No Access for Half of those Needing Insulin!

In December 2023, Amsterdam played host to a major global gathering, bringing together more than 80 experts to tackle the pressing issues surrounding sustainable access to insulin. The discussions focused on the findings of the Addressing the Challenges and Constraints of Insulin Sources and Supply (ACCISS) Study by Health Action International, particularly focusing on insulin pricing and the case study of Tanzania.

Half of the people who need insulin to manage their diabetes can’t get their hands on it [1]. T1International reported that 1 out of 4 people responding to a survey underused insulin at least once in the last year due to high costs [2]. That’s a major hurdle and relying solely on donors isn’t going to cut it. Solving this challenge requires a team effort involving various stakeholders.

The ACCISS study highlighted the success story of Tanzania [3], which transitioned from relying on donor support to establishing a sustainable national diabetes program. This transformation was made possible by a stable political environment, a government committed to improving public health, and a push towards universal health coverage through social health insurance.

The discussions also delved into the ambitious goal set by the World Health Assembly in 2022: ensuring 100% of people with type 1 diabetes have access to affordable insulin and blood glucose monitoring supplies. In 2021, the World Health Organization (WHO) added Glargine, a long-acting insulin analogue, to the Essential Medicines List. This move has changed the landscape of insulin procurement, especially since previous studies consistently revealed that analogue insulins, like Glargine, were often priced out of reach for those on lower incomes.

The ACCISS study took a closer look at Glargine insulin prices across 47 countries [4], and the results are eye-opening. The cost of Glargine varies widely around the world, but the bottom line is that it’s still too expensive for many people in lower and middle-income countries. On average, individuals in these regions are spending a significant chunk of their monthly wages, around 10 days’ worth, just to afford Glargine insulin. This sheds light on the ongoing struggle for access to this crucial diabetes treatment, emphasising the need for global collaboration and creative solutions to make insulin more accessible for everyone.

[1] Basu S, Yudkin JS, Kehlenbrink S, et al. Estimation of global insulin use for type 2 diabetes, 2018-30: A microsimulation analysis. Lancet Diabetes Endocrinol. 2018;7(1):25–33. doi: 10.1016/S2213-8587(18)30303-6.




Advocacy Action: In the wake of the global discussions on sustainable insulin access, it’s time for diabetes advocates to take the lead and make a difference in their own countries. Reach out to your parliamentarians and urge them to prioritise and implement affordable insulin and diabetes care policies. This could involve measures such as price controls, subsidies, or support for local production to reduce dependency on costly imports.