A century after it was discovered, insulin still remains out of reach for many people living with diabetes, the World Health Organization (WHO) said in a report published on Saturday to commemorate the milestone anniversary, on the eve of World Diabetes Day on November 14.
Insulin was discovered as a treatment for diabetes almost 100 years ago and has been on WHO's list of essential medicines since it was published in 1977.
It is the bedrock of diabetes treatment as it turns a deadly disease into a manageable one for nine million people with Type-1 diabetes. For more than 60 million people living with Type-2 diabetes, insulin is essential in reducing the risk of kidney failure, blindness and limb amputation.
However, one out of every two people needing insulin for Type-2 diabetes does not get it. Data collected by WHO in 2016-2019 from 24 countries in four continents showed that human insulin was available only in 61 per cent of health facilities and analogue insulins in 13 per cent.
High prices, low availability of human insulin, a market dominated by just a few producers, and weak health systems have all created barriers to accessing the lifesaving medicine, the report said.
"The scientists who discovered insulin 100 years ago refused to profit from their discovery and sold the patent for just one dollar," said Tedros Adhanom Ghebreyesus, Director-General of the UN health agency.
"Unfortunately, that gesture of solidarity has been overtaken by a multi-billion-dollar business that has created vast access gaps," he added.
Diabetes is on the rise in low and middle-income countries, and yet their consumption of insulin has not kept up with the growing disease burden.
The report highlights that while three in four people affected by Type-2 diabetes live in countries outside of North America and Europe, they account for less than 40 per cent of the revenue from insulin sales.
The report also outlined measures to improve access to insulin and related products. The actions include boosting human insulin production and supply, and diversifying manufacturing of biosimilar products to create competition and reduce prices.
The WHO explained that global markets have shifted from human insulin, which can be produced at relatively low cost, to pricier synthetic insulins, which can be up to three times more expensive.
The UN agency also called for improved affordability by regulating prices and mark-ups through pooled procurement and greater price transparency, and promoting local manufacturing capacity in under-served regions.
At the same time, research and development (R&D) should be centred on the needs of low and middle-income countries, while increased access to insulin should be accompanied by prompt diagnosis along with access to affordable devices for injecting the medicine and monitoring blood sugar.
The WHO said it is working with countries and manufacturers to expand access to everyone who needs it.
As part of this the global health body has launched the first-ever insulin prequalification programme to expand access to life-saving treatment for diabetes in low- and middle-income countries. WHO prequalification of insulin is expected to boost access by increasing the flow of quality-assured products on the international market, providing countries with greater choice and patients with lower prices.
"Diabetes is on the rise globally, and rising faster in low-income countries," Ghebreyesus said.
"Too many people who need insulin encounter financial hardship in accessing it, or go without it and risk their lives. WHO's prequalification initiative for insulin is a vital step towards ensuring everyone who needs this life-saving product can access it," Ghebreyesus added.