On November 14, 2025, organisations globally observed World Diabetes Day. One key area of focus during the recent Diabetes and Hypertension Association’s panel discussion on the subject was the high cost of non-communicable diseases in the workplace. Stakeholders came to the stark reality that this health crisis is not just a burden on the healthcare system, it is a silent, insidious threat to the economy, particularly to the very engine of economic growth – micro, small, and medium enterprises (MSMEs).
Diabetes and the wider spectrum of non-communicable diseases (NCDs) are eroding the foundation of business productivity and threatening the resilience of the Barbadian workforce. The figures are nothing short of a national crisis. NCDs, including cardiovascular diseases, cancers, and most prominently diabetes, are responsible for a staggering 75 per cent of all deaths in the Caribbean. For Small Island Developing States (SIDS) like Barbados, the economic ramifications of this health epidemic are devastating. While acknowledging the costs of treatment and hospital care (the direct costs), the true financial drain comes from the indirect costs, the loss of human capital and workforce efficiency. It has been estimated that NCD-related illness, which includes diabetes, costs Barbados approximately US$75 million annually due to decreased work efficiency and productivity. This haemorrhage of capital directly impacts MSMEs, which represent a formidable 92.2 per cent of formal businesses and employ over 60 per cent of the workforce. When workers suffer, businesses cannot thrive.
Unpacking the invisible drain: Lost productivity
The true financial burden of diabetes on businesses is largely invisible, rooted in two key areas: premature mortality and productivity impairment. A scholarly paper titled Uncovering the Indirect Costs of Diabetes in the Small Island Developing State of Barbados by Economist Nicholas A. J. Landis shone a critical light on this issue by decomposing these costs for the period 2015 – 2019. The findings are a wake-up call to every CEO, manager, and business owner.
The study estimated the total indirect costs for losses from diabetes in Barbados over the five-year period is a staggering BD$32 054 937. This figure accounts for the economic loss from:
Premature mortality: The loss of highly skilled and experienced workers who die before the age of retirement due to diabetes complications, valued at BD$8 792 699.
Productivity impairment: The loss of output from employees who are present at work but are operating at a reduced capacity due to their condition, a phenomenon known as presenteeism, which accounts for BD$23 262 237.
This data confirms a crucial point: productivity impairment is the single biggest cost driver of the indirect economic burden of NCDs, exceeding the costs of absenteeism (missed workdays) and replacement costs for lost workers. A worker struggling with uncontrolled blood sugar, fatigue, or the mental strain of managing their condition is a worker who is unable to fully engage, innovate, or contribute to the bottom line.
The prevalence of diabetes in Barbados, which was reported to be around 14.9 per cent in adults (with a higher rate of 16.7 per cent in women) a few years ago, is alarming, but what is perhaps more concerning is the work culture that often fails to accommodate and support those living with the disease.
It is evident that not enough is being done at the level of the firm to truly support the workforce. While the direct cost of treatment is a national concern, the failure of many employers to adopt flexible and compassionate practices creates a debilitating culture of silence.
A recent global study conducted by the International Diabetes Federation (IDF) reveals the unspoken toll of managing diabetes in the workplace, and the parallels for the region are compelling:
Negative treatment: Four out of every ten employees globally living with diabetes reported experiencing negative treatment in the workplace because of their condition.
The fear of disclosure: One in ten did not disclose their condition to their employer, with many fearing being treated differently or that it would limit their career progression.
Furthermore, the lack of supportive policies creates direct barriers to essential self-care. More than a quarter of respondents in the IDF study reported being denied breaks or time off for the vital self-management of their condition. This is more than just poor practice; it is a direct attack on a worker’s health, dignity, and, by extension, the company’s stability. When an employee is forced to choose between managing their chronic illness and maintaining a professional façade, the resulting stress and inadequate management will inevitably lead to complications, greater absenteeism, and, most damagingly, greater presenteeism.
A national mission: MSMEs’ role in resilience
Barbados’ government and social partners have already acknowledged the gravity of this crisis in the Declaration of Mission Barbados. One of the six ‘missions’ is to “create a society that prioritises wellness and happiness”, with the ambitious target to achieve a 50 per cent reduction in new cases of non-communicable diseases by 2030.
This national aspiration cannot be achieved by the Ministry of Health alone. It requires a fundamental shift in corporate culture; a paradigm shift away from simply treating the sick towards preventing illness and supporting wellness. The Investment Case for NCD Prevention and Control in Barbados highlighted that scaling up prevention interventions could yield to a return on investment of 4.1, resulting in a total of BDS$580 million in increased productivity over the 2016 – 2030 period. The onus is now squarely on the MSME sector, as the largest employer, and other stakeholders, to step up and make the change.
The indirect cost of diabetes, that BD$32 million drain on the economy, is a cost of inaction. By investing in the health of our people, we are not just fulfilling a moral obligation, we are enacting the single most vital strategy for ensuring the resilience, profitability, and longevity of the Barbadian small business sector. The productivity of our companies, and the sustainable development of our economy depends on it.
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