In coming decades, the United States will face devastating human and financial costs from two leading chronic diseases: Alzheimer's and diabetes. We've written quite a bit on private funders working to combat Alzheimer's and dementia. But what about diabetes?
Before answering that question, let's underscore just how alarming the trends are in regard to diabetes. A recent study found that the prevalence of diabetes (type 2 and type 1) will rise by 54 percent to "more than 54.9 million Americans between 2015 and 2030; annual deaths attributed to diabetes will climb by 38 percent to 385,800; and total annual medical and societal costs related to diabetes will increase 53 percent to more than $622 billion by 2030."
Those are terrifying statistics, especially when paired with equally scary numbers related to dementia. And while you might think that a lot of major health funders would be focused on diabetes, that's not really the case. On the upside, some of the foundations that are paying attention have very deep pockets.
Frontiers of Research
As we've reported before, the Helmsley Charitable Trust, which has assets around $5.5 billion, is the undisputed leader in this important niche, focusing on type 1 diabetes, or TD1. In recent years, it's pumped out tens of millions in grants annually through Type 1 Diabetes Prevention Initiative—$48 million in most recent fiscal year.
The initiative supports scientists investigating the early stages of TD1 development and the study of novel pathways to prevent the disease. While the overall goals of the program are to prevent and delay the onset of TD1, the trust supports efforts to build and improve therapeutic interventions, and initiatives developing novel tools for research.
Helmsley's diabetes funding keeps changing and evolving as this funder seeks new paths to progress. In October, for example, the foundation made a $5 million investment in a new venture philanthropy fund housed at the other top private funder of TD1 research—the Juvenile Diabetes Research Foundation. The JDRF TD1 Fund, launched earlier this year, is focused on "investments in companies committed to accelerating efforts to cure, treat and prevent T1D," a press release explained at the time. It's seeking to raise $80 million, and Helmsley's commitment last month was the biggest outside commitment to date. The fund has made investments in cell biology, immunology, restoration, prevention and devices.
Earlier this month, Helmsley announced an even bolder move when it provided $52 million in grants for the Global Platform for the Prevention of Autoimmune Disease (GPPAD) in support of its Primary Oral Insulin trial. GPAAD is a multinational organization that works on type 1 diabetes primary prevention trials focusing on infants with a higher genetic predisposition for the disease. The expectation, here, is that Helmsley’s funding will help GPAAD “provide a bioresource to share with scientists who study the causes of early autoimmunity and type 1 diabetes.” Sometime down the line, GPAAD is hoping this approach will translate to other childhood diseases.
The big Helmsley grants for GPAAD weren't that unusual; the funder’s grants are often sizable. Grantees include the Technical University München, Lund University, the University of Oxford, Catholic University of Leuven, Technical University of Dresden, Hannoversche Children’s Hospital, Warsaw’s Institute of Mother and Child, and the Medical University of Warsaw. Funds are also being used to expand existing GPPAD activities in Sweden, the United Kingdom, Belgium, and Poland.
A Public Health Approach
The Robert Wood Johnson Foundation (RWJF) is another important funder fighting diabetes, but it takes a different approach. The nation’s largest private health funder doesn't have an explicit focus on diabetes. Rather, it seeks to improve U.S. public health and wellness broadly and, as we've often reported, has been a pioneer in grantmaking focused on the socioeconomic determinants of health. Unsurprisingly, the foundation's crusade to create "a culture of health" has involved a range of work that relates to diabetes, a disease closely linked to poor nutrition and lack of exercise. Childhood obesity, a longtime focus of RWJF grantmaking, is a key risk factor for developing type 2 diabetes as an adult.
Among other things, RWJF has sought to bring better data to understanding diabetes and other chronic health problems, as well as forge the kinds of new partnerships needed to tackle conditions related to lifestyle or environmental factors. A few years ago, the foundation, along with powerful partners like the Kresge, W.K. Kellogg, and Blue Cross and Blue Shield foundations created the BUILD Health Challenge. BUILD is an ambitious national program encouraging and supporting collaborations across communities, sectors, and health institutions in an effort to “give everyone a chance to be healthy.” The main focus of BUILD is low-income and urban neighborhoods, both of which are often underserved in regard to healthcare. Diabetes tends to be pervasive in such communities.
Around the same time the BUILD Health Challenge was getting underway in 2015, RWJF, the CDC Foundation and the U.S. Centers for Disease Control (CDC) laid the groundwork for the 500 Cities Project. This ongoing health data effort focuses on 27 chronic disease measures for the 500 largest American cities.
As part of this deep health data dive, University of Texas Health Science Center at Houston (UTHealth) received a three-year, $2.4 million grant earlier this year to create the "Healthy Cities Research Hub: Exploring Drivers of Diabetes and Other Chronic Disease." The virtual research hub focuses on "the social and environmental conditions that impact health in urban settings throughout North America."
The Healthy Cities Research Hub is a collaboration with global healthcare company Novo Nordisk’s Cities Changing Diabetes program. Novo Nordisk launched the first-of-its-kind program in the U.S. in 2014, choosing Houston as the only U.S. city involved in the program. The RWJF grant will allow researchers at UTHealth to foster Houston’s adaptation of the Cities Changing Diabetes program, and perhaps serve as a template for other cities interested in getting involved with the program.
Cities Changing Diabetes is working with local organizations to “explore diabetes through multiple lenses with a focus on assets, priorities, and opportunities.” Through its partnerships with RWJF and its grantees, the hope is to improve public health in cities through community-based interventions. In addition to Houston, the other cities that are part of Cities Changing Diabetes are Vancouver, Mexico City, Copenhagen, Johannesburg, Rome, Shanghai and Tianjin.
There are currently 415 million people in the world suffering from diabetes, and two-thirds live in urban areas. The U.N. predicts that by 2050, 66 percent of humanity will live in a city, with most of that growth happening in Asia and Africa. Meanwhile, as the New York Times recently reported, the fast food industry is engaged in a major push to get these new urban dwellers to embrace the dietary habits that have contributed to the type 2 diabetes epidemic in the United States.