🟠 Moderate Evidence
More than a century after its discovery transformed diabetes from a fatal diagnosis into a manageable condition, insulin remains out of reach for millions of people worldwide. Despite being included on the World Health Organization’s Essential Medicines List, access barriers continue to prevent effective diabetes management across low- and middle-income countries.
Key takeaways
- Insulin transformed Type 1 diabetes from a death sentence to a manageable chronic condition following its 1921 discovery
- Access barriers persist globally despite WHO classification as essential medicine
- Supply chain and affordability challenges disproportionately affect low- and middle-income countries
Global Diabetes Burden and Treatment Access
Estimated population affected by diabetes and access challenges, 2026
Source: International Diabetes Federation, 2022 | Georgian Medical Journal News
Century-Old Discovery Still Life-Saving
The 1921 discovery of insulin by Frederick Banting, Charles Best, James Collip, and John Macleod at the University of Toronto marked one of medicine’s greatest breakthroughs. Before insulin, Type 1 diabetes carried a grim prognosis, with patients typically surviving only months after diagnosis.
The World Health Organization estimates that approximately 8.4 million people worldwide live with Type 1 diabetes, requiring daily insulin injections for survival. The hormone enables glucose uptake by cells, preventing the dangerous accumulation of blood sugar that characterizes diabetes.
Access Barriers Persist in Modern Era
Despite insulin’s essential status, significant access challenges remain across global healthcare systems. The WHO Essential Medicines List includes human insulin as a core medicine, yet supply chain disruptions and economic barriers continue to limit availability.
Manufacturing complexities contribute to access challenges, as insulin production requires sophisticated biotechnology processes and cold-chain storage infrastructure. These requirements can strain healthcare systems in resource-limited settings, according to analyses by WHO diabetes experts.
The Global Health community continues to advocate for improved insulin access as part of universal health coverage initiatives.
Ongoing Innovation and Future Outlook
Modern insulin formulations have evolved significantly from the original pancreatic extracts of the 1920s. Today’s synthetic human insulins and analog formulations offer improved glucose control and dosing convenience, though these advances often come with higher costs.
The U.S. Food and Drug Administration has approved biosimilar insulin products to increase market competition and potentially reduce costs. However, implementation of these cost-reduction strategies varies significantly across different healthcare systems and regulatory environments.
Recent initiatives by organizations including WHO’s Global Diabetes Compact aim to address persistent access gaps through coordinated international action on diabetes prevention and care.
Insulin transformed Type 1 diabetes from a uniformly fatal condition to a manageable chronic disease, yet access barriers continue to limit this life-saving treatment for millions worldwide.
— WHO Global Health Observatory, Diabetes Fact Sheet (2022)
What this means
Frequently asked questions
Why does insulin access remain limited after 100+ years?
Complex manufacturing requirements, cold-chain storage needs, and economic barriers create ongoing access challenges. Supply chain infrastructure limitations particularly affect low- and middle-income countries.
How has insulin treatment evolved since 1921?
Modern synthetic human insulins and analog formulations offer improved glucose control compared to original pancreatic extracts. However, newer formulations often cost more than basic human insulin.
What role does WHO play in insulin access?
WHO includes insulin on its Essential Medicines List and coordinates global diabetes initiatives. The organization’s Global Diabetes Compact aims to improve prevention and care access worldwide.
As the diabetes epidemic continues to grow globally, ensuring equitable insulin access remains a critical public health priority. The remarkable scientific achievement of insulin’s discovery must be matched by equally determined efforts to guarantee its availability for all who need this life-saving treatment. International coordination on pricing policies, supply chain strengthening, and healthcare infrastructure development will be essential to bridge persistent access gaps.
Source: Why insulin, the core element of diabetes treatment remains inaccessible for millions of people
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Disclaimer. This article is health journalism intended for general information and education. It is not medical advice and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your individual circumstances. Full disclaimer →
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
