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Rate of diabetes is rapidly going up in India. In addition scientists have shown that Indians are more prone to diabetes if they are obese to the same extent as someone from Canada or the U.S. This is called thin-fat diabetes- a higher impaired glucose intolerance- and comes from centuries of body changes following famine in parts of the country from failure of monsoon rains. The obesity rate is going up dramatically and with it diabetes is up significantly.  From 6.4% obese or overweight in 1990, by 2017 18.8% are obese or overweight, according to Health Metrics and Evaluation Institute of the University of Washington. The International Diabetes Federation now predicts 123 million with diabetes in India by 2040. By 2017 diabetes rates went up from 1990- from 5.5% to 7.7% or 63 million people. The major problem in South Asian countries and in China is the growing use of packaged and processed foods, fast food and carbonated drinks. Efforts to prevent the sale of junk foods is a battle being fought between private citizens and the large processed foods companies such as Coca Cola, Pepsi and Nestle. This is the subject of this article with Mr. Verma taking the case to the Delhi High Court facing large opposition. Mr. Verma left his job as a marketing executive as he took care of his sick child. He filed a case in the Delhi High Court in 2010, and faces the opposition of the India Food Processors Association- so far there is little progress.   ...

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A study published in the British journal Lancet shows that the number of people suffering from diabetes went from 153 million in 1980 to 353 million in 2008. The study shows the U.S. having 24.7 millon diabetics in 2008, which is three times the number from 1980. About 70% of this is from population growth and aging, and the rest from obesity, lack of exercize, changing diet. The American Diabetes Association estimated the cost of treating diabetes in the U.S. at $174 billion for 2007. About 138 million diabetics live in China and India. In India there is an additional cause- malnutrition in early childhood years for the poorer segment of the population. European countries have done better than the U.S., Mexico, India and China. S. Korea and Thailand have done better than other Asian countries. And this is attributed to healthier lifestyles, diet and less obesity in these countries.

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Anand Chaturvedi, an executive for Korean Company Doosan Infracore- which acquired Bobcat from Ingersoll Rand- and his wife Garima, a doctor in internal medicine, both in their mid 30's, and their lives between two continents. Chaturvedi works for Doosan in Atlanta and Garima set up the diabetes clinic in Udaipur, Rajasthan. A couple's unique way of working to provide help to deal with diabetes in India, as a way of honoring a brother who died of cancer.

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Chile, Mexico and the U.S. rank high in the diabetes rate for top soda consuming countries. In the U.S. the diabetes rate is at 7.7% of the population, in Chile 9.6% and Mexico 9%. Soda consumption per capita was at 165 litres in the U.S., 146 litres in Mexico and 134 litres in Chile, and 145 litres in Argentina where the diabetes rate is at 3.9%, for 2012. A new public service ad in Mexico City subway stations says it all, showing an ad with a soda bottle and the words- "Would you take 12 teaspoonfuls of sugar? Soda is sweet, diabetes isn't." The new Pacto de Mexico agreed to by all major political parties includes the soaring diabetes rate in Mexico as a problem to be tackled, including lunches at public schools and the consumption of coke and sodas by children. A particular acute problem in Mexico is the lack of clean drinking water in many areas and the dependence on coke and sodas for liquids. But bottled water could be used in its place if available at lower prices. One proposal is for a soda tax which could generate $2 billion and be used for setting up clean drinking water fountains in schools and other places. Elected officals in Mexico are firm about the need for action, as Mexico recently became the first country over 100 million inhabitants with the highest obesity rates at 7 adults out of 10 over the age of 20 obese or overweight, and the consequently high diabetes rate. Diabetes is the No. 2 killer in Mexico, and a serious health danger. Coca Cola gets its second highest revenues from Mexico after Europe, and the situation has evolved after years of heavy coke advertising to the point where Coca Cola is taken at every meal by some Mexican families, and is a sign of prestige. The company's response is to fight the public service ads with ads showing people burning off 149 calories by walking. The country now faces a long and uphill fight. Russia is one of the countries which is also conducting a similiar fight against soda drinks. The Bloomberg Philanthropy is financing efforts against soda drinks in Mexico, as part of its campaign against smoking and sodas as health hazards, and this maybe Bloomberg's bigger contribution to society than his service to New York City. Developing middle income countries such as Mexico, Chile, India, China, Brazil, are the hardest hit by soaring diabetes. And the costs to their health systems in 10-20 years from uncontrolled obesity and diabetes will be enormous. The U.S. is a developed country with similiar high rates of obesity and diabetes, with soaring medical costs, and serious problems that strangely have not received the public awareness and efforts that one should expect. ...

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Jacobs and Richtel of the NYT give this exceptional story of how Mexico changed between 1980 and 2016. Following the joining of NAFTA free trade zone the Mexican diet and food ecosystem began to more closely resemble the food diet system in the U.S. bringing with it severe health consequences. Soda and coke are now more entrenched in Mexico, as are fast food outlets. In 1980 only 7% of Mexicans were obese, compared to 20% in 2016, according to Institute for Health Metrics at the University of Washington. And diabetes kills 80,000 people a year, becoming the top killer according to the World Health Organization. A trade expert at Tufts University, Timothy Wise, says Mexico took on the worst aspects of a first world country like the U.S., with few protections. A similar problem is taking place in India and China as obesity grows, according to the T.H. Chan School of Public Health at Harvard, as low nutrient highly processed foods of large food companies with huge advertising budgets take a prominent place in diets. This is a growing problem for countries from Colombia to Ghana and Nigeria. ...

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June 21 is designated International Yoga Day by the United Nations. India celebrates International Yoga Day with 35,000 children and adults doing Yoga in central Delhi. Narendra Modi leads the effort to promote yoga for fitness and health. Yoga research centers are being established to improve health and treat diseases such as diabetes alongside modern medicine. Yoga day practice sessions of yoga were organized throughout India, with the participation of millions of people. Yoga Day activities in Paris, France, included a outdoor yoga session below the Eiffel Tower. In his address to the UN General Assembly on September 27, 2014, Narendra Modi said about yoga: "yoga is not about exercize, but to discover the oneness with oneself, the world and nature." It is part of a 5000 year old tradition from ancient India that promotes meditation, spiritual development and health. This ancient tradition is gradually being revived and is useful in India, China, the Middle East, the U.S. and other countries that see the spread of obesity, diabetes and other health problems. It helps improve spiritual concentration of mind, and increases the body's vital energies....

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President Biden removes one of the costly boondoggles thrust on the American people with Bush's Drug Improvement and Modernization Act of 2003, which was anything but an improvement. .The following are the 10 pharmaceutical drugs that will be negotiated for Medicare prices under the Inflation Reduction Act- Eliquis and Jardiance (strokes), Jardiance, Xarelto (diabetes), Entresto (heart failure), Enbrel (arthritis). Laws passed under Republican president younger Bush incomprehensibly took away the right of the government to negotiate drug prices with pharmaceutical companies in one of the most egregious and costly decisions in postwar history by the government of the United States. It has only aggravated the problems and cots of healthcare for the American people. President Biden reversed this with the passage of the Inflation Reduction Act during the pandemic. Strangely it is part of the real culture war in America in which about 80% of both Republicans and Democrats support this but the media allowed the Bush legislation to be passed without saying it made no sense to say this negotiation was a form of price controls by the US government. This is how low the US policymaking had fallen by 2003 with legislators and press unable to make a simple point. Bush's legislation was called even more incomprehensibly the Medicare Drug Improvement and Modernization Act, when it was one of the biggest financial disasters for the American people costing them hundreds of billions of dollars in their savings and incomes to pay inflated prices of pharmaceuticals that people in Europe and Asia (India and China) were not paying.  ...

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With a mere 1% of GDP invested in public healthcare India remains backward in its commitment to the welfare of the rural poor. Prime minister's Modi's plan is laudable says this BBC report, but the record of implementation is spotty at best at the state level for such plans. The new plan announced in the 2018 Indian Budget is for a health plan covering 500 million Indians with 5 lakh rupees coverage, something never tried before but with a cost of a mere $1.7 billion is something that the country woefully lacked or neglected to tackle.

This plan may be better implemented at the national level, and particularly where the reputation of the governing party and its plans for industrialization are at stake in the coming year's national elections. If accomplished and the Modi government is eager to take on these challenges it would be a significant step to balanced and overall development of the Indian economy.

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A partnership is formed between Dr. Reddy's and Glaxo focussed on emerging markets, excluding India. The products will be manufactured by Dr Reddy's and licensed and supplied by Glaxo in countries in Africa, the Middle East , Asia-Pacific and Latin America. In certain markets they will be co-marketed by the two companies. The deal gives Glaxo exclusive use of over 100 branded pharmaceuticals in areas like cardiovascular, diabetes, oncology, gastroenterology and pain management. Under the terms of the agreement the revenue results will be reported by Glaxo and shared between the two companies. This is part of Andrew Witty's strategy to take the expansion in emerging markets -especially in association with India- to a new level. Witty recently took over as CEO of Glaxo and is one of the younger drug executives at 43. Last month Glaxo acquired a 16% stake in South Africa's Aspen Pharmacare's Holdings Ltd. in a deal that expanded an existing partnership. Glaxo agreed in June 2009 to a deal with Shenzen Neptunus Interlong Bio-Technique Co. to make influenza vaccines for China....

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Delayed FDA approval of diabetes drug Tresiba in the U.S. market. The FDA requested additional testing data which Novo Nordisk says it cannot provide in 2013. Novo Nordisk has 27% market share in the diabetes market with its fast acting NovoLog insulin. Sanofi has 19% market share with its long acting Lantus insulin. Tresiba was approved for use in Europe. About 44% of Novo Nordisk drug sales in 2012 were in the U.S. market.

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Zaraska says a vegetarian diet or one that includes vegetarian diet in meals is a good idea to reduce the risk of heart disease, obesity, diabetes and other medical problems. Be sure to add zinc, iron and calcium, Vitamin B12 to the diet if you are older she points out, to compensate for the change. About 2.5 million Americans over the age of 55 are vegetarian according to a 2012 Harris poll done for the Vegetarian Resource Group. There is a common perception of vegetarianism as purely vegetable type foods. However vegetarianism in India is practiced with the inclusion of all dairy products- milk, yogurt, and buttermilk. Not only are they included, they play a significant role in the diet. Also included and playing a large role in the diet are lentils and beans which provide a significant source of protein. When the idea of vegetarianism is broadened to a more normal vegetarianism as practiced in countries like India and includes dairy, lentils and beans, the diet is able to provide most of the nutrients needed. By including this kind of vegetarian food as an integral part of the diet and reducing meat is another way the health needs of Americans facing a high rate of obesity and other medical problems can be met. If insurance companies were to give incentives for increased consumption of these vegetarian foods and lowered consumption of meat, and the public was made aware of its benefits through advertising, the cost of health care in the U.S. could be brought down....

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Under a new program to increased spending on healthcare from 1.3% of GDP to 2.5% the Indian government plans to provide free pharmaceuticals at state run hospitals. This is expected to cost $5 billion over 5 years. Initially 350 drugs would be on a list of essential medicines and would be purchased from generics manufacturers in India. Dr. K. Srinath Reddy, heads the committee advising the Indian government on healthcare. He says this will help improve access to medicines for the vast majority of the people. Estimates show 70% of out of pocket medical costs for Indians come from spending on drugs. About 40 million people are pushed into poverty each year because of the high cost of medicines, says Dr. Reddy. He said that in 1984 31% of the medicines at government run hospitals were provided free to admitted patients, dropping to 9% in 2004. For outpatients this dropped from 18% to 5%. The free medicine program would be part of a larger universal health care program to be introduced over the next decade. India's large generics pharmaceutical industry makes the provision of free medicines on a large scale a feasible option in India because of the lower prices, with additional pricing advantages when purchased in larger volumes by the government. This would also have a major impact on the quality of healthcare in the country of 1.2 billion people for a relatively small investment. It also promotes a sense of fairness and equal access because the benefits of decades of modernization have been unevenly distributed and because of widespread poverty....

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Aizenman in this must-read describes the National Soda Summit and the presentation of one man Todd Putnam, a former executive from Coca-Cola that throws light on one of the truly important things that happened in the lives of Americans in the postwar period of development and growing prosperity. This is the development of marketing and advertising and its singular application in the case of Coca Cola to promoting sugary drinks. It is also related to what even business people describe as the single biggest problem in America. And it is happening at a time when the story is being repeated in developing countries such as China and India. Putnam describes the exhilaration, he and other Coca-Cola managers felt when the graphs at internal presentations showed Coke passing milk in consumption per capita in America. Several other facts stand out in Putnam's description of his experience- the ignorance on health issues among his marketing peers, the huge marketing prowess and dollars brought to bear once a goal such as increasing per capita consumption of sugary drinks was set- he was hired out of Purdue by P&G and worked at Disney before joining Coca-Cola- and the focus on the 12-24 demographic with 90% of all soft drink marketing targeted at this segment. What he regrets most is the focus on minorities who suffer some of the highest levels of obesity in America. No mention is made of the efforts underway in developing coutnries such as China and India which are seeing a surge in obesity rates and diseases such as diabetes. Coca-Cola says 41% of its sugary drinks are low calorie, but compared to milk, fruit juice and other healthier alternatives where does this rank? The cost to the nation's health care system alone would show that the performance of Coca-Cola's stock price over the postwar period came with a price tag that was never even thought about, when healthier alternatives as health drinks companies have found sell well when well marketed and formulated for different groups....

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Two of three obese people live in developing countries. About 29% of the global population is obese in 2013, according to the Institute for Health Metrics and Evaluation at the University of Washington. Between 1980 and 2013, obesity increased by 47% for kids and 27% for adults in the global population. Dr Murray of IHME says no country was the exception. Diet and inactivity are the principal culprits. About 37% of world's men and 38% of women are obese. Obesity increased rapidly first in developed countries, becoming noticeable by 1980 and slowing since 2006, and now is growing fast in developing countries. Germany is a surprise No. 8 on the list. The U.S. No. 1 ranking tells a lot about the misguided priorities of living in the U.S., lack of education on healthy eating and healthy living, and not putting healthy habits at the top of things to do above making more money. An extreme case is South Africa where 42% of women are obese. The most obese countries are by rank - U.S., China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, Indonesia. Middle Eastern and North African countries have high obesity rates for children. The study is funded by the Bill and Melinda Gates Foundation....

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Samuelson points to the risks to the American economic growth from excessive health care costs. This is hurting take home pay and shows up in consumer spending. It is hurting government spending in other areas such as needed infrastructure spending and efforts to reduce the deficit. This hurts private capital investment to create jobs because of lower demand from constricted consumer spending. The U.S. budget has as its largest single expense 27% on health care compared to 20% on defense the next largest expense, with growth in health care spending taking this to one third of the budget in coming years. Without addressing health care, says Samuelson, the Supercommitte in Congress even if successful at deficit reduction will basically have failed to do its job, and it did not have the time, resources or conviction to do this. According to a new study from the Organization for Economic Cooperation and Development (OECD), U.S. healthcare spending per person is $7,960 per person in 2009. This compares with Norway $5,352, Britain $3,487, France $3, 978, an OECD average of $3,233. Life expectancy in the U.S. is 78.2 years, compared to Japan 83 years, OECD average of 79.5 years. Chile and the Czech Republic have life expectancy equal to the U.S. Except for cancer care where the five year survival rate is 89.3% in the U.S. and the OECD average is 83.5%, the U.S. lags far behind in much needed critical areas such as diabetes and asthma. Rates of emergency hospitalization for asthma are 3 times that in France and 6 times that in Germany and Italy. The U.S. has fewer doctors per thousand population and higher cost per medical procedure- with more frequent use of the costliest procedures- creating a supply shortage that induces higher prices, and less preventive and early action care through physician visits. The number of practicing U.S. doctors is 2.4 per thousand population in the U.S. compared to 3.1 per thousand for the OECD average; and number of annual doctor consultations 3.9 per capita in the U.S. versus 6.5 for the OECD average. Appendectomy cost $7,962 in the U.S., $5,004 in Canada and $2,943 in Germany. Coronary angioplasty cost $14,378 in the U.S., compared to $9,296 in Sweden, and $7,027 in France. Knee replacement cost $14,946 in the U.S., $12,424 in France, and $9,910 in Canada. Knee replacements, angioplasties and MRI exams are twice as common in the U.S. compared to the OECD countries. ...