Dr Qais Saleh Al Duwairi, Director-General, Dasman Diabetes Institute (DDI): Interview

Interview: Dr Qais Saleh Al Duwairi

How can Kuwait compete with more established, cost-effective health care providers abroad to reverse medical tourism outflows?

DR QAIS SALEH AL DUWAIRI: Global growth in the flow of patients and health professionals – as well as medical technology, funding and regulatory regimes – across national borders has given rise to new patterns in the consumption and production of health care services over recent decades. A significant new element of the growing trade in health care has involved the movement of patients across borders in pursuit of medical treatment and health services. Medical tourism may span the full range of services, but most commonly includes dental care, elective surgery and fertility treatment. It began to gain popularity about 15 years ago when patients from Kuwait and the GCC started to seek medical treatment overseas. People from the GCC tended to travel to the US and the UK from the early to mid-1980s, and then increasingly to Germany as well towards the end of the decade.

At present, the Kuwait Ministry of Health has approved a plan to construct eight new hospitals and extensions with an allocated budget of $1bn within five years. Moreover, the Ministry of Public Works has dedicated a budget of $4.19bn for nine additional hospitals to be established in the country. This initiative by the government will provide an additional 3334 hospital beds in the public sector, and an estimated 15,000 positions for health care professionals.

Given the prevalence of diabetes within the wider Gulf region, in what ways are stakeholders collaborating to enhance treatment?

AL DUWAIRI: There are already 300m people in the world with the disease – 6.6% of the adult population – and by 2030 the International Diabetes Federation (IDF) estimates that 438m people will be affected. The increase in the MENA region is set to be even more dramatic, almost doubling from 26.6m people today to 51.7m in 2030. It is anticipated that there will be many more people with pre-diabetes, indicative of an elevated risk of diabetes. This is an increase from 24.4m to 43.1m. The pandemic is being fuelled by a number of factors, notably demographic changes and increasing rates of obesity. Through eating a healthy diet and increasing physical activity, more than 50% of cases of type 2 diabetes can be prevented or delayed in people with pre-diabetes and those with known risk factors. Regionally, plans including the IDF MENA Action Plan of 2009 and the Integrated Gulf Executive Plan for Diabetes Control for 2008-18 can help address the burdens of the disease.

What kinds of awareness campaigns and treatment methods can be used to address the increased rates of type 2 diabetes?

AL DUWAIRI: Type 2 diabetes is being tackled through a multifaceted approach which begins with prevention. First, we believe in creating an environment that encourages healthy living and prevents diabetes through public awareness initiatives and outreach programmes at malls, universities and in public and private companies.

This entails deploying a wide variety of interventions to change behaviour. Second is the establishment of effective surveillance to help identify and support those at risk of developing type 2 diabetes.

Furthermore the DDI is educating and training health care professionals in the latest evidence-based standards of care through collaborations with the University of Dundee and the Joslin Diabetes Centre, and many other international organisations including the IDF. Beyond working on prevention, another focus lies in improving disease management for patients with diabetes to reduce complication rates. We do this through providing research-based and evidence-based approaches to diabetes treatment, screening, patient education and self-management.