Legislative development in the CIS states

The Saint-Petersburg Diabetes Association in Russia is playing a major role to promote implementation of the DAWN objectives into the national health care systems in the CIS-member states. The association is a particularly successful example of how patient-centred psychosocial approaches can be spearheaded at the local and national/regional levels.

In general across the CIS region there is a huge need to promote patient-orientated health care: To reach the DAWN goals, the health care systems need significant modification. State recognition of the importance of psychosocial aspects of diabetes is one of the most powerful tools available, as government funding of diabetes programmes (often in the face of many competing healthcare priorities) is necessary for comprehensive healthcare for all. This makes the new ‘model law’ ‘On fundamentals of medical and social protection of citizens with Diabetes Mellitus’, which has been spearheaded by the St Petersburg Diabetes Association, particularly important. It aims to improve access to drugs for those with diabetes, and also to improve psychosocial care.

This law was adopted by all the CIS states at plenary stage in 2004, when it was agreed to implement the model law into state legislation and policies as a part of the national health care strategies of all 12 states. The governments are now required to bring the requirements of the model law into national legislation – Azerbaijan has already done so, and Kyrgyzstan and Russia have begun the process of adoption. All the other CIS states are preparing national diabetes programmes.

An international draft agreement on diabetes is now being drawn up, on the back of the model law. It is hoped that this will be signed at the next CIS summit – it will include requirements on preventive measures, improve the quality of psychosocial aid to people with diabetes, and also that states undertake studies of the psychological aspects of diabetes within the framework of national and international programmes.

This agreement, in fact, need not be restricted to the 12 CIS states – it will be open for signature by any country in the world that shares its fundamental provisions. Indeed, Ms Shipulina from the St Petersburg Diabetes Association hopes that ‘this agreement will become a modern equivalent of St Vincent Declaration and will help to realise the main goals of the DAWN programme’.