World Diabetes Day - The Problem with World Wide Access to Insulin

World Diabetes Day - The Problem with World Wide Access to Insulin

First of all let me wish you a Happy World Diabetes Day. Seems a hallow greeting doesn’t it? Maybe it is just me, but celebrating World Diabetes Day leaves me a little ambivalent. It is possible I have not caught the spirit of the celebration or the intention of the day. But to me celebrating something that happened to me is a little off putting. It is like I was walking down the street one day (in Disney World no less) and wham I was summoned to a worldwide club I never wanted to join. I got drafted to diabetes and I bet most of the people who are reading this blog were also drafted.

Of course if we are put in the club the least we can do is acknowledged others and when I did I found a wide discrepancy between the resources I enjoyed and the ones others had to make due with. Once I become aware of how wide the gap was and remains I had to be thankful for my blessings.

Today, I live in in a suburban city near Indianapolis and for the most part it is an affluent area. People have basic things like medical care, test strips, syringes and insulin if they need it. That is for the most part. As a School employee, if I looked I found children who were surviving on half doses of insulin, reusing syringes 10-20 times before a change and one or two test strips a week. It broke my heart and I suspect most of us would have been shocked at the discrepancies between diabetes as we know it and diabetes as many others know it…

I recall one little guy (a third grader) and I discovered his parents simply could not afford his ‘diabetic habit’ as his mom called it. So with some scrambling and many calls and the help of a very good school nurse we got him a steady stream of supplies. I am convinced he is alive today because generous doctors stepped in to help.

Of course the need is bigger than one student. It turns out that homeless individuals have a high incidence of type 2 diabetes and they often lack test strips or the means to obtain medicine. The local need is amazing. I imagine it is great in your community as well.

Or if we prefer we can look outside our communities. I recently wrote a blog for the 100 Blog campaign a group organized to help normalize the cost of insulin worldwide. I cannot say I agree with all their positions, but I cannot ignore some basic facts. One of the papers referred to on their site states

“A study in Malawi found that one month’s supply of insulin (purchased from a combination of public and private vendors) cost almost 20 days’ wages”. ( From Mendis et. al 2007 Cohen, 2011, p. 1)

To me that is a foreign concept. I have always known affordable available insulin products. I have my choice of which vendor to use and I am alive because of it. To think it might require 20 days of wages to obtain a month’s supply of insulin is completely beyond my comprehension. In a widely published commentary Gale wrote:

“What is the commonest cause of death in a child with diabetes? The answer—from a global perspective—is lack of access to insulin. Families in the poorest parts of the world must make a choice between insulin for one child or starvation for the rest” (2006, p. 1626).

I am deeply grateful that Dr. Banting had the foresight to discover insulin. I am thrilled the products have evolved so much and that we now have high quality safe insulin. On November 14, 2014 I will be thankful for what I have and grieve because in many parts of the world the gift has not arrived. To me the lesson of World Diabetes Day is the disparity of resources. I hope that as you honor Dr. Banting’s birthday, you will remember that we have so much more to do.


Cohen, D. (2011). The prickly problem of access to insulin. BMJ, 343.

Gale, E. A. (2006). Dying of diabetes. The Lancet, 368(9548), 1626-1628.



Rick, you get an A from me for your thoughts

This is exactly why diabetes is a problem of society, not a business case. Here in the US we can "spend through" some of these issues, but there is no reason that a global supply of insulin could not be made available for a really modest investment. Seriously, how much would it cost to ramp up current production of N and R to give away insulin to everyone who needs it. A couple hundred million? This is why we shouldn't let corporations make decisions about societal problems.