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IOF embarks on intensive targeted support program in Asia

Three of Asia's largest, most economicallyactive countries are receiving intensive IOF support to promote changes in health care policy for the benefit of people with osteoporosis.

The IOF Targeted Support Program is aimed at the development of three-year programs in India, Indonesia and Vietnam, three Asian countries which are, respectively, the world's second, fourth and 14th most populous countries. Each of the countries is experiencing dramatic economic growth, and the expanding and ageing populations are putting extreme pressure on government health care systems.

Although it is projected that by the year 2050 more than 50% of all osteoporotic fractures will occur in Asia, there are many serious health issues in this region which will compete with osteoporosis for scarce health care resources.

India: fundraising a main priority

IOF has assisted two Indian members of IOF’s Committee of National Societies (CNS) – Arthritis Foundation of India (AFI) and Indian Society of Bone and Mineral Research (ISBMR) to develop a comprehensive threeyear program. The program, which follows a similar structure to the IOF international program, includes projects on science, network development, policy change, outreach and education. AFI will take responsibility for the public awareness activities, while ISBMR will take responsibility for the science and physician education elements.

The most urgent policy issue in the program is to develop a “white paper" on the economic impact of osteoporosis. This report will help provide the data needed to convince policymakers that osteoporosis is a serious burden on the population and that it is worthwhile investing in prevention measures from a health economic standpoint.

A major fundraising presentation was held in Delhi on March 30, 2005 at which AFI and ISBMR presented their plans to potential sponsors. Participants included Ambrish Mithal (president of ISBMR) and Sushil Sharma (chairman of AFI), IOF Secretary General Jean Yves Reginster, IOF CEO Daniel Navid, and IOF Head of Communications Paul Sochaczewski.

From left: Ambrish Mithal, president of ISBMR; Jean-Yves Reginster, IOF secretary general; Daniel Navid, IOF CEO; Sushil Sharma, chairman of AFI.

Expert groups place the number of osteoporosis patients in India at approximately 26 million (2003 figures) with the numbers projected to increase to 36 million by 2013. In the face of these overwhelming statistics, it is no wonder that there is increasing high level support for the osteoporosis movement. The Chief Minister of Delhi, Mrs Sheila Dixit, was at the launch of the IOF Asian advertising campaign in Delhi last year. And, during the targeted support visits, IOF and the society representatives met with Ms. Dixit, with A. Ramadoss, union minister of health, a doctor with a special interest in gerontology, and with Renuka Chaudhary, the minister of tourism, a former minister of health and strong advocate of women’s health issues. Both ministers pledged government support for the osteoporosis movement.

Vietnam: Five key projects planned

Working with the Vietnam Rheumatology Association (VRA), IOF is developing a program of five projects that can be run over the next three years. The VRA already runs successful programs in physician education and has carried out public awareness activities and basic research on osteoporosis in the country. However there are major challenges facing the society. Many doctors lack awareness of osteoporosis and there is a scarcity of diagnostic tools, with just six ultrasound and nine DXA machines in the entire country of 70 million. Furthermore, while most approved drugs are available, they are too expensive for the vast majority of the population – a problem common to the region as a whole.

The targeted support discussions have resulted in plans to further expand the physician awareness programs, establish a website and launch the IOF ‘mannequin’ advertising campaign. As in India, one of the priorities in Vietnam will be the development of a white paper, since there are few statistics about the extent of osteoporosis in the country.

The IOF targeted support team includes Judy Stenmark (CEO of Osteoporosis Australia and vice chair of IOF Committee of National Societies) and IOF Head of Communications Paul Sochaczewski. The next step is to present the program to all the potential sponsors in the country in November 2005.

Indonesia: Building on a sound foundation

IOF targeted support meetings were held with PEROSI (Indonesian Osteoporosis Society) and PERWATUSI (Indonesian Healthy Bone Foundation) in early 2005. A major presentation to potential funding partners is planned for July 2005, at which time the new threeyear program for PEROSI and PERWATUSI will be unveiled.

The further development of these societies is based on a sound foundation. The well established scientific and patient society work closely together and already enjoy high profile political and celebrity support. For example, the Indonesian Ministry of Health recognizes an official National Osteoporosis Day – and the minister participated personally at the 2004 press conference. Currently, PERWATUSI has five branches and more than 20 clubs throughout Indonesia. PEROSI is active in promoting physician awareness. Having just organized an osteoporosis seminar in East Java, PEROSI is planning the Second Indonesian Congress on Osteoporosis in November 2005.

The lack of osteoporosis statistics in this country of 240 million is partly due to the scarcity of DXA testing equipment. However, as more testing facilities become available in major centres throughout the country, including West Sumatra and East Java, it is expected that country-wide prevalence statistics will become available, hopefully as early as next year.

Plans for a program of approximately eight projects that can be run over the next three years have resulted from this first targeted support meetings. Here too, a white paper will be commissioned.

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