Diabetes is often considered a peculiarly Western disease, but this chronic disease is worth taking note of on World Health Day, April 7.
Diabetes -- and the fast-food culture that provokes it -- is not just an American problem. It is quickly spreading to the rest of the world, too.
We think of McDonald's as an American restaurant, but of the five new McDonald's that open around the world every day, four are located beyond our borders.
Coca-Cola is the quintessential American drink, but that company has been buying up water licenses in poor countries -- many still bereft of safe drinking water -- where they sell soda for less than the price of a glass of clean water. In Africa, the number-one employer is not a mining company or an agricultural firm, but Coca-Cola.
Our health suffers when we rely on fast foods and sugary drinks to sustain ourselves. But in places where malnourishment and poverty are rampant, the ramifications are even more profound.
In Western countries, the transition from hardscrabble malnourishment to today's drive-through, fast-food cornucopia occurred over centuries, with the happy result that our societies were able to control infectious diseases spread by hunger and poverty before facing the maladies of richly calorific diets, including diabetes, obesity and heart disease.
As anyone who has seen the KFCs and Pizza Huts sprouting along the alleys of Mumbai, India, and Cape Town, South Africa, knows, in developing countries, no such time lag exists. What experts call the "nutrition transition" is taking place within a single generation.
Malnourished mothers tend to bear babies predisposed to storing excess energy as fat. This is a useful adaptive advantage in communities where calories are often scarce, enabling babies to survive nutritional deficits.
But when such babies grow up to consume Western-style diets chock-full of fatty, sugary foods, that benefit turns into a deadly curse, causing kids to gain disease-causing extra fat much more rapidly than they would have otherwise.
Today, four of out five people who die of chronic, noncommunicable diseases such as diabetes and heart disease perish in developing countries, according to the World Health Organization (WHO).
For developing countries barely treading water amid the flood of malnutrition, HIV infections, malaria and tuberculosis, "the public health implications of this phenomenon are staggering," the WHO has noted.
The era of strings-attached International Monetary Fund and World Bank loans -- which forced the dismantling of the public-health infrastructures of many indebted countries -- is partly to blame.
Global trade agreements forged throughout the 1990s eased the entry of soda makers and fast-food companies into the emerging markets of the developing world.
The World Health Organization's World Health Day should help raise awareness of the global implications of diabetes, but the solution lies beyond the ken of health advocates alone. Stamping out diabetes will take more than just great advocacy and awareness, but taking on the multinational food industry itself.
Until widespread hunger and malnutrition are addressed, purveyors of marginally nutritional foods loaded with empty calories should be expected to provide better food -- or go elsewhere.
Sonia Shah's new book, "The Body Hunters: Testing New Drugs on the World's Poorest Patients," is forthcoming from The New Press in September. A Puffin Foundation writing fellow at The Nation Institute, she is also author of "Crude: The Story of Oil" (Seven Stories, 2004). She can be reached at pmproj@progressive.org.