Rollins Faculty Leading Destination Zero Project to Lower Diabetes and Hypertension in India

Diabetes and hypertension are two of the world’s costliest, fastest growing, and most deadly and disabling epidemics—and among the biggest threats to health and development in the 21st century. On a global scale, 425 million people suffer from diabetes and more than a billion have hypertension. Projections expect a nearly 50 percent increase in diabetes incidence worldwide by 2045 and a 29 percent increase in hypertension rates by 2025. Eighty percent of the burden of these two clinically linked diseases is experienced in low-and middle-income countries, where incidences continue to grow. India, a country of 1.3 billion people with rapidly changing demographics and economics, is at the epicenter of the global diabetes and hypertension epidemics. These diseases together affect over 275 million Indians, many young people, and their families, with disproportionately worse outcomes—such as higher rates of death, blindness, kidney failure, heart attacks, and stroke—seen among the poor and underserved.

Destination Zero builds on the political will of the Indian government to eliminate the burden of diabetes and hypertension within the country and on the team's 10-year-plus partnership with India’s leading academic, public health, and health care institutions. They leverage the country’s existing primary health care systems and structures to effectively deliver proven high-quality affordable diabetes and hypertension prevention and treatment strategies. A community-based component takes advantage of an established cadre of community health workers, providing training and technologies so they can better educate and identify people at risk in underserved populations. The clinic-based component trains patient advocates and arms them with tested technologies to monitor patients’ health, update electronic medical records, provide personalized treatment plans, and ensure motivation to adhere with life-long treatment and care. Evidence from rigorous studies conducted internationally and in India (by the team) indicate that these interventions can reduce mortality and disability from these diseases by as much as 50 percent.