OTTAWA — Despite millions poured into reducing a growing health crisis, Canada’s national diabetes strategy is so unco-ordinated, fragmented and weak that the lead federal agency has no idea whether the program is helping people living with diabetes or those at risk of developing the disease, according to Canada’s auditor general.
Since 2005, the Public Health Agency of Canada has received $18 million a year in funding to lead the Canadian Diabetes Strategy, which was designed to target investments in diabetes prevention and control to those at high risk of developing the disease, as well as those suffering its complications.
The agency committed to co-ordinating activities with Health Canada, which received $55 million in 2010-11 for Aboriginal diabetes initiatives, as well as with the Canadian Institutes of Health Research, which funded nearly $44 million in diabetes research in 2010-11.
But after seven years, the public health agency still doesn’t have a national strategy for diabetes prevention and control, Auditor General Michael Ferguson says in a report released Tuesday.
Instead, “Each organization has spent millions and undertaken initiatives in isolation of each other, resulting in fragmented efforts and limited progress.”
The auditor found “weak management practices” within the agency, and insufficient tracking of the millions spent on its diabetes program. Information on the agency’s website is outdated and inaccurate and little progress has been made in improving diabetes surveillance among First Nations, Ferguson said.
Funding of community projects has been hamstrung by administrative delays. A random survey of 22 of 83 community-based projects funded by the health agency between April 2009 and March 2012 found that each project took an average of five months to approve; and the projects even required approval of the federal health minister. The report estimates that the agency’s regional offices spent $2.44 million to distribute $5.13 million in funding.
“In other words, it costs the agency an additional 48 cents to administer every dollar it distributes to the community,” the auditor general reported.
In 2011-12, only 60 per cent of available funding was committed to community-based projects.
Almost 2.4 million Canadians — 6.8 per cent of the population — live with diabetes, and it is estimated that about 20 per cent of diabetes cases remain undiagnosed. From 1999 to 2009, the incidence of diabetes among Canadians increased by 70 per cent, and the disease is increasingly striking people at younger ages.
People with diabetes are three times more likely to be hospitalized with cardiovascular disease, 12 times more likely to be hospitalized with life-threatening kidney disease and almost 20 times more likely to require lower limb amputations than people without the disease.
Among First Nations, the picture is even more grim: The prevalence of diabetes among First Nations is two to three times higher than in the general Canadian population. Aboriginal peoples with type 2 diabetes are younger and have higher rates of complications, including blindness, high blood pressure, kidney disease and lower limb amputations.
