An apple a day: Combatting non-communicable diseases has become a priority

Improving public health has been the overarching goal of health care development in Kuwait for over a century. The nation has had a considerable amount of success in this area. As of 2011, life expectancy in the country was nearly 78, up from the low 60s at the time of independence in 1961, according to the World Health Organisation (WHO). Similarly, the infant mortality rate fell from 80-100 per 1000 live births in 1950 to 10.7 per 1000 live births in 2011, according to data from the WHO. Most communicable diseases have either been almost entirely eradicated or are under control. The numerous improvements in public health over the years are the result of continual investment and careful oversight on the part of the government.

CHANGING PROFILE: Over the course of the past decade, non-communicable diseases have become the most pressing public health issue facing Kuwait. The rise in non-communicable diseases in the country over the past few decades is the result of a variety of social and economic factors that have transformed the way most Kuwaitis live. Indeed, according to the WHO, as of 2011 (the most recent year for which data was available) noncommunicable diseases – including accidents – accounted for 76% of deaths in Kuwait.

The government has worked to treat these diseases and change the population’s collective bad habits, primarily by investing heavily in specialised treatment centres and hospitals. The Dasman Diabetes Institute (DDI), for example, which was officially launched in June 2006, is at the core of the state’s battle against diabetes. Similarly, the Kuwait Cancer Centre (KCC), which is currently in development, will likely eventually serve a similar role in terms of cancer research, treatment and education. In addition to health care infrastructure, the state has ramped up education and awareness campaigns in recent years. That said, morbidity rates for diabetes, cancer, heart disease and other increasingly common non-communicable diseases have been on the rise. In an effort to stem this tide, the country’s state-funded hospitals and other institutions are investing heavily in new technology and studies, with a particular focus on preventative methods, which are widely considered the best way to address the issue. The activity in this area bodes well for future success.

“It is high time that there was an effective and coordinated regional approach to address and, crucially, work toward preventing non-controllable diseases of high prevalence in our region,” Qais Marafie, CEO of Kuwait Life Sciences Company, told OBG. “This will require a public policy shift and the implementations of measures such as screening programmes.”

A BRIEF HISTORY: The rise in non-communicable diseases in Kuwait and the wider Gulf region since the early 1990s has numerous root causes. The country’s harsh climate makes it nearly impossible to exercise outside during much of the year. In the summer months, temperatures regularly reach 50 C, and dust storms are relatively common. Consequently, many locals live mostly sedentary lives, relying on automobiles to get around.

Perhaps more importantly, over the past two decades in particular many restaurants and supermarkets have begun selling processed foods, which currently constitute a substantial percentage of local diets. Prior to the 1991 Gulf War, there were not many fast food restaurants in Kuwait. During the war, however, numerous US chains entered the country to cater to the influx of US troops on the ground. US franchises that set up shop in Kuwait in 1991 included Hardee’s, Taco Bell, Nathan’s Famous hot dogs and Baskin-Robbins, among others.

“The [Gulf War] was the demarcation line,” Abdulwahab Naser Al Isa, a professor in the department of community medicine and behavioural sciences at Kuwait University, recently told the media. While the US military only stayed in Kuwait for a short while, the fast food industry endured, and quickly became a staple of Kuwaiti diets. These changes have resulted in steadily increasing rates of obesity, diabetes and cancer.

OBESITY: According to a June 2012 study released by the London School of Hygiene and Tropical Medicine, Kuwait is the second-most obese country in the world, behind the US. Around 88% of Kuwaitis were considered to be overweight, according to the study, which was based on body-mass index calculations and data provided by the WHO. The local health care industry is working to address this issue in a number of ways. The Food and Nutrition Administration (FNA), which is part of the MoH, oversees a variety of programmes. In recent years, the organisation has focused on developing education and awareness-building materials and courses, with a particular focus on children. Additionally, the FNA operates an outpatient clinic, which offers dietary advice and nutrition management plans, as well as basic care for Kuwaitis suffering from obesity-related issues. Finally, the FNA oversees the Kuwait Nutrition Surveillance System, a public health monitoring programme set up in 1995 with support from the WHO and the US Centres for Disease Control and Prevention.

DIABETES: Like obesity, diabetes affects a significant percentage of the local population. According to a recent study released by the International Diabetes Federation, in 2011 between 21% and 25% of the population suffered from Type II diabetes, with this figure expected to rise in the coming years. In the report Kuwait was ranked first in the Middle East and North Africa and third in the world for prevalence of diabetes. Additionally, according to DDI, around 22 of every 100,000 Kuwait children suffer from diabetes.

Over the past seven years DDI has become a major regional player in diabetes research, education and treatment. The institute offers treatment facilities, including a cardiology centre, a cell therapy centre and numerous related clinics. DDI has also taken a leading role in diabetes prevention in Kuwait, primarily through its subsidiary Diabetes Kuwait Resource Centre, which provides consultations, educational programmes and workshops throughout the country.

CANCER: The incidence of cancer in Kuwait is in line with rates throughout the region, which are on the rise. According to MoH data, some 41,700 cases of cancer were recorded in Kuwait between 1970 and 2009. Around 40% of these cases were Kuwaitis, while the remaining 60% were expatriates. The most common types include breast, colon and lymph node cancers.

While some MoH hospitals include oncology departments, the primary cancer organisation in the country is the Kuwait Cancer Control Centre (KCCC), which was founded in 1968 and falls under the umbrella of the MoH. The 200-bed centre is equipped with state-of-the-art equipment and facilities, and treats more than 2000 cancer patients on an annual basis.

Cancer treatment technology in Kuwait is expected to see major improvements in 2014, when the $617.5m KCC is expected to be completed. The MoH-funded facility, which is part of the government’s large-scale Jaber Al Ahmad Al Jaber Al Sabah Hospital complex (see overview), will be home to more than 700 beds in around 250,000 sq metres of hospital space. The KCC will be the country’s flagship cancer care facility.