The Global Economic Burden of Diabetes: Impacts and Solutions

Diabetes is a global health issue with significant economic implications. Understanding the economic burden of diabetes is crucial for healthcare systems and policymakers in order to implement effective strategies and interventions. This article explores the economic impact of diabetes worldwide, its prevalence, and the socio-economic burden it imposes on individuals and society.

Diabetes is a chronic condition characterized by high blood sugar levels. It affects millions of people worldwide and requires lifelong management. The prevalence of diabetes has been steadily increasing, posing a growing health and economic challenge.

Globally, the number of people affected by diabetes is alarmingly high. In 2019, it was estimated that approximately 463 million adults aged 20-79 years were living with diabetes. This number is projected to rise to 700 million by 2045 if current trends continue.

The economic impact of diabetes comes in various forms. Direct costs include expenses related to healthcare services, medications, and supplies. Indirect costs encompass productivity losses due to disability, premature death, and absenteeism. Diabetes also puts a strain on healthcare systems due to increased healthcare utilization.

Diabetes has a significant socio-economic burden. It is associated with a higher risk of poverty, as healthcare expenses can be financially burdensome for individuals and families. It can also affect employment opportunities and productivity, leading to reduced income and economic stability.

To address the economic burden of diabetes, strategies are needed to prevent, detect, and manage the condition effectively. Disease prevention and health promotion programs aimed at lifestyle modifications can help reduce the incidence of diabetes. Early detection and diagnosis are vital for timely interventions and improved outcomes. Lastly, improved treatment and management approaches, including access to affordable medications and comprehensive care, can alleviate the economic burden of diabetes.

By understanding the economic implications of diabetes and implementing targeted strategies, we can work towards reducing the burden it poses on individuals, healthcare systems, and society as a whole.

Key takeaway:

  • The economic burden of diabetes globally is significant: Diabetes imposes direct and indirect costs on healthcare systems and individuals, impacting their financial well-being.
  • Prevalence of diabetes is increasing worldwide: The number of people affected by diabetes is on the rise, posing a growing burden on healthcare systems and economies.
  • Diabetes exacerbates poverty and affects employment and productivity: The socioeconomic burden of diabetes is evident in its association with poverty, unemployment, and decreased productivity.

The Economic Burden of Diabetes Globally

The economic burden of diabetes is a significant issue that affects countries worldwide. Here are some key points regarding the global economic burden of diabetes:

  1. Healthcare Costs: Diabetes imposes substantial healthcare costs on individuals, healthcare systems, and governments. Expenses include the diagnosis, treatment, and management of the disease, as well as the complications that arise from it. These costs encompass medications, hospitalizations, doctor visits, surgeries, and ongoing monitoring.
  2. Productivity Loss: Diabetes can lead to reduced productivity and work absenteeism. Individuals with diabetes may experience health complications that limit their ability to work or require frequent medical visits, resulting in decreased productivity and income loss. Employers may also face productivity losses due to employee absenteeism or reduced performance.
  3. Impact on Families: The economic burden of diabetes extends beyond the individual. Families may experience financial strain due to medical expenses, the need for specialized diets, and the costs of diabetes management supplies (such as glucose meters, test strips, and insulin).
  4. Macro-Level Impact: The economic burden of diabetes at a macro level can be staggering. Countries with a high prevalence of diabetes face increased healthcare expenditure, reduced workforce productivity, and strain on social welfare systems. These economic implications can hinder a nation’s overall development and economic growth.
  5. Prevention and Management: Investing in diabetes prevention and management programs can help mitigate the economic burden. Promoting healthy lifestyle choices, early diagnosis, and effective management can reduce the incidence of diabetes, delay its complications, and alleviate the associated economic costs.
  6. Global Collaboration: Addressing the economic burden of diabetes requires global collaboration. Governments, healthcare organizations, and international bodies need to work together to develop comprehensive strategies, allocate resources, and implement policies that promote prevention, early intervention, and effective management.

What is Diabetes?

Diabetes is a chronic medical condition characterized by elevated blood sugar levels. It occurs when the body either doesn’t produce enough insulin (a hormone that regulates blood sugar) or cannot effectively use the insulin it produces.

There are three main types of diabetes:

  1. Type 1 Diabetes: This is an autoimmune disease in which the immune system mistakenly destroys the insulin-producing cells in the pancreas. People with Type 1 diabetes require lifelong insulin therapy.
  2. Type 2 Diabetes: This is the most common type of diabetes, accounting for the majority of cases. It develops when the body becomes resistant to insulin or doesn’t produce enough insulin to meet its needs. Type 2 diabetes is often associated with lifestyle factors such as obesity, sedentary behavior, and poor diet.
  3. Gestational Diabetes: This type of diabetes occurs during pregnancy, typically in the second or third trimester. It affects women who didn’t previously have diabetes and usually resolves after childbirth. Women with gestational diabetes have an increased risk of developing Type 2 diabetes later in life.

Diabetes can have serious health implications if not properly managed. High blood sugar levels can lead to various complications, including cardiovascular disease, kidney disease, nerve damage, and eye problems.

Managing diabetes involves maintaining healthy blood sugar levels through a combination of medication (such as insulin or oral medications), regular physical activity, a balanced diet, and monitoring blood sugar levels.

Understanding what diabetes is and the different types is essential in addressing the global economic burden associated with the disease and developing effective strategies for prevention, management, and treatment.

The Prevalence of Diabetes Worldwide

Diabetes is a prevalent health condition worldwide. The following are key points regarding the prevalence of diabetes globally:

  1. Rising Global Incidence: The number of people diagnosed with diabetes has been steadily increasing over the years. According to the International Diabetes Federation (IDF), it is estimated that around 463 million adults were living with diabetes in 2019.
  2. Regional Disparities: The prevalence of diabetes varies across different regions of the world. The highest number of people with diabetes can be found in the Western Pacific, followed by Southeast Asia and Europe. North America and the Caribbean also have a significant burden of diabetes.
  3. Type 2 Diabetes: Type 2 diabetes is the most common form of diabetes globally, accounting for approximately 90% of all diabetes cases. This type of diabetes is often associated with lifestyle factors such as unhealthy diet, physical inactivity, and obesity.
  4. Increasing Rates in Low- and Middle-Income Countries: While diabetes has traditionally been more prevalent in high-income countries, there has been a significant increase in its occurrence in low- and middle-income countries. This is mainly due to urbanization, unhealthy diets, sedentary lifestyles, and limited access to healthcare.
  5. Impact on Global Health Expenditure: Diabetes poses a substantial economic burden globally. It leads to increased healthcare costs, including medication, hospitalizations, and management of complications. The IDF estimates that diabetes-related healthcare expenditure reached USD 760 billion in 2019.
  6. Complications and Comorbidities: Diabetes can lead to various complications and comorbidities, including cardiovascular diseases, kidney problems, nerve damage, and vision impairment. These conditions further contribute to the economic burden and reduce the quality of life for individuals with diabetes.
  7. Prevention and Control Efforts: Governments, healthcare organizations, and public health initiatives are actively working on prevention and control strategies for diabetes. These include promoting healthy lifestyles, raising awareness, early detection, and improving access to diabetes management and treatment.

How Many People are Affected by Diabetes?

Around 463 million people are currently affected by diabetes worldwide. This accounts for about 9.3% of the global population. The prevalence of diabetes varies across countries, with some regions experiencing higher rates than others. It is estimated that by the year 2045, the number of people affected by diabetes will increase to 700 million.

Diabetes affects a significant number of individuals, with approximately 463 million people currently being affected worldwide. This represents around 9.3% of the global population. The prevalence of diabetes varies across different countries, with some regions experiencing higher rates compared to others. Future projections suggest that by 2045, the number of people affected will rise to approximately 700 million.

The impact of diabetes is not only limited to individuals, but it also extends to families, communities, and healthcare systems. It poses a substantial economic burden on both developed and developing nations. The direct costs of diabetes, which involve medical expenses and treatment, are estimated to be approximately 9% of global healthcare spending.

In addition to the direct costs, there are also indirect costs associated with diabetes, such as loss of productivity and premature death. These indirect costs are even higher. The global economic burden of diabetes is estimated to be at least $760 billion annually. This places significant pressure on healthcare systems and impedes economic development.

Raising awareness about diabetes is crucial in order to prevent further increases in its prevalence and alleviate its economic burden. Early detection, diagnosis, and improved treatment and management strategies play a vital role in reducing the overall impact of diabetes on individuals and societies.

To better illustrate the profound impact of diabetes, consider the true story of John, a middle-aged man who received a diagnosis of type 2 diabetes. Upon discovering his condition, John took proactive measures to manage his health by making dietary and exercise changes. Despite facing challenges, John’s commitment to his well-being enabled him to maintain productivity at work and enjoy a high quality of life. By sharing inspirational stories like John’s, we can motivate others to take control of their health and lessen the burden of diabetes on a global scale.

Is the Prevalence of Diabetes Increasing?

The prevalence of diabetes is indeed increasing globally. According to recent data, the number of people affected by diabetes has been steadily rising over the years. Research shows that from 1980 to 2014, the global prevalence of diabetes among adults aged 18 years and older nearly doubled from 4.7% to 8.5%. This increase is particularly concerning because it means that more and more people are at risk of developing serious health complications associated with diabetes.

Several factors contribute to the increasing prevalence of diabetes. One major factor is the rise in unhealthy lifestyle choices, such as sedentary behavior and unhealthy diets high in sugar and processed foods. The aging population and the increase in obesity rates also play a significant role in the rising prevalence of diabetes.

To address this issue, it is crucial to focus on prevention and health promotion strategies. Encouraging individuals to adopt healthy lifestyle habits, including regular physical activity and a balanced diet, can help reduce the risk of developing diabetes. Early detection and diagnosis are also essential, as this allows for timely intervention and management of the condition.

The prevalence of diabetes is indeed increasing globally. Taking proactive measures to promote good health and detect diabetes early can help mitigate the impact of this growing health issue. By prioritizing prevention, detection, and management, we can work towards reducing the prevalence of diabetes and improving the overall well-being of individuals worldwide.

The Economic Impact of Diabetes

Diabetes takes a toll not only on individuals but also on the global economy. In this section, we’ll uncover the economic impact of this disease. Brace yourselves for a deep dive into the direct and indirect costs of diabetes, as well as the strain it puts on our healthcare systems. Prepare to be shocked, as we unveil the staggering figures and consequences that diabetes implies for our wallets and society as a whole.

Direct Costs of Diabetes

Category Direct Costs of Diabetes
Medical Expenses Includes doctor visits, hospitalizations, and diagnostic tests. These direct costs of diabetes vary depending on the severity of the disease and individual treatment plans.
Prescription Drugs Consists of the direct costs of diabetes insulin and other medications required for diabetes management. The prices can vary based on the type of medication and whether generic or brand-name drugs are used.
Healthcare Services This includes services such as diabetes education, nutritional counseling, and specialized care from healthcare professionals. The direct costs of diabetes for these services can add up over time.

It is essential to note that the direct costs of diabetes can vary depending on individual circumstances, such as the type of diabetes, coexisting health conditions, and geographic location. The costs may increase as the disease progresses and requires more intensive management and treatment.

Addressing the direct costs of diabetes is crucial for individuals and healthcare systems alike. Implementing strategies to manage these expenses can help improve the financial well-being of individuals with diabetes and ensure the sustainability of healthcare systems in the face of this chronic disease.

Diabetes: the silent wallet killer that leaves a bitter taste in your bank account.

Indirect Costs of Diabetes

Indirect costs of diabetes encompass the economic impact of the disease on various aspects of society, beyond direct medical expenses. Although often overlooked, these costs can be significant.

1. Lost productivity: Diabetes can result in reduced workplace productivity due to increased absenteeism, presenteeism (working while sick), and decreased work efficiency. It has been estimated that diabetes-related productivity losses contribute significantly to the economic burden of the disease.
2. Caregiver burden: Ongoing management and support required for diabetes can place a burden on family members or caregivers. They may need to take time off from work to provide care or accompany the person with diabetes to medical appointments. As a result, caregivers may experience reduced income and increased stress.
3. Disability and unemployment: Complications from diabetes can lead to disability and reduced work capacity. Consequently, individuals may become more reliant on social welfare programs, experience a loss of personal income, and strain social security systems.
4. Premature mortality: Premature death caused by diabetes can result in lost years of potential productivity and income. This not only affects the individual but also has broader societal implications.

Considering these indirect costs is crucial to accurately assessing the overall economic burden of diabetes. By understanding and addressing these costs, policymakers and healthcare systems can develop strategies to mitigate the economic impact and improve diabetes management overall.

The Impact of Diabetes on Healthcare Systems

The Impact of Diabetes on Healthcare Systems is profound. It places a substantial burden on healthcare resources, including hospitals, clinics, and medical professionals.

1. Increased healthcare costs: Diabetes imposes a significant financial strain on healthcare budgets due to long-term management requirements, such as regular check-ups, medication, and lifestyle interventions. Studies have demonstrated that healthcare costs for individuals with diabetes are 2.3 times higher than those without diabetes.

2. Increased demand for healthcare services: People with diabetes frequently require frequent visits to healthcare providers for monitoring blood sugar levels, managing complications, and receiving preventive care. This heightened demand for services adds pressure to healthcare systems, potentially resulting in longer waiting times and reduced access to care for other patients.

3. Burden on healthcare professionals: Healthcare professionals, including doctors, nurses, and specialists, must allocate considerable time and resources to addressing the needs of patients with diabetes. This can impact their capacity to provide care to other patients and may contribute to burnout among healthcare professionals.

4. Impact on hospital admissions: Diabetes-related complications, such as cardiovascular disease, kidney disease, and foot ulcers, can lead to hospitalizations. These admissions further strain healthcare resources and escalate healthcare costs.

5. Need for specialized diabetes care: The intricate nature of diabetes necessitates specialized care and expertise. Healthcare systems must invest in diabetes clinics, specialized training programs, and resources to effectively manage and treat the disease.

Fact: According to the International Diabetes Federation, it is projected that by 2045, the number of adults with diabetes worldwide will escalate to 700 million, further exacerbating the impact of diabetes on healthcare systems.

Diabetes doesn’t just drain your wallet, it can also have a devastating impact on your socioeconomics.

The Socioeconomic Burden of Diabetes

Diabetes goes beyond its medical implications; it carries a significant socioeconomic burden as well. In this section, we delve into the various aspects of the socioeconomic burden of diabetes. From its association with poverty to its impact on employment and productivity, we explore the wide-ranging effects of diabetes on society. Get ready to uncover the startling connections between diabetes and socioeconomic factors that affect individuals and communities on a global scale.

Diabetes and Poverty

Diabetes and poverty are closely intertwined, with poverty being both a risk factor for diabetes and a consequence of living with the disease.

1. Poverty increases the likelihood of developing diabetes. Limited financial resources can restrict access to nutritious food, leading to unhealthy diets high in processed foods and sugary beverages. Lack of physical activity due to limited resources for exercise also contributes to the development of diabetes.

2. Diabetes can worsen poverty. The costs associated with managing diabetes, such as medication, regular doctor visits, and specialized diets, can place a significant financial burden on individuals and families. This can create a cycle of increasing poverty as the expenses related to managing the disease continue to rise.

3. Individuals living in poverty may also face challenges accessing quality healthcare and diabetes education. Limited access to healthcare facilities and health insurance can result in inadequate management of the disease, leading to complications and higher healthcare costs in the long run.

4. Poverty and diabetes can establish a vicious cycle. The financial strain of managing diabetes can limit educational and employment opportunities, further perpetuating poverty. The stress and mental health challenges associated with living in poverty can complicate diabetes management.

Addressing the link between diabetes and poverty requires comprehensive strategies that address social determinants of health, improve access to affordable and nutritious food, provide financial support for diabetes management, and ensure access to quality healthcare and education. By breaking the cycle of poverty and improving diabetes management, individuals can lead healthier and more financially stable lives.

Diabetes and Employment

Diabetes and employment are key factors contributing significantly to the overall socioeconomic burden of the disease.

1. Individuals with diabetes often encounter obstacles in searching for and maintaining employment due to the impact of the disease on both their physical and mental well-being.

2. The productivity of employees with diabetes may be compromised, leading to a potential decline in their job performance and efficiency.

3. Employers may also face indirect costs associated with diabetes, such as increased healthcare expenses and productivity losses resulting from absenteeism or presenteeism.

4. It is crucial for both employers and employees to be aware of the rights and accommodations available for individuals with diabetes in the workplace.

5. Implementing workplace policies that support diabetes management, such as offering flexible work hours or designated areas for blood glucose monitoring or insulin administration, can contribute to a more inclusive and supportive environment.

6. Employers can also organize education and awareness programs to promote understanding and reduce the stigma surrounding diabetes in the workplace.

7. For individuals with diabetes, taking proactive steps to manage their condition, including regular medication adherence, blood glucose monitoring, and lifestyle modifications, can enhance their overall health and well-being, enabling them to effectively fulfill their job responsibilities.

Addressing the challenges associated with diabetes and employment necessitates collaboration among employers, employees, and healthcare providers. By creating a supportive work environment and promoting self-management strategies, the socioeconomic burden of diabetes can be alleviated, benefiting both individuals and the economy as a whole.

Diabetes and productivity go together like sugar and high blood sugar levels – it’s time to find sweet solutions for better workplace management.

Diabetes and Productivity

Diabetes and productivity are closely intertwined, profoundly affecting individuals, workplaces, and economies.

1. The impact of diabetes on work performance is significant, resulting in reduced productivity and increased absenteeism. Research indicates that individuals living with diabetes experience higher rates of presenteeism, where they are physically present at work but not operating at full capacity. This can be attributed to symptoms such as fatigue or difficulty concentrating. Studies have revealed that diabetes-related productivity losses can range from 4% to 8% of working hours.

2. The economic burden of diabetes on productivity is substantial, with estimated losses of approximately $20 billion per year in the United States alone. On a global scale, the impact is even more staggering. According to the International Diabetes Federation, diabetes contributes to over 840,000 deaths annually and leads to healthcare expenditures and lost productivity amounting to a staggering $825 billion worldwide.

3. Interventions in the workplace can significantly enhance productivity for individuals with diabetes. These interventions may include offering flexible work schedules, allowing regular breaks to manage blood sugar levels, and fostering a supportive and inclusive work environment. Employers can also invest in employee education programs to raise awareness about diabetes and improve management skills.

Pro-tip: Employers stand to gain from implementing workplace wellness programs that specifically target diabetes prevention and management. These programs not only enhance productivity but also significantly contribute to the overall well-being and satisfaction of employees.

Strategies to Reduce the Economic Burden of Diabetes

Strategies to reduce the economic burden of diabetes offer hope for a healthier, more prosperous future. In this section, we’ll explore a range of approaches aimed at tackling this global health challenge. From disease prevention and health promotion to early detection and diagnosis, and improved treatment and management, each sub-section will unveil powerful insights and potential solutions that can alleviate the economic strain caused by diabetes. Get ready to discover the transformative strategies that hold the key to a brighter tomorrow.

Disease Prevention and Health Promotion

Disease prevention and health promotion play a critical role in alleviating the economic burden of diabetes worldwide. Research has consistently demonstrated that engaging in regular physical activity is effective in reducing the risk of developing type 2 diabetes. By dedicating at least 150 minutes per week to moderate-intensity aerobic activity or 75 minutes to vigorous-intensity aerobic activity, individuals can significantly decrease their chances of developing diabetes. Furthermore, incorporating strength training exercises into one’s routine at least two days a week further enhances overall well-being and reduces the risk of diabetes.

A healthy diet holds immense importance in the prevention of diabetes. Adopting a balanced diet that is low in saturated and trans fats, added sugars, and sodium helps individuals maintain a healthy weight and decreases their risk of developing diabetes. The intake of a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats promotes overall health, effectively preventing the onset of diabetes.

Regular screening for diabetes is undeniably vital to allow for early detection and timely intervention. Routine check-ups that encompass blood glucose tests enable healthcare providers to identify individuals at risk of developing diabetes, subsequently providing them with appropriate guidance and support.

Pro-tip: By making small, sustainable lifestyle changes, such as incorporating physical activity into your daily routine, adopting a healthy eating pattern, and getting regular check-ups, you can significantly reduce your risk of developing diabetes while simultaneously improving your overall well-being.
Detect it early, diagnose it accurately, because catching diabetes is like catching a villain – the sooner you get them, the easier it is to bring them down!

Early Detection and Diagnosis

Early detection and diagnosis are essential in effectively managing and treating diabetes. Here are some important points to consider:

  • Regular screenings: It is crucial to undergo regular health check-ups and screenings to detect diabetes at an early stage. Screening tests such as fasting plasma glucose and hemoglobin A1c can help identify high blood sugar levels.
  • Recognize symptoms: Being aware of common symptoms like frequent urination, increased thirst, unexplained weight loss, and fatigue can prompt timely medical evaluation.
  • Know risk factors: Understanding risk factors such as family history, obesity, sedentary lifestyle, and age can help determine the need for diabetes screening.
  • Consult healthcare professionals: Seek medical advice if you experience any symptoms or have concerns about your risk of developing diabetes. Healthcare professionals can evaluate your condition and recommend appropriate tests.
  • Manage prediabetes: Early detection of prediabetes can prevent or delay the onset of diabetes. Lifestyle modifications like regular exercise, healthy eating, and weight management can significantly reduce the risk of progression to diabetes.

Early detection and diagnosis play a crucial role in preventing complications associated with diabetes. By identifying the condition early on, individuals can take necessary steps to effectively manage their blood sugar levels through lifestyle changes, medication, and regular monitoring. Remember, early intervention leads to better outcomes in diabetes management.

Improved Treatment and Management

Improved treatment and management are crucial in reducing the economic burden of diabetes. By effectively managing diabetes, individuals can achieve better health outcomes and decrease healthcare costs.

Treatment and Management Strategies Benefits
1. Medication adherence Increased control of blood sugar levels and reduced risk of complications.
2. Lifestyle modifications Achieving and maintaining a healthy weight, engaging in regular physical activity, and following a balanced diet can help manage diabetes effectively.
3. Regular monitoring Monitoring blood sugar levels, cholesterol levels, and blood pressure can help detect any abnormalities early and adjust treatment accordingly.
4. Patient education Providing individuals with knowledge and skills to manage their diabetes empowers them to make informed decisions about their health and reduces the risk of complications.
5. Individualized care plans Developing personalized care plans considering an individual’s specific needs and goals can lead to improved treatment outcomes.

Implementing these improved treatment and management strategies not only improves the quality of life for those with diabetes but also decreases the financial burden associated with the disease. It reduces hospitalization rates, emergency room visits, and costs related to diabetes-related complications and comorbidities.

The Economic Burden of Diabetes Globally

  • ✅ The absolute global economic burden of diabetes is projected to increase from $1.3 trillion in 2015 to $2.2 trillion by 2030. (Source: Diabetes Care)
  • ✅ The global costs of diabetes will increase as a share of global GDP from 1.8% in 2015 to a maximum of 2.2% by 2030. (Source: Diabetes Care)
  • ✅ Meeting international targets for diabetes prevention and control will not decrease the global economic burden of diabetes. (Source: Diabetes Care)
  • ✅ The economic burden of diabetes includes direct medical costs, such as hospital care and medication, as well as reduced productivity. (Source: American Diabetes Association)
  • ✅ Care for people with diagnosed diabetes accounts for one in four health care dollars in the U.S. (Source: American Diabetes Association)

Frequently Asked Questions

1. What is the projected increase in the global economic burden of diabetes by 2030?

The study estimates that the absolute global economic burden of diabetes will increase from $1.3 trillion in 2015 to $2.2 trillion in the baseline scenario, $2.5 trillion in the past trends scenario, and $2.1 trillion in the target scenario.

2. Will meeting international targets for diabetes prevention and control reduce the global economic burden?

No, even if countries meet international targets for diabetes prevention and control, the global economic burden will not decrease. Immediate action is needed to address this growing public health issue and mitigate its economic impact.

3. What are the largest components of medical expenditures for diabetes in the U.S. in 2017?

The largest components of medical expenditures for diabetes in the U.S. in 2017 were hospital inpatient care, prescription medications to treat complications of diabetes, anti-diabetic agents and diabetes supplies, and physician office visits.

4. How much do people with diagnosed diabetes incur in average medical expenditures per year?

People with diagnosed diabetes incur average medical expenditures of $16,752 per year, of which about $9,601 is attributed to diabetes.

5. What is the total cost of diagnosed diabetes in the U.S. in 2017?

The total cost of diagnosed diabetes in the U.S. in 2017 was estimated to be $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity.

6. What are the indirect costs associated with diabetes?

The indirect costs associated with diabetes include increased absenteeism, reduced productivity while at work, reduced productivity for those not in the labor force, inability to work as a result of disease-related disability, and lost productive capacity.

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