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.
David Beran: What has impressed me most is the collaboration between outstanding scientists across Europe
David Beran, a member of JACARDI’s Scientific Advisory Board, highlights the value of the network being built through JACARDI, fostering exchanges that will have a positive impact on science beyond the project. He is a Swiss citizen and Assistant Professor at University of Geneva specialized in health management and diabetes. In his view JACARDI exemplifies the strength of the European ideal of uniting individuals from different member states to collectively improve lives. David Beran is currently involved in leading a new initiative that aims to bridge science and policy, the NCD Policy Lab at University of Geneva. In this interview, he shares his insights on the connection between evidence-based outcomes and policy making, the anticipated local and global impacts of the JACARDI pilot projects and the importance of collaboration and mutual learning in research.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
I think there’s three ways to answer this question. As a university researcher specialized in diabetes, I believe we need more research to document and develop a wide range of tailored solutions. JACARDI does this with the diversity of pilot projects across different countries and contexts.
I would say another important element is that one of the missions of the division I’m in focuses on partnerships and learning from others. One of the key values I’ve observed in JACARDI is the interactions, discussions and presentations among colleagues from different countries, exchanging their experience, their knowledge and working together.
Finally, I’m leading a new initiative at the University of Geneva, the NCD Policy Lab, which aims to bridge science and policy. This goal is in line with the objectives of JACARDI. This Joint Action also recognises the need to engage a wide range of policymakers, including the EU, the World Health Organisation, ministries of Health, local authorities and even mayors or lower level officials. I think these three areas are crucial for JACARDI: research, partnership and knowledge sharing, and the link between science and policy.
How do you see JACARDI’s role in tackling the increasing prevalence of diabetes in Europe?
I think JACARDI has an important role to play in the fight against diabetes. The different work packages address concrete challenges that exist and the approach is to document the challenges and to also find innovative solutions. The approach of having different pilot projects and how these can address local specific challenges, as well as how these lessons from a small context can then be transferred to the whole country or even to the whole of Europe is really innovative. I really think that the strength of this project is to look at those local specificities and then to take that mutual learning and spread the lessons learned beyond that small pilot either to the whole country or to other countries.
From your extensive experience as a diabetes researcher, how do you think JACARDI will influence future collaboration on diabetes prevention in Europe?
Beyond the scientific aspects, what has impressed me most is the collaboration between the outstanding scientists across Europe in this Joint Action. A valuable outcome of this project is the network that is being created, fostering exchanges that will have a positive impact on science beyond JACARDI.
As a Swiss citizen living outside “Europe”, I’m also a proud European. I think this project exemplifies the strength of the European ideal of uniting individuals from different member states to collectively improve lives. To really tackle diabetes, which is a global challenge and a European challenge. And again, JACARDI is bringing together the best scientists to tackle it.
Moreover, diabetes is not only a health problem, it is also a social and economic problem. I firmly believe that research has the power to document, to provide solutions and to guide governments in their responses to this challenge.
What impact do you hope JACARDI will have on future research and policy-making?
The pilot projects have the potential to move from pilots to full-blown projects. So, what does it take to scale up a pilot? Scaling up can mean different things: does it involve expanding to one more region, to an entire country, or even to other European nations? Will these larger initiatives within a specific country drive progress? Could they also be regarded as multi-country studies based on the initial pilot fostered by JACARDI?
As I mentioned earlier, I believe that the networks created are the greatest impact that JACARDI can have on future research. Research thrives on collaboration and the exchange of ideas, and this project has excelled in fostering these connections. For example, I was involved in the work package tackling patient pathways, where colleagues from different countries, such as Spain, Italy or Finland, all worked together on important data issues.
There are so many ideas floating around that you can clearly see this could lead to future research and have a clear impact on diabetes policy. One potential impact is on policies that continue to support research in this area, while another is on policies to adopt the outcomes of JACARDI. I think we need more research and this Joint Action has a role to play in highlighting the importance of research and continued funding for research. Both of those will take investment, time and engagement with policy makers and I think JACARDI has already started to do that. It will take persistence and patience to really be able to keep this on the policy makers’ agenda both by emphasizing the need for further research and by highlighting what JACARDI’s results mean for the future of diabetes.
I also see an opportunity to demonstrate the value of JACARDI’s work for people with diabetes and non-communicable diseases. By involving advocates and patient organizations and sharing JACARDI’s successes with the media, we can remind everyone that people with diabetes are citizens with rights and a voice. With one in ten people in Europe affected by diabetes, they represent a significant political bloc. Building on this momentum, JACARDI can continue to show policymakers the return on their investment, while also highlighting the need for ongoing support for this unique and exciting initiative.
David Beran is an Assistant Professor at the Geneva University Hospitals and University of Geneva within the Division of Tropical and Humanitarian Medicine. Previously, he has worked as Project Coordinator of the International Insulin Foundation based at University College London (UCL) where he developed and implemented a health systems tool to assess access to diabetes care. This work was carried out in Kyrgyzstan, Mali, Mozambique, Nicaragua, Vietnam and Zambia and led to the development of specific policies and projects to address the barriers identified.
His research interests include health systems and health systems research, management of chronic diseases, diabetes, access to insulin and the issue of multi-morbidity. Current projects include the NCD Policy Lab at University of Geneva, a global survey of barriers to access to insulin, and he has worked closely with the WHO on the issues of diabetes and access to medicines for noncommunicable diseases.
Learn more about David Beran’s work, the NCD Policy Lab, and connect on LinkedIn.
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.
Birgit Beger: An EU Cardiovascular Health Plan is the best way forward
Birgit Beger, CEO of the European Heart Network (EHN) and member of JACARDI’s Stakeholder Advisory Board, strongly believes that investment in health is a win-win for society overall. With the EU stepping up with the European Commission’s recent announcement of an EU Cardiovascular Health Plan, Birgit Beger shares her hope for an ambitious proposal by the European Commission in line with the work undertaken for the European Beating Cancer Plan. She sees JACARDI’s importance in leveraging knowledge and best practices across Europe and underscores the need to involve stakeholders early on, because they can help bridge the gap between policy and practice.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
In line with EHN Strategy, JACARDI, with its joint action of European pilot projects to reduce the burden of cardiovascular diseases and diabetes, mirrors one of EHN’s core pillars: prevention. Furthermore, EHN supports JACARDI’s overarching goal of improving CVDs and diabetes in terms of disease management.
In your experience, what are the most pressing challenges in implementing effective healthcare policy at both the EU and national levels in the area of cardiovascular disease prevention?
There is a disconnect between the political and healthcare practice levels. For example, the pressing societal burden of cardiovascular diseases has only recently come to the attention of policy makers at national and European levels. The recognition of the urgency for action is growing and yet, given that we are speaking these days about a permacrisis, many politicians are dealing with a myriad of urgent priorities simultaneously. However, as has always been argued, investment in health is a win-win for society overall, financially, for social inclusion and cohesion. This is particularly relevant for cardiovascular disease (CVD), which is the number one cause of mortality and morbidity in Europe and globally.
EHN’s vision is that “every person in Europe should grow up and live in a sustainable environment which promotes cardiovascular health. Premature and preventable deaths due to cardiovascular diseases should be reduced by 30% in 2030. State of the art, personalised care and quality of life should be accessible and attainable for those born or living with CVD”. In this context, taking legislative action to reduce the impact of major risk factors for CVD (unhealthy nutrition, smoking, physical inactivity, air pollution and climate change, but also hypertension, obesity and high cholesterol levels) are of the utmost importance in reducing the burden of CVD.
This being said, not all CVDs are preventable. Therefore, it is equally important to invest in early detection and management of cardiovascular diseases, thereby enabling people who are at high risk of developing CVD, or who have already contracted a CVD, to actively manage their condition, so that they can live to a mature age, with a good quality of life.
What do you see as the key success factors for achieving long-term impact in reducing the prevalence and burden of CVD? How is the EU CVH plan coming along?
Indeed, EHN believes that an EU Cardiovascular Health Plan is the best way forward since it represents a structured and financed approach to combat the cardiovascular burden on society and the increasing CVD numbers, which are already emerging for 2023 and 2024 following the Covid-19 pandemic. We see that many Member States are taking action for national CVH plans, that the European Parliament is supporting a European CVH plan and we are pleased to hear that the European Commission President Ursula von der Leyen identified CVD as a new health priority for her renewed mandate. It is important that the European Commission comes forward with an ambitious proposal in line with the work undertaken for the European Beating Cancer Plan.
Therefore, we applaud wholeheartedly the recent adoption of Council Conclusions on the Improvement of Cardiovascular Health in the EU on 3 December 2024, as well as the commitment from the new Health Commissioner, Olivér Várhelyi, to develop a European Cardiovascular Health Plan. EHN particularly welcomes references made to prevention, women’s health and research. A strong focus on the patients’ voice will be a decisive quality element of such a future European plan. It will hopefully trigger efforts at national level to improve or develop national cardiovascular health plans.
How important are EU-funded projects like JACARDI in addressing NCDs, and what role do they play in complementing the work of other organizations like EHN?
JACARDI has a real potential to implement policy at national level and to make tangible inroads at the European level. It is very promising that so many health institutions are involved in leveraging knowledge and best practices across Europe. EHN is there to support and advise on the work, but also help to disseminate results across its membership.
As CEO of the European Heart Network, you have a unique perspective on the dynamics of cardiovascular health advocacy across Europe. What lessons from your experience there could be applied to projects like JACARDI to maximize their effectiveness?
It is most important to involve stakeholders early on because they can help bridge the gap between policy and practice. As EHN, we can bring expertise to the table from our members at national level, namely, the patient experience, but we also speak to national and European policy makers. In this way, projects such as JACARDI can be fast-tracked further to develop results, through our consolidated support, which will work in practice through the informed connections these layers will bring.
About Birgit Beger
With 22 years of EU public policy experience focusing on leading European Associations like Medical Doctors, Lawyers, Health NGOs, Birgit Beger is a well-respected senior executive. Birgit is a qualified lawyer and skilled communicator with senior management experience and diplomatic outreach to all political levels, both at the national and European level. She has brought considerable added value to the leadership roles she has held during her tenures as CEO of the European Cancer Organisation (ECCO), and as Secretary General of the Standing Committee of European Doctors (CPME). She is a member of WHO-Europe Regional Director’s Advisory Council on Innovation for Noncommunicable Diseases (the NCD Advisory Council) and is the CEO of the European Heart Network, a leading advocate and key partner in shaping and advancing the European Cardiovascular Health Plan.
Learn more about the European Heart Network here & connect on LinkedIn here.
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.
Charles Agyemang: The challenge, especially with minority populations, is building trust
Some communities may seem hard to reach, but the real issue is that we don’t know how to connect with them, says Charles Agyemang, professor of Global Migration, Ethnicity and Health at the University of Amsterdam. As a member of JACARDI’s Scientific Advisory Board and an expert on ethnic inequalities in health and non-communicable diseases, he shares his experiences in working to connect with and empower minority communities. We also discussed the importance of addressing diversity in Europe and how JACARDI is leading the way.
What significance does JACARDI hold for you and your organisation in terms of its mission and values?
JACARDI is bringing a new dimension and aims to change the way things are done at the European level. The extensive network provides an excellent opportunity to interact with people, re-evaluate existing practices, and learn from other countries. It is quite exciting that JACARDI places inequalities at the center of its focus.
For me and my team, this is an opportunity to learn about what is happening across Europe and to contribute to ensuring that care and services related to cardiovascular disease are delivered equitably across Europe, taking into account people from diverse backgrounds such as migrant and ethnic minority groups.
How do you see JACARDI’s role in tackling the increasing prevalence of CVDs and diabetes in Europe?
Over the years, many countries have been working on cardiovascular diseases, but often in silos. When it comes to diversity and its various aspects, such as ethnicity and gender, many countries have been addressing these issues in their own ways and often with limited attention.
Now JACARDI provides an opportunity to raise awareness, share best practices among countries, and develop excellent ideas that can be implemented locally. It also allows countries to assess how far they have progressed, and engage with others in the process. More importantly, it ensures that countries are not working alone in silos. They have a network of people to rely on and seek input from when needed, fostering a collective responsibility to address this issue at the European level.
What is our role in promoting equity in healthcare?
Diversity cuts across the entire project, which is what makes it unique. In other words, regardless of what you are working on in your country, it is essential to apply a vested lens to it. I believe that adopting diversity as a horizontal approach should be the approach that is taken across the world.
This is the flagship element of the project. Everyone involved is expected to take it seriously and actively work on it. Having a dedicated work package focused on this ensures a constant reminder and provides a source of support for those seeking help. Some countries are more advanced in addressing these themes, and this project creates an opportunity to support countries that are less developed in their approach to diversity.
One important issue is the sustainability of the project’s results. There should be a plan and funding to enable the implementation of the diversity lens across all of Europe and ensure equitable healthcare for everyone regardless of ethnic background, gender, sexual orientation and so forth after JACARDI.
How do you see the significance of considering cultural diversity in the development of treatment for diabetes and cardiovascular disease and what is the most critical aspect of this?
The fact of the matter is that Europe today is very diverse, especially in urban centers. This is a reality, and we must address it. Diversity plays a crucial role in cardiovascular diseases, and understanding it is key to addressing inequalities in health and healthcare.
It also makes economic sense to address these gaps. For example, if we know that a specific group is affected by hypertension and we ignore this, individuals may eventually end up in the hospital with strokes, and society will bear a heavy cost of treating and caring for stroke patients. We should focus on the individuals or groups most affected and implement effective interventions to support them in living healthier lives.
Many of these inequalities are tied to social determinants of health and access to resources. For example, not everyone has the privilege of living a healthy life because of financial constraints, which may prevent them from buying healthy food. No matter how much health information you provide to specific communities, it is not going to be effective if their social and economic circumstances are not right. There must be a plan backed by resources to simultaneously promote healthy life and improve social and economic circumstances among a culturally diverse population.
Do you have any tips or valuable experiences on how to implement research findings in healthcare to benefit both the system and the patients?
It is crucial to involve the communities that matter from the very beginning of the implementation process. Their voices, especially those that are often unheard, must be included. We need to empower these communities, ensuring they are not just recipients but co-creators of the initiatives. By working together with communities from the start, we can ensure that the program is meaningful and sustainable.
Often, there is a tendency to go into communities and tell them what they should do. Instead, we should focus on ensuring that people are actively engaged in decisions, so that they take ownership of the program. When communities take ownership, they are more likely to ensure the program’s continued success after its initial implementation.
It’s crucial to recognize that long-term commitment is necessary for the success of a program. Governments must invest in supporting communities, especially those from lower economic groups and minorities, as it offers long-term benefits.
Do you have advice on how we can reach different communities?
People often say some communities are “hard to reach,” but the real issue is that we don’t know how to connect with or reach them. In fact, these communities are quite accessible if we approach them the right way and through proper channels.
The challenge, especially with minority populations, is building trust. To truly connect with people, we need to focus on establishing trust and building bridges. It’s about making people feel comfortable and valued. We need to invest time, establish relationships, and co-create with them.
Many times, researchers only engage when they need something, but we should connect even when we don’t need anything. By forming relationships and spending time with communities, it becomes easier to reach out when the need arises.
Charles Agyemang is a professor of Global Migration, Ethnicity and Health at Amsterdam University Medical Centres, University of Amsterdam. He is currently the Vice President of the EUPHA Migrant health section, Secretary of EUPHA’s Governing Board and Scientific Chair of the Global Society of Migration, Ethnicity, Race and Health. He is also a member of the prestigious US National Academy of Medicine and The European Academy. His work focuses on migration and health, particularly in relation to cardiovascular diseases. One of his most notable projects is the RODAM study, which investigates obesity and type 2 diabetes among African migrants.
Learn more about Charles Agyemang and his work here and connect on Linkedin here