Lack of adequate access to insulin has dealt a blow to the global management of diabetes, particularly in low-income countries with inadequate funds to shoulder the health burden.
A new report released by World Health Organisation (WHO) has revealed even after having been used for a century, insulin remains scarce and higher prices have priced out some countries hence increasing the mortality in countries battling diabetes.
The 2021 report conducted by WHO, titled “Keeping the 100-year-old promise: making insulin access universal,” reveals that millions of people globally have no access to diabetes care. And this problem is aggravated by a lack of insulin. The gap in universal access to insulin is due to fewer producers in the market as well as a weaker health system that needs support.
As WHO notes in a press release: “Insulin is the bedrock of diabetes treatment that can turn the deadly disease into a manageable health condition for nine million people with diabetes type 1.”
‘‘It also said insulin is essential to reduce the risk of kidney failure, blindness and limb amputation for more than 60 million people with diabetes type 2 but it said one out of two people who needs insulin for type 2 across the world does not get it’’.
Speaking during the commemoration of 100 years since the discovery of insulin, on November 12, WHO Director-General Dr Tedros Adhanom Ghebreyesus called on countries and manufacturers to work collaboratively to close the gaps and expand access to insulin.
Patent sold for peanuts
He said the drug’s patent was dished out cheaply and some businesses jumped in to make a kill at the expense of ensuring quality delivery.
“The scientists who discovered insulin 100 years ago refused to profit from their discovery and sold the patent for just one dollar,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Unfortunately, that gesture of solidarity has been overtaken by a multi-billion-dollar business that has created vast access gaps. WHO is working with countries and manufacturers to close these gaps and expand access to this life-saving medicine for everyone who needs it,” he said.
Dr. Tedros emphasized the importance of concerted efforts by governments, UN agencies, development partners, and stakeholders to increase access to life-saving diabetes medicines in the fight against the disease.
“The expansion of WHO’s a prequalification programme to include glucose monitoring devices, test strips and diagnostic tools, and the inclusion of additional forms of insulin and other diabetes medicines in the latest update of the WHO Model Lists of Essential Medicines are expected to lead to improved access in countries where demand is currently unmet,” he said.
Grim statistics
According to the data from the International Diabetes Federation (IDF), there is a continued increase in diabetes prevalence around the world that remains a significant challenge to the health and wellbeing of individuals, families, and society.
For instance, in 2021, 537 million adults between 20-79 years are living with diabetes and 1 in 10 people is diagnosed with diabetes. The number is predicted to rise to 643 million by 2030 and 784 million by 2045.
IDF data further shows that 4 in 5 (81%) adults with diabetes are reported to be living in low and middle-income countries, with 24 million people in Africa, 90 million people in Southeast Asia and 73 million people in the Middle East and North Africa.
According to the data, 6.7 million people died of diabetes globally in 2021 alone, with one person dying every two seconds. Also, 541 million adults have impaired glucose tolerance (IGT), which places them at a high risk of type 2 diabetes.
What’s diabetes
According to the WHO, diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.
Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. More than 95 per cent of people have type 2. According to WHO, this type of diabetes is largely a result of excess body weight and physical inactivity.
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterised by deficient insulin production and requires daily administration of insulin.
In 2017, WHO said there were 9 million people with type 1 diabetes; the majority of whom lived in high-income countries. Neither its causes nor the means to prevent it are known.
The symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes, and it occurs during pregnancy.
Women with gestational diabetes are at an increased risk of complications during pregnancy and delivery and that their children are also at increased risk of type 2 diabetes in the future said WHO.
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at a high risk of progressing to type 2 diabetes, although this is not inevitable, WHO said.
Diabetes effects include an increased risk of heart attacks and strokes among adults, reduced blood flow, neuropathy (nerve damage) in the feet that increases the chance of foot ulcers, infection, and the eventual need for limb amputation, including blindness caused by diabetic retinopathy.
WHO says diabetes can be prevented through the maintenance of healthy body weight, being physically active by doing at least 30 minutes of regular moderate-intensity activity on most days to control weight, eating a healthy diet, avoiding sugar and saturated fats, and avoiding the use of tobacco.