Bart Torbeyns: JACARDI’s unified strategy makes perfect sense
Meet Bart Torbeyns, the Executive Director of the European Diabetes Forum (EUDF) and a pivotal voice in the fight against diabetes and cardiovascular disease. As a member of JACARDI’s Stakeholder Advisory Board, Bart commends JACARDI’s integrated approach to addressing both diseases simultaneously. “For primary care physicians and patients managing multiple chronic conditions, JACARDI’s unified strategy makes perfect sense,” he observes. Bart passionately advocates for the elimination of discrimination against individuals living with diabetes and establishes that the critical step for lowering its burden is establishing clear targets through better data.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
At its core, JACARDI is about improving outcomes for people living with diabetes and cardiovascular disease. While I work for the united diabetes community, we’re acutely aware that many of the people living with diabetes also face cardiovascular risks and, in some cases, complications. What makes JACARDI so valuable is its focus on the entire patient journey, starting with health literacy, labor participation, patient pathways, screening, and better management. These areas are still critically needed across many European countries.
For example, in the area of screening, we know that up to one in three people with diabetes are unaware they have the disease, reaching one in two in certain countries. These individuals, by definition, are not receiving education or proper treatment, leading to severe complications. Addressing these gaps is fundamental to the work we do.
How do you think JACARDI’s work aligns with promoting the overall well-being of patients?
The well-being of people with diabetes is crucial, and JACARDI’s work aligns perfectly with this focus. Health literacy and labor participation are especially vital in this context. Self-management is another key element. When people are well-treated, well-managed, and educated about their condition, they gain confidence in how to handle it, which provides peace of mind.
This is particularly important for families, parents, and teachers who support younger individuals with type 1 or type 2 diabetes. The better they understand the disease, the better the overall well-being of those involved.
Labor participation is another critical area. Unfortunately, discrimination against people with NCDs, including diabetes, still exists. Many individuals hesitate to reveal their condition, for instance, I know people who would never inject insulin publicly and instead hide to do it. It’s crucial to combat this stigma. People with diabetes can make valuable contributions to the economy and society. I’ve encountered many brilliant individuals with diabetes, and ensuring they have opportunities to participate fully is essential for their well-being but also for our economy and society. The work JACARDI is doing on labor participation is a prime example of addressing these challenges.
What are the most critical next steps for Europe in addressing the dual burden of cardiovascular disease and diabetes?
A critical step is establishing clear targets to achieve better outcomes for people living with diabetes and cardiovascular disease. This process begins with better data, improving its availability, sharing, and utilization. For instance, many European countries don’t even know how many people in their population have diabetes. Without this basic information, it’s difficult to make progress.
Once we have reliable data, the next step is setting targets to improve results and prevent complications. What I particularly appreciate about JACARDI is its collaborative approach, bringing together the cardiovascular and diabetes communities. There’s so much we can learn and share from each other.
By adopting a patient-centric perspective, it’s clear that many people with diabetes are at high risk of developing cardiovascular disease, and the reverse is also true. Often, we think in silos, creating separate plans for diabetes, obesity, or cardiovascular disease, but for primary care physicians and patients managing multiple chronic conditions, JACARDI’s unified strategy makes perfect sense, and that’s an approach I fully support.
Recently the new Commissioner for Health and Animal Welfare, Mr. Várhelyi, announced he will propose a comprehensive cardiovascular health plan that will also address diabetes and obesity. We very much welcome such a comprehensive approach and we are confident that JACARDI’s deliverables will be consolidated in this new plan.
Bart Torbeyns is a dedicated leader in public health policy and advocacy, with a focus on improving healthcare systems and addressing chronic diseases. With master’s degrees in Pharmacy and Business Economics from the University of Louvain, he has contributed to initiatives like the SUGAR and the DYSIS studies, generating vital local data for diabetes and atherosclerosis care in Belgium. He has worked as Head of Public Affairs in Belgium and Europe at MSD and Sanofi, and analyzed healthcare systems and developed strategies to promote equitable access to care. Now serving since 2020 as the Executive Director of the European Diabetes Forum (EUDF), he works to advance collaborative, patient-centered policies addressing diabetes and cardiovascular health across Europe.
Learn more about the European Diabetes Forum (EUDF) here and connect with Bart Torbeyns on LinkedIn here.
Janne Sørensen: Being aware of one’s own biases is part of a patient-centered approach
The diversity of JACARDI’s experts is a tremendous asset to the project, as it brings many different perspectives to the table, according to Janne Sørensen, diversity expert at the University of Copenhagen in the Department of Public Health. As a member of JACARDI’s Scientific Advisory Board, she shines a light on how vulnerable groups are impacted by diabetes and cardiovascular disease, and how healthcare professionals can better answer their needs. Her message to people working in healthcare is to see the whole person in front of them and to consider implementing equity as a lifelong learning process.
What significance does JACARDI hold for you and your organisation in terms of its mission and values?
As a public health expert, one of the core elements of my work is addressing health inequalities and striving for greater health equity for all. JACARDI’s focus on combating these inequalities, particularly in the context of cardiovascular diseases and diabetes, resonates deeply with both my personal mission and the goals of my organization.
How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular diseases and diabetes in Europe?
Well, this is a big question and a significant challenge, as diabetes is on the rise. We need to stop its progression and bring the situation under control. JACARDI is a large initiative and, I believe, a serious attempt to address this challenge. You are confronting the problem head-on with innovative approaches. JACARDI positions itself at the heart of the EU’s efforts to tackle this issue. It is an impressive project, and I am very happy to be part of it.
How do you see our role in promoting equity in healthcare?
JACARDI plays a significant role here because it aims to address inequalities. In other words, we see disparities affecting many vulnerable groups who are significantly impacted by these health issues. For example, people with lower socio-economic status, migrants, ethnic minorities, and LGBT groups all have a higher prevalence of diabetes and cardiovascular diseases.
I must say this is an ambitious objective for such a large project, and it might be quite challenging to mainstream diversity, reach everyone, and ensure that everyone adopts principles of equity and diversity.
How do you see the significance of cultural diversity in the development of diabetes and CVD treatment? And what is the most important or critical aspect of this?
This is significant because you are addressing these particularly vulnerable groups. It is therefore crucial to ensure that you consider meeting people with their diverse identities, vulnerabilities, and characteristics in order to effectively tackle the issues of diabetes and cardiovascular disease.
Implementing diversity can be challenging, but you’ve brought it to the forefront. Ideally, the insights gained from this project will inspire experts to incorporate them into their own work and organizations long after it concludes. JACARDI brings together a diverse group of experts, representing a wide range of educational backgrounds, nationalities, ethnicities, and experiences. This diversity is a tremendous asset to the project, as it brings many different perspectives to the table.
You are providing training for healthcare professionals on cultural diversity. Are there questions that professionals often ask?
Some people ask why it is necessary to discuss diversity, especially if they are already working with a patient-centered approach. My answer is always that while you might have a patient-centered approach, it doesn’t necessarily require that you, as a health professional, reflect on your own background, biases, and stereotypes. Understanding these is crucial when interacting with patients.
Additionally, we discuss health inequalities: that many people are worse off in terms of health because they have fewer opportunities from the beginning of their lives, simply because they belong to specific groups and face discrimination within the healthcare system. These differences also exist among various groups, such as people with disabilities or those from the LGBT community, and so on.
What is your message to healthcare professionals then?
My message is that you need to see the whole person in front of you, in addition to knowing the prevalence of diseases and risk factors and being able to diagnose. This is not easy, because as a healthcare professional, you have to consider many things during a short appointment.
I believe we are trying to improve communication and interaction between healthcare professionals and patients by raising awareness of the disadvantages the patient may face, as well as the risk factors. At the same time, it’s important to recognize what professionals bring into the meetings.
This is a lifelong learning process, not something that can be mastered through a short course. Applying these lessons in practice after completing a course is an entirely different challenge.
Janne Sørensen is a specialist in diversity and diversity competence, based at the Department of Public Health at the University of Copenhagen. Her work focuses on integrating diversity competence into medical education through training programs for students and healthcare professionals. Alongside her teaching, Janne conducts research on various aspects of diversity and addresses issues of discrimination within medical student communities.
Learn more about Janne Sørensen and her work and connect on LinkedIn.
Silvia Ussai: JACARDI aims to fill the gaps in the management of NCDs
“This initiative is remarkable because, while many projects focus on non-communicable diseases, JACARDI prioritises policy integration”, says Silvia Ussai, a member of JACARDI’s Scientific Advisory Board. Drawing on over a decade of experience in shaping health policies across local, national, and international levels, and managing major programs like H2020, and NextGenEU, she underscores how JACARDI tackles critical gaps towards the reduction of major risk factors leading to cardiovascular diseases and diabetes.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
JACARDI truly goes beyond the state of the art in non-communicable diseases (NCDs). It is a transformative initiative in the fight against NCDs. For the first time, JACARDI seeks to standardise approaches within and beyond the EU to ensure a coherent strategy for NCDs, and cardiovascular diseases in particular.
The project recognises that there are significant differences in the way countries address NCDs due to differences in government investment and health care frameworks, resulting in different patient pathways. By adopting a standardised approach based on the highest scientific standards, JACARDI brings an innovative dimension to healthcare.
This initiative is remarkable because, while many projects focus on non-communicable diseases, JACARDI prioritises policy integration. Its commitment to high standards of care throughout the patient journey is closely aligned with the mission and values of our organisation.
In your experience, what are the most critical economic and policy considerations when implementing health initiatives in diverse global settings?
When I was a medical student, my professor of internal medicine used to say: “the two most challenging things to achieve with patients are convincing them to stop smoking and losing weight”. These are the main drivers of non-communicable diseases. It’s important to focus on behavioural science and provide patients with evidence to effectively support these changes.
Let me give you an example. Pregnancy is often accompanied by advice to stay physically active, but the consequences of insufficient activity — such as what it means in real life to depend everyday on insulin injections to keep your baby safe — are not clearly communicated. Many patients do not fully understand how their habits affect their lives, with consequences such as gestational diabetes, which is highly disruptive. And that is where JACARDI comes in, to fill that gap, to give patients the information to understand what they can do, what their power is, and the consequences of not following certain guidelines.
Policymakers also need to recognise the importance of investing in the prevention of NCDs. The effectiveness of preventive programs remains largely overlooked, despite all the evidence highlighted during the COVID pandemic. Budget constraints make it difficult to prioritise among multiple health threats, including infectious diseases and cancer. Patients need to be actively involved in prevention, rather than relying on drugs alone. Without their engagement and empowerment, financial resources will always be insufficient to address these pressing health challenges.
How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?
JACARDI addresses key gaps in the management of cardiovascular disease and diabetes, such as health literacy and patient behaviour. If you look at the JACARDI work plan, work packages reflect this in a crystal clear manner, relying on the highest standard of scientific evidence to date to improve outcomes of NCDs. So JACARDI is leading the healthcare transformation toward the prevention of NCDs at the EU level and beyond.
What role do you believe JACARDI can play in shaping future healthcare policies and practices, especially in low-resource settings?
I believe the most important role it can play is to scale up and transfer lessons learned in developed countries to low-resource settings. By acting as a pioneer, it can help to replicate successful policies and practices and guide other regions in addressing these health challenges.
Silvia Ussai is an International Public Health Manager with a unique skill set obtained through a double degree as Doctor of Pharmacy and Medical Doctor. She holds a specialization in International Healthcare Management from SDA Bocconi and, in 2019, she successfully completed the Program on Negotiation (PON), the executive-level negotiation training offered by Harvard University. With over a decade of experience, Dr. Ussai has made significant contributions to health policies and pharmaceutical systems at local, regional, national, and international levels.
Learn more about Silvia Ussai and her work and connect on LinkedIn.
Knut Inge Klepp and Linda Granlund: It’s important to find ways to build a community
With more than 1,600 health care professionals, scientists and public health experts involved, both JACARDI and JA PreventNCD recognize the necessity of fostering and building a strong sense of community and collaboration. According to the coordinators of JA PreventNCD, Knut Inge Klepp and Linda Granlund, building that sense of unity is no small feat, but is essential to make the most of the extraordinary investment and collective effort to tackle non-communicable diseases across Europe. In this conversation, the two coordinators explore the opportunities presented by this unprecedented joint commitment to prevention and the challenges of coordinating such large-scale projects.
What does JACARDI mean to you personally and to JA PreventNCD?
Knut Inge Klepp: There are so many synergies and so many opportunities for collaboration. It’s really useful to be able to work closely with the coordination team at JACARDI. Having colleagues you can share your victories and challenges with strengthens us as a team.
Linda Granlund: I agree with Knut Inge. Working closely with JACARDI is incredibly valuable for us, both as coordinators and as collaborators. It allows us to discuss details, but also to make sure that we avoid any overlap. On a personal note, I have lived with type 1 diabetes for 42 years, so staying informed about the developments in this field is not only professionally important but also deeply relevant to me.
Thank you for sharing! As Dr. Gauden Galea of WHO Europe explained at the Synergy meeting in Brussels this autumn (Strengthening NCD Monitoring Systems in the EU: A Collaborative Approach), after the COVID pandemic, the momentum for prevention and treatment of noncommunicable diseases was lost and the focus shifted to other areas of public health. How do you see the situation now?
Knut Inge Klepp: Well, we have these two joint actions, where the European Commission and the Member States have combined their efforts together, along with the smaller action grants. In total, almost 200 million euros are on the table. I think that reflects a significant turning point. Moving forward, our focus will be on making the best use of the substantial financial support, human capital and political commitment behind these projects.
Linda Granlund: When the Commissioner emphasized this focus, it signaled a significant shift, underscored by strong engagement and active involvement from Member States. With 21 countries participating in JACARDI and 25 in JA Prevent, it’s clear that these nations are committing substantial effort and resources to support our work.
How do you maintain focus while providing flexibility for task leaders and experts?
Linda Granlund: It’s important, to refer back to the background documents, Europe’s Beating Cancer Plan and the Healthier Together initiative. These provide essential guidance amid the many details of the project, work packages, tasks and subtasks. Without anchoring our efforts to these overarching goals, it’s easy to lose focus.
Knut Inge Klepp: First and foremost, it’s important to recognize that this is a significant challenge and we are fully committed to addressing it. Building on what Linda mentioned, our main objective is to ensure that our work aligns with the background documents. We regularly review these objectives and ask work package leaders, task leaders, subtask leaders and even pilot leaders to reflect on how their efforts contribute to the overall objectives. This ongoing process ensures that we are constantly reminded of what we are working towards and what we want to achieve.
Coordinating a project of this scale requires resilience, flexibility, bulletproof management and scientific rigor. What has been the most unexpected challenge you have faced so far in your first year, requiring you to think outside of the box?
Knut Inge Klepp: There are many challenges. One thing we’ve focused on recently is realizing that while we have frequent contact with a smaller group of work package leaders and maybe the task leaders and so on, there are probably between 500 and 1,000 people involved in this project – many of whom we haven’t met personally. We’ve interacted with a lot of them on screen, but it’s also important to find ways to build community, ownership of the project and a common culture. And that is also something that you are very consciously working on within JACARDI.
Linda Granlund: We have talked a lot about the different cultures involved when you have 25 countries working together. Finding a common tone is very important. How do we talk about the project? What do we emphasize? This process takes time, especially as the people involved come from different backgrounds, even if some share similar expertise.
Your dedication to creating a more health-promoting environment in Europe is well reflected in your work with a Youth Advisory Group. In your vision, what’s the NCD issue you envision for them to have to solve when you hand over the future?
Knut Inge Klepp: I started working on my first international non-communicable disease (NCD) prevention project in 1979. That was 45 years ago. Looking back, 30 years seems like a pretty short time. The scale and the context are different, but it’s striking that some of the issues we’re dealing with are quite similar. I think one of the values of this youth panel is their ability to bring a perspective that is grounded in their reality. In terms of health issues, we are seeing the convergence of NCDs with mental health and infectious diseases. The pandemic highlighted the vulnerability of people with underlying NCDs to infectious diseases. Addressing these interconnected challenges is something that today’s young people will have to deal with, even as we continue to work towards solutions in the present.
Linda Granlund: I think when we hand over the results in four or five years, we’ll have an understanding of that. Collaboration across sectors is essential, as we now focus on addressing the underlying factors that contribute to preventing NCDs. These are primarily related to the health care system, but we need to involve the other sectors more, such as the school sector, the transport sector, and create a mutual understanding of why they need to be involved and in what capacity. With the support of the EU Commission, this approach will benefit all the countries involved.
Learn more and connect:
JA Prevent NCD
Linda Granlund is the Division Director for Public Health at the Norwegian Directorate of Health, a role she has held since 2015. With over 20 years of experience, she has led initiatives to improve public health and nutrition. Previously, Linda worked in roles including Director of Health and Nutrition at a Norwegian food company that produces and markets some of the country’s most well-known and beloved food products, where she advanced projects to promote healthier eating. Linda also served as Vice Chair of Diabetesforbundet, the Norwegian Diabetes Association, advocating for better diabetes care. Her expertise spans health policy, nutrition, and public health advocacy.
Knut Inge Klepp is the Executive Director of the Division of Mental and Physical Health at the Norwegian Institute of Public Health. He has had an extensive career in public health, previously serving as the Director General of Public Health at the Norwegian Directorate of Health. Klepp is also an adjunct professor at the University of Oslo. His academic focus includes adolescent nutrition, obesity prevention, and nutrition policy. He has led numerous EU research projects, has published over 250 papers in peer reviewed journals and contributed significantly to international health initiatives, including WHO’s efforts to reduce non-communicable diseases.
Learn more about Knut Inge Klepp and his work here and connect on LinkedIn here.
Elisabeth Dupont: A joint approach on CVD and diabetes is more than just the sum of the two!
JACARDI has the potential to be truly transformative according to Elisabeth Dupont, Regional Manager at the International Diabetes Federation Europe (IDF Europe) and member of JACARDI’s Stakeholder Advisory Board. In an enlightening discussion, we explore the powerful synergy of tackling diabetes and cardiovascular diseases through an integrated approach. With years of experience in patient advocacy, Elisabeth shares valuable insights on policy engagement, stressing the importance of early collaboration with policymakers, while harnessing the collective voice of national diabetes associations and people with lived experience. Her expertise particularly shines through when discussing patient involvement in healthcare initiatives.
How do you see JACARDI’s role in tackling the increasing prevalence of diabetes in Europe?
Over 32 million people in the EU live with diabetes, and this figure is expected to rise to 38 million by 2030. Adding to this challenge is the fact that more than one-third of people with diabetes remain undiagnosed, underscoring the urgent need to improve diabetes prevention, management, and care. Diabetes is a highly complex and evolving condition, with various expressions and causes, requiring a life-course approach. Its scientific and policy links to cardiovascular diseases (CVDs) further highlight the importance of initiatives like JACARDI.
The Joint Action on Cardiovascular Diseases and Diabetes, which addresses the entire patient pathway, has the potential to be truly transformative. By bringing together 76 partners across 21 countries, JACARDI will enhance understanding of the diabetes landscape at regional, national, and European levels. Successful pilot projects will serve as proof of concept, demonstrating what truly impacts health outcomes and quality of life for people with diabetes, and how healthcare systems must adapt or transform to improve detection, early diagnosis, access to education, and high-quality treatment and care. A joint approach on CVD and diabetes is more than just the sum of the two!
What advice do you have for JACARDI’s pilots to translate their results into policy?
My first piece of advice would be to engage with policymakers as early as possible, leveraging the support and influence of national diabetes associations and people with lived experience. Translating project results into policy changes requires collaboration with the community and a clear understanding of how the project aligns with regional and national diabetes priorities, such as addressing healthcare workforce shortages, improving access to care in rural areas, or enhancing early diagnosis, integrating care and ensuring equitable access to innovation. It’s also essential to demonstrate the added value for healthcare systems and highlight the pilot’s positive impact on patient outcomes and quality of life.
IDF Europe is one of the key stakeholders of JACARDI. How can we strengthen this cooperation to address the growing challenge of diabetes and bring real and tangible added value to populations and patients?
IDF Europe is an umbrella organization of 72 diabetes associations, active in 45 countries, representing both people living with diabetes and healthcare professionals. IDF Europe strongly believes that the voice of people living with diabetes must remain central at all levels to ensure that interventions, innovations, and policy changes truly address their needs and deliver tangible impact. We welcome the opportunity to advise work package leaders and pilot leaders to ensure patient input and feedback are consistently integrated.
To ensure the long-term sustainability of the Joint Action, it is crucial to establish ongoing communication with the wider diabetes community, keeping them regularly informed of progress and involving diabetes associations in pilot activities where their contributions can enhance the project. Additionally, we suggest leveraging the IDF Europe network to communicate about the Joint Action and co-develop advocacy campaigns that promote policy changes based on successful pilot outcomes.
Elisabeth Dupont has been working for more than 15 years as senior project manager for the International Network for Cancer Treatment and Research, the African Cancer Registry Network and the US National Cancer Institute Center of Global Health. In 2019 she joined IDF Europe as Regional Manager. She is passionate about promoting collaboration and partnerships and putting the voice of people living with chronic conditions, including diabetes, center stage.
Learn more about IDF Europe here and connect on LinkedIn here.