2009 Global Business Forum - Session Papers
Global Impact: Transforming Health Care through Biotechnology and Advances in Medicine
In 2003, the United Nations estimated that 194 million people worldwide had diabetes, a chronic disease caused by abnormally high levels of glucose in the bloodstream. By 2008, that figure had increased by 28 percent to 246 million, with one person dying of diabetes every 10 seconds. “It is the fourth-largest main cause of premature death,” said Jay Skyler, a professor at the University of Miami’s Miller School of Medicine’s Diabetes Research Institute and Division of Endocrinology, Diabetes and Metabolism.
At a discussion titled “Global Impact: Transforming Health Care Through Biotechnology and Advances in Medicine,” held during the University of Miami Global Business Forum Jan. 15 – 16, 2009, Skyler noted that while diabetes is spreading rapidly throughout the world, the rate of increase in the U.S. is staggering, costing this country billions of dollars.
Finding new ways to treat diabetes and other diseases, and exploring how such breakthroughs can benefit the economy were among the topics discussed by Skyler and fellow panelist Bart Chernow, vice provost for technology advancement; professor of medicine and vice president for special programs and resource strategy at the UM Miller School of Medicine.
Chernow pointed out that improving health care is not only morally right but financially savvy. “Why is health care so important to business?” he posed at the start of the discussion. “The answer is that it affects everyone in this room. All of us are affected by health care, whether it is for yourself or members of your family.”
Chronic illnesses like diabetes, he said, have a potentially devastating impact on the workforce. “If your employees are out of work due to any illness, productivity falls while expenses stay the same, or maybe even increase because somebody has to substitute [and do] their work.”
According to Chernow, data indicate that the U.S. spends 16 percent of its gross domestic product on health care, a figure that could increase to as much as 25 percent by 2025. The expense of the American health care system, he says, is currently too high.
Diabetes represents one of the nation’s greatest health care challenges, Skyler added. Roughly 24 million Americans — 8 percent of the U.S. population — have the disease. That figure, he noted, is growing by a million each year, costing approximately one out of every five U.S. health care dollars. “The American Diabetes Association says someone is diagnosed with diabetes every 21 seconds,” he added. “It is the fastest-growing disease in America.” The leading cause of adult blindness, kidney failure, and amputations in this country, diabetes can also lead to heart disease, stroke, pregnancy complications, and death from flu and pneumonia.
According to figures from the American Diabetes Association, said Skyler, “the economic cost in the United States in 2007 is estimated to be $174 billion. Sixteen percent of that is direct diabetes treatment, and 33 percent is treatment of complications.”
Obesity, like diabetes, has increased dramatically in the U.S., particularly in the past 13 years. In 1994, no state reported a population obesity rate higher than 19 percent. By 2007, 30 states reported obese populations of more than 20 percent, while three states — Tennessee, Mississippi and Alabama — had obese populations of greater than 30 percent. Skyler remarked that in one hospital in Tennessee, chairs were built 50 percent wider “so the patients can sit down.”
Obesity is on the rise in other parts of the world as well, but for different reasons. In the developing world, obesity largely affects the upper classes, which have access to an abundant food supply. In the U.S. and other developed nations, it’s more likely to affect the poor, who often rely on cheap but nutritionally deficient food products. Lack of exercise is another contributing factor.
For Skyler, obesity and diabetes together are among “the biggest public health problems facing the world today” — what he calls “a potential global catastrophe.” He added that advances in biotechnology and medicine “have the potential to alter the treatment of some of these individuals.”
Though insulin was discovered in 1922, and the 1950s saw the development of oral antidiabetic drugs for type 2 diabetes (formerly called “adult-onset”), few advancements in treatment have been developed since then. Skyler pointed to one relatively recent breakthrough, the 2005 introduction of the drug Exenatide. An injectable medication used to treat type 2 diabetes, Exenatide belongs to a new class of drugs called incretin mimetics, which lower blood sugar levels without causing the weight gain frequently associated with oral antidiabetic drugs. As a side effect of diabetes treatment, Skyler pointed out, weight gain is “counter-intuitive,” since obesity is one of the primary triggers for type 2 diabetes. Skyler, a diabetic, noted that he takes Exenatide himself.
Chernow observed that more must be done to prevent conditions like obesity and diabetes, rather than simply treating them.
For Skyler, innovations in medical science can go a long way toward improving treatment for diabetes and other chronic illnesses around the world. And, he pointed out, biotechnology and medicine can be an economic generator for the U.S. He is optimistic that the Obama administration will invest more in science, medicine and biotechnology, not only for the health of the world, but for the country’s fiscal well being. “That,” he said, “is a future economic driver.”
By Erik Bojnansky
