During our preparations for WDF´s anniversary, several colleagues asked me about my proudest WDF moment of the past 20 years. Many come to mind, but all have one thing in common. They involve seeing the impact of WDF partnerships on peoples’ lives.
Tanzania offers a good example. When we first visited Tanzania in 2002, there was very limited diabetes treatment in the country. There were not many people with insight in diabetes treatment – Dr Kaushik Ramaiya, founder of the Tanzania Diabetes Association, was one of the few. The first project WDF supported was to open diabetes clinics in donated shipping containers at Muhimbili and Temeke hospitals in Dar es Salaam, providing integrated diabetes care where previously there was none.
The project began with four clinics. Dialogue with the government to get diabetes services inside hospitals came next. Diabetes care was integrated into the Tanzania´s wider healthcare system. Over the years, we went from four clinics to 148 clinics across the country. Then, in 2019, we started a nationwide primary health care project to reach more than 500 health facilities by 2024.
Dr Kaushik Ramaiya (left) and Leif Fenger Jensen, Tanzania, 2004.
When we began thinking about creating a World Diabetes Foundation back in 2001, we had two main hopes. We wanted to put diabetes and non-communicable diseases on the agenda in low- and middle-income countries (LMICs), and we wanted to do this through partnerships.
This was simple to say, but – it turned out – quite difficult to do.
Getting NCDs and diabetes on the agenda was difficult because the countries we were approaching had many different problems. It didn’t always help to come and say you also have this problem, diabetes. Diabetes was considered a rich man’s disease with little relevance in an LMIC context – which, as we know, is very wrong.
Sometimes we met resignation, and we understood - it really is tough out there. A very little part – currently only 7% - of overseas health development aid goes to NCDs. This is way out of proportion. Non-communicable diseases kill 41 million people each year, and 77% of all NCD deaths are in LMICs.
Fortunately, we quickly found that our partnership model was the right approach. There were very, very few people and organisations working with diabetes in LMICs when we started. But we found these local champions, and they found us. Together we developed locally formulated solutions, piloted them, and scaled them up. It was a sensible response to a huge, complex problem, and it worked.
Working through public-private partnerships was difficult too; surprisingly so. While public-private partnerships are in fashion today, they were still new 20 years ago. Many people and organisations talked about the necessity of public-private partnerships, but the reality it was more difficult. A lot of organisations were reluctant to talk to us because of our Novo Nordisk funding - there was real scepticism.
To succeed on this front, we needed to prove ourselves. We needed to show the right attitude, approach, and above all results. Now, we are working closely with the WHO, UN organisations, the NCD Alliance, global NGO’s, government institutions and other key global partners, and a lot of good things are coming out of that.
Strong partnerships, and patience. These were promises we made from the beginning – that we would find the right partners and be there for the long term.
I think it’s important to note that we´ve had very few projects that have not succeeded – our success rate is high. I believe this is because we have the heart of a philanthropic organisation, and the mind of a business. People can ask WDF for support, and we deliver it in a professional way that involves trust, long-term relationships, and solid monitoring and evaluation.
This is quite unique. We are a philanthropy born from a business, so we need to speak both the languages both of philanthropy and business. We have learned a lot from this duality, and our experience has taught our partners some useful skills as well.
Giving money away is really hard work. Our founding Board Member Lars Rebien Sørensen used to say that “WDF must spend the money as responsibly as it was earned.” I really feel this obligation. We try to do our work as professionally as possible. Professional philanthropy – this is something I believe in. Philanthropy is serious business.
What´s next? The same and more. 20 years ago, WDF resolved to fight diabetes among the most vulnerable through partnerships. We started with many small, locally anchored projects. Now we work with bigger projects that are integrated in health systems in order to meet the fast-growing need.
Diabetes continues to hit LMICs the hardest. You can say we have not been successful in the sense that there are still 500 million people with diabetes worldwide, three-quarters of them in LMICs. So the problem is not solved - this is a marathon and we’re lagging behind. The need for what WDF and its partners is doing continues to grow.
Fortunately, we are here, and stronger than ever. The NCD agenda is moving in the right direction, creating opportunities for new, synergetic partnerships on a global scale. We have a great network within diabetes, with more than 300 partners in 119 countries, and this is a core source of our strength.
Happy anniversary, World Diabetes Foundation Secretariat, Board, partners and donors. There is plenty left to do. But thank you for all we have achieved together so far. It has been a remarkable 20 years.