Dollars denied as diabetes runs riot

Governments have been pouring money into acute care that operates like an ambulance ‘at the bottom of the cliff’ yet refuse to offer long-term, secure funding for ­prevention programs.

The EON Foundation is achieving results in Jilkminggan in the NT, and elsewhere, but funding has not been locked in.

Governments have been pouring money into acute care that operates like an ambulance “at the bottom of the cliff” yet refuse to offer long-term, secure funding for ­prevention programs that deliver enormous results at low cost.

An assessment of the escalating diabetes epidemic by a bipartisan parliamentary committee has called for a fundamental shift to preventative healthcare, highlighting the government’s warped priorities as billions are instead spent on amputations, dialysis and acute care admissions.

One such low-cost preventative program, based around planting vegetable, fruit and bush tucker gardens in Northern Territory and West Australian schools, and teaching children how to grow, harvest and cook the produce, has lowered the prevalence of type 2 diabetes in four of six communities where the project has been fully implemented.

The EON Foundation has more than 40 remote Australian communities on its waitlist, with program founder Caroline de Mori saying: “People are telling us, ‘We’re dying too young, please come and help us’.”

Yet the federal government has not committed to funding the program – which sees EON project managers follow up with communities fortnightly for at least five years – beyond December 2024.

Australian Medical Association president Steve Robson called Australia’s approach to preventative health “an international embarrassment”, with a “paltry 2 per cent” of Australia’s hundreds of billions of dollars in health ­expenditure devoted to “true preventive measures”.

“The diabetes report has shown us that failing to deal with prevention, and putting all of our eggs into the treatment basket, leaves us dealing with a catastrophic epidemic of ill health that is overwhelming our ability to deal with it,” he said. “Unless Australia takes preventive care seriously, and develops a comprehensive plan to stop these conditions before they take our communities in their grip, then chronic disease will become a lead weight across the chest of our economy.”

Public Health Association of Australia chief executive Terry Slevin said the government should urgently implement a funding program, like the PBS and its adjoining advisory scheme, to assess the ­effectiveness and cost-benefit of preventative programs.

“We don’t see cardiovascular, or cancer programs on a three-, two- or one-year cycle, as is the case for some preventative healthcare programs. They are an ongoing service delivery and should be treated as such,” he said.

Royal Australian College of General Practitioners chair Lara Roeske said investing in preventive care in general practice was “key”.

“This will not only help more Australians live healthier lives, it will also save the health budget. We know type 2 diabetes can be prevented or delayed in up to 58 per cent of people,” Dr Roeske said.

New analysis of the EON Foundation initiative showed that between 2020 and 2023, there were 112 fewer cases of diabetes than predicted across the six NT communities. A cost-benefit analysis also showed the program cost $2.9m over four years, and $244,000 each year from the fifth year, with a net program benefit of $1.3m per year from the fifth year.

Ms de Mori said despite exceptional results, long-term government funding had not been locked in. “Costs of more dialysis machines, forget that. Cost to people being on Centrelink who are too sick to work, forget that,” she said.

While the parliamentary committee report found that type 2 diabetes was fast becoming entrenched as a multi-generational disease in the most disadvantaged pockets of the nation, Ms de Mori said it did not have to.

“Young people now can have a different outcome to their parents and grandparents. The tragedy of type 2 diabetes on quality of life, such as having limbs cut off, is a miserable, miserable life, but doesn’t have to be,” she said.

“The government needs to step up and make longer-term commitments to preventing this hideous disease and reversing it.”