Unlocking Access to Insulin at the World Health Assembly 2025: Event Report
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More than a century since its discovery, insulin remains out of reach for too many people — especially in low- and middle-income countries (LMICs). With global cases of type 1 diabetes in children and young people projected to reach 2.2 million by 2040, addressing insulin access is imperative.
It was against this backdrop that the Helmsley Charitable Trust and the Access to Medicine Foundation convened a side event during the 2025 World Health Assembly in Geneva. “Unlocking Access to Insulin: Advancing Public-Private Partnerships for Equitable Diabetes Care” brought together more than 100 leaders from across sectors to examine what it will take to close the access gap.
A Crisis of Reach and Reliability
The Access to Medicine Foundation’s new report, Access to Diabetes Care for Children and Young People: Pharma Companies’ Current Actions and Opportunities Ahead, spotlights 11 initiatives led by four major companies — Biocon Biologics, Lilly, Novo Nordisk, and Sanofi — that are designed to support children and young people living with type 1 diabetes in LMICs.
For many of these children, these initiatives are their only path to care. Despite broad geographic reach and the range of products provided, efforts are only reaching a fraction of those in need. For example, of the estimated 825,000 children and young people with type 1 diabetes across 71 LMICs, only around 8% were reached in 2023.
Many of these initiatives rely on donations, often delivered through temporary or volume-limited agreements with partners, such as NGOs or ministries of health. While vital for providing care in the short-term, they do not provide the steady supply or system integration that lifelong diabetes management demands.
Over half of LMICs analyzed are covered by at least one company-backed initiative, yet access remains fragmented and unpredictable. National programs that could secure more reliable care — through public procurement, distribution to rural areas, and integration into primary care — are still too limited in scale and ambition.
Still, the report found promising results. “The 11 initiatives show that the partnerships between the companies and local actors are powerful vehicles for change,” said Claudia Martínez, Director of Research at the Access to Medicine Foundation. “But they need to be backed by sustainable access strategies… [and] collaborative, long-term solutions that help transition from donation-based models into more sustainable systems.”
Supply-Side Realities: Progress and Remaining Gaps
In a rare public gathering, the four firms that supply most of the world’s insulin — Biocon Biologics, Lilly, Novo Nordisk, and Sanofi — shared a stage, agreeing that we need more coordination and transparency to overcome barriers such as complex regulation, volatile demand, and fragmented cold-chains.
While each company shared promising examples, they also acknowledged that isolated projects, even successful tech transfers, are not enough. Access planning must start early in research and development; regulation must be harmonized regionally; and governments, industry, and donors must co-create procurement pathways that guarantee both affordability and continuous supply at scale.
Centering Demand: Systems, Voices, and Action
Access to insulin is not only a matter of supply but also of demand — driven by the lived realities of people with diabetes, health systems, and governments working in concert.
Emmanuella Selasi Hormenoo, a young advocate living with type 1 diabetes and the General Secretary of Diabetes Youth Care in Ghana, emphasized that people with diabetes must be engaged as co-creators in health system solutions. Drawing from her own lived experience, Hormenoo detailed persistent barriers in Ghana, such as uneven insulin distribution by geography, frequent stockouts, high transport costs and limited education on insulin use, especially in rural areas.
While community-led initiatives help address these barriers locally, challenges around funding and scale limit their reach. She urged national health insurance schemes to expand coverage beyond limited insulin types and for governments to invest in proven models like PEN-Plus rather than launching new pilots.
Ethiopia offers national perspective on advancing diabetes care through systemic integration and policy reforms, including the inclusion of essential analog insulins in national guidelines. This approach enables people with type 1 diabetes to access standardized, reliable care closer to home. Representing Ethiopia’s Ministry of Health, Dr. Abdulkedir Gelgelo, Director General, Ethiopian Pharmaceutical Supply Service, shared progress Ethiopia has made: doubling public insulin procurement, training over 800 health workers, and expanding care to more than 70 sites. Ethiopia is also partnering with the World Health Organization (WHO) on forecasting tools to better predict and meet insulin demand, bridging supply-side gaps by helping manufacturers plan precise volumes, avoid waste, and strengthen supply reliability.
Despite these gains, high prices continue to undermine sustainable procurement. To address this, Gelgelo underscored the need for harmonized regulatory frameworks — such as through the AMA — not only to streamline approval processes and support local manufacturing, but also to ensure that insulin produced for Africa remains within the continent to meet local demand.
Scaling progress requires alignment not only within countries, but also across global platforms. That’s where initiatives like WHO’s Global Diabetes Compact (GDC) play a role. The GDC supports countries through implementation targets and frameworks, normative guidelines, and technical guidance on essential medicines. These efforts align stakeholders and strengthen accountability at the international level.
Bianca Hemmingsen, Medical Officer at WHO, emphasized WHO’s role as a cross-sector convener, helping align public and private actors to coordinate country-led, scalable access strategies. Hemmingsen stressed that “it comes down to political commitment and prioritization” to achieve 100% access to affordable insulin for people living with diabetes by 2030.
Toward a Sustainable Access Agenda
Insulin access isn’t just a supply issue or a financing problem — it’s a systems challenge. That means every actor has a role: industry must embed access in its core models, governments must invest in system reform, philanthropy must help catalyze solutions, and people living with diabetes must be treated as partners, not beneficiaries.
Closing the event, James Reid, Program Officer at the Helmsley Charitable Trust said, “In some ways, insulin is a true indicator of how well we’re doing at delivering innovation. I’m optimistic that we’re finding momentum and creating pathways together. I’m optimistic that if we can solve this seemingly intractable challenge, we actually set ourselves up to deliver more innovations more quickly for those who need them.”
The path forward demands urgency, but also alignment. This is not a moment for siloed action or short-term fixes. It’s a moment for bold, shared investment in systems that make insulin truly available, affordable, and accessible for all.
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