying– Insulin belongs to the world, not me.   Let us commit to building a movement around healthy living. I appeal to you all for support:   

          Governments –please increase emphasis on diabetes prevention at the central, state and city government levels, get commitments from all sectors of society to advance the health of communities, do more to help the next generation lead healthier lives

          Individuals – you can take steps every day to advance your health and well-being, by eating right, getting to 50,000 steps a week, all while practising COVID appropriate behaviour.

          Companies – as you battle with decisions on whether and when to bring employees safely back to work, you can contribute to this movement by advancing workplace health and tackling the mental health of your employees.

          Furthermore, you can extend your reach and marketing muscle and the platforms you have already built to get diabetes prevention messages broadly disseminated

          Education NGOs – you are in a unique spot to help the children you educate also learn about health in win-win adjacencies and collaborations with health NGOs

          CSR funders – you are needed now more than ever. Please fund programs that empower people to change behaviour and prevent diabetes and other NCDs. Please help transform rural communities into healthy communities. Help make Every Child a Healthy Child. It is the need of the hour as we look beyond immediate COVID relief. 

          Civil Society – We in the NGO world can make outsized contributions to this movement.  At Arogya World just to provide one example, we commit to helping millions of women, children and working adults lead healthier lives, mobilise cities in this drive-in new and innovative ways, attempt to change the way India eats, partner with other non-profits and the government and help India meet the SDGs. 

I call on everyone to galvanise into action and fulfil the legacy of insulin’s 100 years. Some are fighting to get access for the 100 million who need insulin to live. Let’s also do our best to prevent diabetes and accelerate the healthy living movement.

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