#Breaking
: 3 manufacturers control most of the global market for insulin

WHO
launches first-ever insulin prequalification programme to expand access to
life-saving treatment for diabetes

14 November
2019. The World Health Organization (WHO) Yesterday announced the start of a
pilot programme to prequalify human insulin to increase treatment for diabetes
in low- and middle-income countries.

14
November : Today is World Diabetes Day

The
decision, announced ahead of World Diabetes Day (14 November), is part of a
series of steps WHO will take to address the growing diabetes burden in all
regions. About 65 million people with type 2 diabetes need insulin, but only
half of them are able to access it, largely due to high prices.  All people with type 1 diabetes need insulin
to survive.

“Diabetes is
on the rise globally, and rising faster in low-income countries,” says Dr
Tedros Adhanom Ghebreyesus, WHO Director-General. “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.”

Insulin
prequalification can lead to lower prices

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.

3
manufacturers control most of the global market for insulin

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.

Despite an
ample supply, insulin prices are currently a barrier to treatment in most low-
and middle-income countries. Three manufacturers control most of the global
market for insulin, setting prices that are prohibitive for many people and
countries.

Access to
insulin a challenge in many countries

Data
collected by WHO in 2016-2019 from 24 countries on four continents showed that
human insulin was available only in 61% of health facilities and analogue
insulins in 13%.  The data showed that a
month’s supply of insulin would cost a worker in Accra, Ghana, the equivalent
of 5.5 days of pay per month, or 22% of his/her earnings.

In wealthy
countries, people often have to ration insulin, which can be deadly for people
who do not get the right quantity of the medicine.

“Prequalifying
products from additional companies will hopefully help to level the playing
field and ensure a steadier supply of quality insulin in all countries,” says
Dr Mariângela Simão, Assistant Director General for Medicines and Health
products.

More than
420 million people live with diabetes. Diabetes is the seventh leading cause of
death and a major cause of costly and debilitating complications such as heart
attacks, stroke, kidney failure, blindness and lower limb amputations.

People with
type 1 diabetes need insulin for survival and to maintain their blood glucose
at levels to reduce the risk of common complications such as blindness and
kidney failure. People with type 2 diabetes need insulin for controlling blood
glucose levels to avoid complications when oral medicines become less effective
as the illness progresses.

Insulin prequalification is one of a number of steps WHO will take in the coming year to address the diabetes burden. Plans are underway to update diabetes treatment guidelines, devise price reduction strategies for analogues and improve delivery systems and access to diagnostics. WHO also works with countries to promote healthier diets and physical activity to lower people’s risk of developing type 2 diabetes.

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