IMPROVING HEALTH OF PEOPLE WITH DIABETES - THE END OF THE BEGINNING

The St. Vincent Declaration Action Programme is one of the major progr ammes for the development of quality of care in the European region at the present time, Starting with the Ist meeting in Saint Vincent, Ita ly, in 1989, where achievable targets were set for improvement of diab etes outcomes, St, Vincent has developed into a movement with activiti es in all the 51 Member States of the European region of the World Hea lth Organization (WHO/EURO): from Vladivostoc In the east to the Azore s in the west, from Spitzbergen in the north to Israel in the south, I t has also become a model for other World Health Organization regions, as confirmed by the Declaration of the Americas, and has been adopted as a model for quality development processes in other chronic disease programmes such as cerebrovascular and renal disease, asthma and ment al disorders, Under the auspices of WHO/EURO and International Diabete s Federation (IDF-Europe), the ''top-down'' approach targets the Minis tries of Health and the ''bottom-up'' approach, together with the incr easingly influential diabetes associations, targets the health care pr ofessionals, reflecting the IDF motto ''Together we are Stronger''. Th e present report focuses on St. Vincent achievements to date, On the m acro level, there has been a rapid and remarkable development of natio nal diabetes task forces with multi-professional and patient participa tion (46 countries by February 1997) and National Diabetes Programmes endorsed by governments (34 by February 1997), More important, the fir st fruits of St. Vincent are being presented as reports on actual redu ctions in blindness, amputations and perinatal mortality due to diabet es, as well as a decrease in emergency admissions of children due to k etoacidosis. (C) 1997, Editrice Kurtis.