This past month I spent a week visiting with CHE Partners in London, Brussels and Geneva. We had an especially valuable meeting in Brussels at the office of the Health and Environment Alliance (HEAL), an anchor CHE Partner in the European Union. At that meeting, 25 scientists and policy advocates working on environmental health issues gathered for a half day of discussions. Below I offer some of my reflections on the current state of chemical policy efforts and related initiatives in the European Union (EU).
The widely agreed on master narrative in the EU is that a remarkable coalition of nongovernmental organizations (NGOs) came together to help pass the Registration, Evaluation, Authorisation and Restriction of Chemicals policy (REACH) by the European Commission. This new set of regulations is seen as a major step forward for precautionary chemical management by many in Europe, the US, and around the world.
There is a well-documented and unexplained increase in the incidence of type 1 diabetes in children around the world, and alarmingly, this increase is most rapid in children under age 5. Type 2 diabetes shows a parallel increase, and is also now appearing even in children. About 6.4% of the world’s adults have diabetes – that’s 285 million people. Health expenditures due to diabetes are estimated to be $376-672 billion US dollars in 2010 worldwide, about 12% of total health expenditures, and this figure does not include expenditures on children with diabetes.
Type 2 is the most common type of diabetes, and the type normally associated with obesity and insulin resistance. Type 1, formerly called juvenile diabetes, is an autoimmune disease where the insulin-producing beta cells of the pancreas are destroyed. There are a number of similarities between type 1 and 2 diabetes, and intermediate types exist as well (such as Latent Autoimmune Diabetes in Adults (LADA), also known as “type 1.5”). For example, dysfunctional beta cells are present in both type 1 and type 2 diabetes, and about 10% of people with type 2 test positive for the autoantibodies characteristic of type 1. Excess weight gain and increased insulin resistance have been associated not only with the development of type 2 diabetes but also with type 1. Women who develop gestational diabetes, meanwhile, are at risk to develop either type 1 or type 2 after pregnancy. Many authors propose that type 1 and type 2 can be thought of as two ends of a “diabetes spectrum,” an idea consistent with findings of genetic susceptibility to these diseases.