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Changing the game to improve the availability and affordability of quality-assured insulin and related equipment

In a four-day workshop that ended on 25 September 2020, WHO and key international health partners formulated plans to promote access to affordable and quality-assured testing and treatment for diabetes.

There are more than 420 million people living with diabetes. Diabetes is the seventh leading cause of death and a major cause of costly and debilitating complications such as heart attack, stroke, kidney failure, blindness and amputation of the lower limbs.

People with type 1 diabetes require insulin to survive. However, many in low and middle income countries are not achieving this, mainly due to high prices and supply challenges. People with type 2 diabetes require insulin to control blood sugar levels to avoid complications when oral medications become less effective in the progressive course of the disease. About 60 million people with type 2 diabetes require insulin, but only about half of them are able to use it.

One problem with the cost of insulin is that the three parent companies control 96% of the global market, setting prices that are prohibitive for many countries. In addition, dispensing devices for insulin and glucose meters to monitor blood sugar levels are missing or rare in many countries.

WHO Director General Drs. “It is a failure of society and the global community as a whole that people who need insulin may face financial hardship to buy it or go without it,” said Tedros Adnom Ghebiusus.

The WHO is working on a package of special focus measures to address the growing diabetes burden in all countries. In November 2019, WHO launched an insulin prequalification pilot to quality-assure more insulin products entering the international market, giving countries more options and potentially lower prices, contributing to improved accessibility.

A number of different stakeholders are working in Insulin and WHO’s workshop this week was an initial attempt to bring all workstreams together for greater impact at the country level.

Bringing all stakeholders together, including regulators, civil society and UN partners, the workshop highlighted opportunities to change the game and do things equally:

  • Global partnership and patient centric approach
  • Better identifying the global impact of diabetes and improving the quality of coverage and diagnosis
  • Increases access to essential diabetes medications, including insulin and related devices (ie, insulin delivery devices, blood glucose meters and test strips)
  • More and more advocacy to create awareness about the continuing challenges in access to insulin, even as we approach the 100th anniversary of its discovery.
  • Better training for health care professionals.
  • Agreement on a global treatment target for diabetes, including% of people diagnosed,% of people on treatment, and% on insulin.

quick Facts:

  • Diabetes is a global epidemic. Today, more than 420 million people worldwide live with diabetes. It is 6% of the world’s population. This is four times more than in 1980. This number is estimated to be 570 million by 2030 and 700 million by 2045.
  • 1 in 2 adults with diabetes are unaware of their condition. 4 out of 5 adults with undiagnosed diabetes live in low and middle income countries. Individuals unaware of their condition are at great risk of debilitating complications.
  • All people with type 1 diabetes require insulin. Sixty million people with type 2 diabetes also require insulin, but nearly half of them do not need insulin because their country’s health system can get it.
  • This year’s WHO Global Capacity Survey on NCDs shows that less than half of the public sector in low-income countries has general availability of insulin.
  • Last year’s WHO UHC monitoring report shows that NCD services are specialized in their progression reduction compared to communicable diseases.
  • Following a call to action by the World Health Assembly, WHO member states prioritized prevention, screening, early diagnosis and appropriate treatment of diabetes and other NCDs in 2000, but WHO had to report over the past two decades. The World Health Assembly states that there is not enough progress in countries to meet the health care needs of people living with diabetes.
  • At this defining moment, COVID-19 is still spreading, many people who need treatment for diabetes do not need health services and medicines. A recent survey conducted by WHO found that 50% of countries had disrupted their services for diabetes and diabetic complications.
  • People with diabetes have an increased risk of serious illness and death with COVID-19, and this poor immunity increases with advanced age. Early clinical evaluation warrants any suspected symptoms.
  • With the issuance of WHO’s operational guidance for maintaining health services in the context of COVID-19 in June, WHO will modify diabetes care for safe delivery of services, and transition towards restoration, Provides guidance in this regard.

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