Improving health of people with diabetes: The ''end of the beginning''

Abstract

The St. Vincent Declaration Action Programme is one of the major programmes for the development of quality of care in the European region at the present time, Starting with the Ist meeting in Saint Vincent, Italy, in 1989, where achievable targets were set for improvement of diabetes outcomes, St, Vincent has developed into a movement with activities in all the 51 Member States of the European region of the World Health Organization (WHO/EURO): from Vladivostoc In the east to the Azores in the west, from Spitzbergen in the north to Israel in the south, It has also become a model for other World Health Organization regions, as confirmed by the Declaration of the Americas, and has been adopted as a model for quality development processes in other chronic disease programmes such as cerebrovascular and renal disease, asthma and mental disorders, Under the auspices of WHO/EURO and International Diabetes Federation (IDF-Europe), the ''top-down'' approach targets the Ministries of Health and the ''bottom-up'' approach, together with the increasingly influential diabetes associations, targets the health care professionals, reflecting the IDF motto ''Together we are Stronger''. The present report focuses on St. Vincent achievements to date, On the macro level, there has been a rapid and remarkable development of national diabetes task forces with multi-professional and patient participation (46 countries by February 1997) and National Diabetes Programmes endorsed by governments (34 by February 1997), More important, the first fruits of St. Vincent are being presented as reports on actual reductions in blindness, amputations and perinatal mortality due to diabetes, as well as a decrease in emergency admissions of children due to ketoacidosis.