New global compact aims to drive down diabetes deaths, boost insulin access

The development comes as risk of early death from diabetes is increasing, underscoring why countries must tackle the disease and bring treatment to all who need it, 100 years after the discovery of insulin. 

The COVID-19 connection 

“The need to take urgent action on diabetes is clearer than ever”, said Tedros Adhanom Ghebreyesus, the WHO Director-General.  

“The number of people with diabetes has quadrupled in the last 40 years.  It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down. And a high proportion of people who are severely ill in hospital with COVID-19 have diabetes.” 

More than 420 million people worldwide live with diabetes, a group of chronic diseases characterized by elevated blood sugar, which can cause damage to the heart, blood vessels, eyes, kidneys and nerves.  

The most common is type 2 diabetes, which occurs when the body becomes resistant to insulin, the hormone that regulates blood sugar. 

Action on insulin 

The global compact focuses on several priorities.  Among the most urgent is increasing access to diabetes diagnostic tools and medicines, particularly insulin, in low and middle-income countries. 

Roughly half of all adults with type 2 diabetes remain undiagnosed, according to WHO.  Additionally, half of all people with the condition do not get the insulin they need, putting them at risk of irreversible complications such as early death, amputation and sight loss. 

The insulin market is currently dominated by three companies, but a pilot programme for WHO prequalification of the medication, introduced two years ago, could change the situation.  The prequalification process ensures medicines meet global standards for quality, safety and efficacy.   

“Prequalification of insulin produced by more manufacturers could help increase the availability of quality-assured insulin to countries that are currently not meeting demand”, WHO said in a press release.

Meanwhile, discussions are underway with manufacturers of insulin, and other diabetes medicines and diagnostic tools, which could help meet demand at prices that countries can afford. 

Quantifying costs, meeting targets 

Another key aim of the compact is to set a “global price tag” that quantifies the costs and benefits of meeting new targets for diabetes care.  Governments also will be encouraged to meet their commitments to include diabetes prevention and treatment in primary healthcare and universal health coverage packages. 

Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO, added that the compact seeks to rally key stakeholders, as well as people who live with diabetes, around a common agenda to generate new momentum and create solutions. 

“The ‘all hands on deck’ approach to the COVID-19 response is showing us what can be achieved when different sectors work together to find solutions to an urgent public health problem,” he said. 

Share knowledge, foster collaboration 

The new compact was launched at the Global Diabetes Summit, co-hosted by WHO and the Government of Canada, with the support of the University of Toronto. 

“Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to one hundred years later, we continue working to support people living with diabetes,” said Patty Hajdu, the country’s Minister of Health.  

“But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives — in Canada and around the world.”