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Changing the game to improve the availability and affordability of quality-assured insulin and associated devices
During a four-day workshop that ended on September 25, 2020, the WHO and key international health partners outlined a plan to strengthen access to affordable and quality diabetes testing and treatment.
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 attack, stroke, kidney failure, blindness, and lower limb amputations.
People with type 1 diabetes need insulin to survive. However, many in low- and middle-income countries do not receive it, mainly due to high prices and supply challenges. People with type 2 diabetes need insulin to control their blood glucose levels to avoid complications when oral medications become less effective in the progressive course of the disease. Approximately 60 million people with type 2 diabetes need insulin, but only about half of them can access it.
One of the problems with the cost of insulin is that three companies with genuine products control 96% of the world market, setting prices that are too high for many countries. In addition, devices for delivering insulin and glucose meters to monitor blood sugar levels are missing or rare in many countries.
“It is a failure of society and the global community as a whole that people who need insulin need to run into financial difficulties to buy it or go without it and risk their lives,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
The WHO is working on a package of special measures to address the growing burden of diabetes in all countries. In November 2019, the WHO launched an insulin prequalification pilot to ensure the quality of more insulin products entering the international market, giving countries more choice and potentially lower prices, thus contributing to an improved approach.
Many different stakeholders are working on insulin, and this week’s WHO workshop was an initial effort to bring together all workflows for greater impact at the country level.
Bringing together all stakeholders, including regulators, civil society and UN partners, the workshop highlighted opportunities to change the game and do things differently:
- global partnerships and patient-centered approaches
- better assessing the global impact of diabetes and improving coverage and quality of diagnosis
- increase access to essential medicines for diabetes, including insulin and related devices (ie insulin delivery devices, blood glucose meters and test strips)
- greater commitment to creating awareness of the continuing challenges in accessing insulin, even as we approach the 100th anniversary of its discovery.
- better training of health workers.
- agreement on a global diabetes treatment goal, including% of people diagnosed,% of people on treatment, and% of insulin.
QUICK FACTS:
- Diabetes is a global epidemic. Today, more than 420 million people live with diabetes worldwide. That’s 6% of the world’s population. It is also four times more than in 1980. It is estimated that number will increase to 570 million by 2030 and to 700 million by 2045.
- 1 in 2 adults with diabetes are unaware of their status. 4 out of 5 adults with undiagnosed diabetes live in low- and middle-income countries. People who are unaware of their status are at high risk of debilitating complications.
- All people with type 1 diabetes need insulin. Sixty million people with type 2 diabetes also need insulin, but about half of them can’t get the insulin they need because their country’s health systems can’t afford it.
- This year’s WHO Global Capacity Survey on NCDs reveals that less than half of low-income countries have general access to insulin in the public sector.
- Last year’s WHO UHC monitoring report shows that NCD services are noticeable due to a lack of progress compared to communicable diseases.
- Prevention, screening, early diagnosis and appropriate treatment of diabetes and other NCDs were made a priority by WHO member states in 2000, following the World Health Assembly’s call for action, but over the past two decades the WHO has had to report to there is not enough progress in countries to meet the health needs of people living with diabetes.
- At this crucial time, as COVID-19 continues to spread, many people in need of diabetes treatment are not providing the health services and medications they need. A recent survey conducted by the WHO found that 50% of countries discontinued their services due to diabetes and diabetes-related complications.
- People with diabetes are also at increased risk of serious illness and death from COVID-19, and this poor prognosis appears to increase with advanced age. Early clinical evaluation is guaranteed for any suspicious symptom.
- With the publication of the WHO Operational Guidelines for the Maintenance of Health Services in the Context of COVID-19 in June, the WHO provides guidance on how to modify diabetes care for the safe provision of services and how to move to restoration.
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