Indian Country officials are singing the praises of the Indian Health Services’ (IHS) Special Diabetes Program for Indians (SDPI), even in the face of decades of flat funding. The program was established by Congress in 1997 and is funded annually. The current round of funding is set to expire Sept. 30.

On July 27, Buu Nygren, president of the Navajo Nation, testified before the U.S. Congressional Joint Economic Committee on the economic impact of diabetes across Indian Country and the importance an SDPI fund increase. He said the Navajo Nation has seen improvements through its community-based diabetes prevention programs.

SDPI helps keep type-2 diabetes intervention and prevention programs running in Native communities. SDPI has helped to increase the number of on-site nutrition services and the number of physical activity and weight management specialists and sites for adults and youth.

The Seminole Tribe has received SDPI funds for several years. It is used for a variety of diabetes prevention and mitigation programs through Integrative Health, part of the tribe’s Health and Human Services Department.

The program is important as Native American communities have traditionally experienced higher numbers of type-2 diabetics compared to other populations. Nygren said, however, that from 2013 to 2017, diabetes incidence decreased across Indian Country. In addition, he said between 1996 and 2013, incidence rates of end-stage renal disease among Native Americans with diabetes declined 54%. The improvements are estimated to have saved health care systems $520 million so far. Nygren said programs like SDPI directly contribute to the decreases.

“ … SDPI has become the nation’s most effective federal initiative to combat diabetes and serves as a useful model both for diabetes programs nationwide and public

health programs in Indian Country,” he said in his testimony.

Even with the decreases, however, officials say the funding doesn’t meet the ongoing demand. In his testimony, Nygren said the annual discretionary appropriated budget for IHS isn’t adequate. He said, for example, that in fiscal year 2021, IHS spending equaled $4,140 per patient, while the national average was $10,680.

SDPI is currently funded through mandatory appropriations at $150 million per year – the same amount for the past two decades. Nygren said current bills in both the House and Senate that would renew SDPI at $170 million, a $20 million increase, encourage him.

“While this is less than the $250 million per year requested by tribal nations and in the president’s [fiscal year] 2024 budget request, we appreciate Congress’ attention to the need for a funding increase for SDPI,” he said. “While type-2 diabetes continues to impact our people at alarming rates, there is hope. Thanks to the impact of SDPI, we have increased nutrition counseling and patient interventions to help them treat or even reverse type-2 diabetes.”