About 800 million people are now estimated to have diabetes with the rise in cases mostly being felt in low and middle-income countries. Reuters
About 800 million people are now estimated to have diabetes with the rise in cases mostly being felt in low and middle-income countries. Reuters
About 800 million people are now estimated to have diabetes with the rise in cases mostly being felt in low and middle-income countries. Reuters
About 800 million people are now estimated to have diabetes with the rise in cases mostly being felt in low and middle-income countries. Reuters

Half of world's 800million adult diabetes sufferers unable to get treatment


Neil Murphy
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More than half of the estimated 800 million adults who have diabetes are not receiving treatment for their condition, research shows.

The World Health Organisation had previously estimated that about 422 million people have diabetes, a chronic disease involving blood sugar levels, which can damage the heart, blood vessels, nerves and other organs if untreated. The rise of the condition has seen a corresponding treatment gap as proportionally fewer people seek medical help.

The study was carried out by the NCD Risk Factor Collaboration and the WHO, and is the first global analysis to include rates and treatment estimates for all countries, the authors said. It is based on more than 1,000 studies involving more than 140 million people.

Three out of five (59 per cent) of adults aged 30 years and older with diabetes. A total of 445 million, were not receiving medication for diabetes in 2022, three and half times the number in 1990 (129 million).

A person receives a free blood sugar test during a campaign to mark the World Diabetes Day in Dhaka, Bangladesh. Reuters
A person receives a free blood sugar test during a campaign to mark the World Diabetes Day in Dhaka, Bangladesh. Reuters

About 14 per cent of people now have the condition globally, rising to 7 per cent in the past three decades, with much of the burden falling on low and middle-income countries. The rate of diabetes stayed the same or even fell in some wealthier countries, such as Japan, Canada or Western European nations such as France and Denmark, the study said.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said in a statement that the rise documented in the study was alarming.

“To bring the global diabetes epidemic under control, countries must urgently take action," he said, including with policies supporting healthy diets and physical activity, as well as health systems that can prevent, detect and treat the condition.

East Asia and the Pacific, as well as Canada and South Korea, have seen vast improvements in treatment rates for diabetes resulting in more than 55 per cent of people with diabetes in these countries receiving treatment in 2022. The highest treatment rates were estimated in Belgium, at 86 per cent for women and 77 per cent for men.

However, for many low and middle-income countries diabetes treatment coverage has stayed low and changed little over the previous three decades, with over 90 per cent of people with diabetes not receiving treatment in some countries in both 1990 and 2022.

In sub-Saharan Africa, only five to 10 per cent of adults with diabetes received treatment in 2022. In addition, just 10 per cent of people with diabetes in the Middle East and North African region received treatment, according to the study.

In 2022, about 133 million people with untreated diabetes lived in India, more than 50 per cent greater than the next largest number which was in China with 78 million.

Similarly, Pakistan had 24 million cases and Indonesia had 18 million cases, the next two countries with the largest number of untreated diabetes surpassed the USA with 13 million untreated cases.

“Our study highlights widening global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries where numbers of adults with diabetes are drastically increasing, said senior study author Majid Ezzati of Imperial College London. “This is especially concerning as people with diabetes tend to be younger in low-income countries and, in the absence of effective treatment, are at risk of lifelong complications.”

Those complications include “amputation, heart disease, kidney damage or vision loss – or in some cases, premature death,” he said.

Ten tax points to be aware of in 2026

1. Domestic VAT refund amendments: request your refund within five years

If a business does not apply for the refund on time, they lose their credit.

2. E-invoicing in the UAE

Businesses should continue preparing for the implementation of e-invoicing in the UAE, with 2026 a preparation and transition period ahead of phased mandatory adoption. 

3. More tax audits

Tax authorities are increasingly using data already available across multiple filings to identify audit risks. 

4. More beneficial VAT and excise tax penalty regime

Tax disputes are expected to become more frequent and more structured, with clearer administrative objection and appeal processes. The UAE has adopted a new penalty regime for VAT and excise disputes, which now mirrors the penalty regime for corporate tax.

5. Greater emphasis on statutory audit

There is a greater need for the accuracy of financial statements. The International Financial Reporting Standards standards need to be strictly adhered to and, as a result, the quality of the audits will need to increase.

6. Further transfer pricing enforcement

Transfer pricing enforcement, which refers to the practice of establishing prices for internal transactions between related entities, is expected to broaden in scope. The UAE will shortly open the possibility to negotiate advance pricing agreements, or essentially rulings for transfer pricing purposes. 

7. Limited time periods for audits

Recent amendments also introduce a default five-year limitation period for tax audits and assessments, subject to specific statutory exceptions. While the standard audit and assessment period is five years, this may be extended to up to 15 years in cases involving fraud or tax evasion. 

8. Pillar 2 implementation 

Many multinational groups will begin to feel the practical effect of the Domestic Minimum Top-Up Tax (DMTT), the UAE's implementation of the OECD’s global minimum tax under Pillar 2. While the rules apply for financial years starting on or after January 1, 2025, it is 2026 that marks the transition to an operational phase.

9. Reduced compliance obligations for imported goods and services

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10. Substance and CbC reporting focus

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Contributed by Thomas Vanhee and Hend Rashwan, Aurifer

Updated: November 14, 2024, 11:58 AM