The Russell Berrie Galilee Diabetes SPHERE
Internal Medicine
By creating local ecosystems oriented toward healthier lifestyles, Bar-Ilan’s pioneering public-health initiative is empowering Israel’s North to emerge stronger after the war.
Home is Where the Health Is
In a recent survey of what Israel’s nearly 100,000 displaced residents required to return to their northern homes, improved healthcare ranked second on the list—before even a rehabilitated economy, and right after security. For Dr. Sivan Spitzer, deputy director of Bar-Ilan’s ten-year initiative to move the needle on the health crisis in the Galilee, the results made perfect sense. “When evacuees began to use the healthcare systems in their new places of residence, they realized the extent of the difference in accessibility and care from what they were used to back home,” explained Spitzer. “And most important, they realized the dramatic effects of better health on their overall quality of life.”
The belief that better health is critical to advancing both individual and collective well-being and prosperity lies at the heart of the Russell Berrie Galilee Diabetes SPHERE, whose unique ecosystem model for improving health outcomes brought the North closer to the center of the country during the course of the past year. With 60 different projects running in 23 municipalities—“we didn’t stop for a single moment,” Spitzer says, “despite the daily rocket fire and constant uncertainty”—SPHERE continued and even expanded its efforts to help the region “learn to speak a new language of health, one not confined to the doctor’s office or necessarily colored by disease,” Spitzer explains. As an example, she points to the new network of community kitchens and gardens SPHERE helped establish with municipalities, which associate healthful food choices with positive social and physical activity. Combined with the introduction of new walking trails, nutritional education in schools, and community gyms, SPHERE helped municipalities develop what she calls the “complementary infrastructure” that allows patients to implement the behaviors encouraged by the healthcare system.
Above: The Russell Berrie Galilee Diabetes SPHERE team (left to right): Deputy Director Dr. Sivan Spitzer, Director Prof. Naim Shehadeh, and COO Martin Duifhuize. Banner: The SPHERE one-stop-shop Mobile Clinic for diabetes testing.
The results of SPHERE’s collaboration with that system demonstrate the importance of another of the initiative’s guiding principles: preemption. In a pilot run jointly with Maccabi, one of Israel’s four HMOs, clinics identified patients at risk for diabetes and proactively set appointments. Thanks to more frequent checkups, enrollment in free nutrition courses, and information on the recommended exercise guidelines, the North saw a 40 percent reduction in the rate of conversion to diabetes last year. And now that the ceasefire with Hezbollah has allowed SPHERE’s one-stop-shop Mobile Clinic for diabetes testing onto the Galilee’s roads, the initiative expects to see a similar drop in the rate of diabetes-related complications, which regular examinations can help prevent.
Perhaps the biggest sign of SPHERE’s victory, however, is its ability to retreat. “Our 23 participating municipalities are doing such an exceptional job, we’re starting to pull our assistance back and adopt new towns in the Galilee,” Spitzer says. “Already, residents can return to a more empowered region, one capable of improving their health and their quality of life.”
The inaugural cohort of SPHERE’s course for northern imams celebrated their graduation at an event with SPHERE Director Prof. Naim Shehadeh and municipal liaison Nassim Assi, who served as instructor. The course was organized in collaboration with Col. (res.) Iyad Sarhan, director of the Religious Affairs Department at the Ministry of Interior, and Sheikh Ziad Abu Mokh, director of the department’s Muslim Division.
partners across six sectors (healthcare, municipal, NGOs, religious and community leaders, academia, and industry)
residents of the periphery benefitting directly
participating municipalities, a 35 percent increase from the previous year
different projects in collaboration with healthcare systems, municipalities, schools, and local religious leaders
participants in SPHERE’s first three-month course for northern imams, which offered tools for encouraging healthy lifestyles in their communities, particularly during the month of Ramadan
members of SPHERE’s new online Physicians Forum, which helps family doctors improve their diabetes and obesity care through seminars, consultations with specialists, and discussions with their peers
participants in SPHERE’s first online Obesity-Management Seminar, a five-month course for healthcare professionals that teaches strategies for treating and managing obesity-related diseases and practical tips for helping patients make healthier choices about diet and exercise
the annual rate of conversion to diabetes in the North as in the rest of the country
Together with pharmaceutical partners including Novo Nordisk and Pfizer and researchers from Spain, Sweden, Germany, Poland, and the Netherlands, Dr. Sivan Spitzer of the Azrieli Faculty of Medicine was awarded a collective €22 million grant from the European Union’s Innovative Health Initiative (IHI) to develop a personalized digital platform for improving medication adherence among patients with cardio-metabolic disease. This marks the first time that a Bar-Ilan researcher has received the prestigious award.
Maximizing Prescriptions’ Impact
Both from lack of familiarity with new diabetes drugs and their patients’ eligibility, northern family doctors often under-prescribe medications that can reduce complications from the disease. Thanks to the SPHERE Rx Calculator developed this past year, however, doctors can now input their patients’ information and receive an updated list of medications covered by the relevant HMO. The calculator also includes information on drug interactions. “30 percent of patients in the Galilee who should be receiving new medications do not receive them, despite these medications being covered by the national health insurance,” said Prof. Naim Shehadeh, director of SPHERE, when explaining the importance of reducing pharmaceutical inequities. “The unique algorithm SPHERE developed allows doctors to significantly increase their prescriptions for improved patient outcomes. In light of the calculator’s success, we are now developing additional Rx calculators for obesity and hyperlipidaemia.”
Graduates of SPHERE’s first Obesity-Management Course for healthcare professionals celebrate their graduation at an event in July.
Explaining the Fine Print
Through new funding from the Edmond de Rothschild Foundation, SPHERE is developing a digital platform that informs northern residents of their rights to new cardio-metabolic disease medications and care under Israeli law. Delivered in simple, easy-to-understand Hebrew or Arabic, the app also provides information on the medications themselves, offers the opportunity to consult with experts, and features an open community forum.
