ONE OF THE most ambitious plans to combat chronic diseases is being introduced in Abu Dhabi, the biggest state in the United Arab Emirates. Nearly one in five of the UAE's population is diabetic. Abu Dhabi is small enough and rich enough to tackle the problem comprehensively. A top-down political system helps. In 2006 the emirate recruited Oliver Harrison, a psychologist and then a consultant at McKinsey, to its new health authority to help tackle chronic disease. When the government launched a health-insurance scheme in 2008, all adult Emiratis were offered a comprehensive health screening. By May 2010 some 92% of them had enrolled in the programme. The results were alarming. In this special report Related topics Thirty-five per cent of those screened were obese and a further 32% were overweight. These figures were similar to those in America, but, worryingly, Emiratis were fatter at younger ages. Some 18% of those screened had diabetes and a further 27% were at high risk of developing it. Dr Harrison and his colleagues have been working to improve the care offered. Patients are given scorecards with a number of indicators, including BMI, the risk of diabetes and smoking habits. Abu Dhabi's insurer, Daman, has tested programmes to help keep patients" conditions under control. From the insurer's headquarters Maitha Al Khalifa calls patients all day to check that they are following their doctors" instructions on diet and medication. But even in Abu Dhabi things have not gone quite according to plan. In Daman's initial experiment less than half of those who qualified for the diabetes and obesity programme signed up for it. Now Dr Harrison and his colleagues are preparing a more comprehensive scheme. They expect to launch a new mobile platform next May, with an array of tools to connect patients to their doctors and monitor diet and exercise. Patients with chronic diseases will be automatically enrolled in a programme and given just one month to opt out. The health authority will pay programme managers only if they improve patients" health. In time, Dr Harrison hopes, Abu Dhabi's hands-on approach may serve as a model for other governments.