By Asmau Ahmad
The number of people living with diabetes worldwide is expected to reach 643 million by 2030, and 783 million by 2045 with most of the cases occurring in low- and middle-income countries like Nigeria, a new report has said.
It noted that the situation was worsened by poverty, conflict, and outbreaks of disease.
The report revealed that lack of access to insulin was a devastating problem for diabetes patients globally, stressing that the burden of treatment of the condition remains significantly high in Nigeria and other LMICs.
According to the report, huge numbers of people living with diabetes in LMICs still do not have access to the diabetes products, including insulin, that they need to stay alive and healthy.
The report was released by a Netherlands-based non-profit organisation, Access to Medicine Foundation which stimulates and guides pharmaceutical companies to do more for the people living in low- and middle-income countries without access to medicine.
The latest report which focused on access to treatment for diabetes also highlighted the cost and the disease burden in Nigeria and other LMICs.
The report indicated, “Daily access to insulin is essential for survival for patients with type 1 diabetes and many with type 2. Unfortunately, insulin products are often unavailable to those living in LMICs – and when they are available, they are often unaffordable.
“The stark reality is that without access to insulin, many more diabetic children and adults will suffer and die from this life-long, chronic disease.”
The report noted that the costs related to managing the condition represent a concerning global burden, as total health expenditure due to diabetes in adults amounted to $966 billion in 2021.
According to the report, only a few drug makers are dominating the insulin market, while gaps persist in access to all forms of insulin.
It further revealed that only 29 countries out of 108 studied have all the insulins classified as “essential medicines” by the World Health Organisation, and only one of those is a low-income country.
The report showed that in 24 countries no insulin was registered at all while urging drug companies to accelerate efforts to widen access to the treatment.
The report indicated that 35 per cent of patients in LMIC pay out-of-pocket for healthcare, compared to 13.6 per cent in high-income countries, where the public sector is more likely to be involved.
The ATMF report which examined the activities of three pharmaceutical manufacturers showed that Eli Lilly, Novo Nordisk, and Sanofi, produce 83 per cent of the insulin sold in LMICs, where they also hold around 95 per cent of the market share.
“Insulin supplied by these firms is sold at higher median prices in LMICs than in high-income countries. The reasons for this include the manufacturer’s selling price, wholesale and retail mark-ups, taxes, and other tariffs,” the report added.
Commenting on the report, the Chief Executive Officer of Access to Medicine Foundation, Dr. Jayasree Iyer, said the number of people living with diabetes is expected to grow over 100 percent in Africa by 2045.
Lyer also said that the current estimate of 3.5 million people living with diabetes in Nigeria is probably understated due to poor diagnosis in many African countries.
Adding that the prevalence of the disease in Nigeria is projected to rise to 8 million by 2045, she emphasized that the costs associated with the prevalence of the disease were not only social but economic.
“The health expenditure related to diabetes care in Africa is about $12.5 billion and this really reflects the fact that most people pay for relatively expensive and unaffordable insulin treatment.
“For example, the average diabetes-related health expenditure per person amounts to approximately $500 a year, which is a huge financial burden if the patient has to pay it all or partially out-of-pocket”, Iyer said.
She assured that these companies were however taking action to address the inequity in access to this essential medicine.
“In Nigeria, Novo Nordisk has signed a memorandum of understanding with the Federal Ministry of Health, and that serves as a base for the rollout of a programme called I-Care.
“The idea of this programme is to provide affordable access to diabetes care, especially for children with type one diabetes.
“Sanofi another large insulin provider has pushed for the listing of insulin in the National Health Insurance Authority and the State Health Insurance Scheme for two of Nigeria’s 36 states.
“These actions will help to make insulin more affordable and accessible to more people. The company is planning to expand this strategy to two more states in 2022,” Iyer said.