Why do so many people lack access to healthcare?

Millions of people living with diabetes and rare blood disorders cannot get the life-saving medicine they need. In some instances, medicine is too costly, or travelling to see the doctor or to pick up a prescription requires a long journey and a loss of wages. 

In extreme situations, there is no doctor to see, healthcare clinic to go to, or medicine on the shelf at the pharmacy. 

The stark reality is that only a fraction of patients are being treated today – and we need to close that gap so that people have affordable access to the medicines we manufacture and the care they need. 

The barriers are complex and differ from country to country, but we know from experience that change is possible.

Our ambition is to provide access to the medicines we have available, to the greatest number of people living with diabetes, rare blood diseases and rare endocrine disorders, while addressing varying levels of affordability. 

Insulin is a lifesaving but delicate molecule. Insulins are temperature sensitive and lose effectiveness over time or when exposed to too high or low temperatures1,2.

The storage instructions for insulin vary, but for most, the recommendation from the moment of manufacture up until the product is in-use to keep the insulin cool – at refrigerator temperatures around 2°C – 8°C range. In many low- and middle-income countries and humanitarian settings, temperatures often exceed this range, and refrigeration may not always be available, affordable, or reliable for people with diabetes3.

We sought to address this barrier by challenging and re-evaluating the thermal stability of our short-acting and intermediate-acting human insulin products. Both are widely used in low- and middle-income countries and humanitarian settings where revised storage guidance could reduce the burden of diabetes management and improve the lives of people with diabetes using the products.

Following the positive scientific opinion from the European Medicines Agency (EMA), we will seek national approvals of more flexible storage conditions in relevant low- and middle-income countries.

Improving access to insulin is a fundamental pillar of our Defeat Diabetes strategy. By definitively proving the thermostability of these products we hope to address a barrier faced by many vulnerable people with diabetes living in challenging settings.

1. Huus K, Havelund S, Olsen HB, van de Weert M, Frokjaer S. Chemical and Thermal Stability of Insulin: Effects of Zinc and Ligand Binding to the Insulin Zinc-Hexamer. Pharmaceutical research. 2006;23(11):2611-2620.

2. Brange J, Andersen L, Laursen ED, Meyn G, Rasmussen E. Toward understanding insulin fibrillation. Journal of pharmaceutical sciences. 1997;86(5):517-525.

3. World Health Organization. Keeping the 100-year-old promise: making insulin access universal. Geneva: World Health Organization;2021.

While limited public health data exists on children with type 1 diabetes, the unbearable truth is that only few live long enough to make it into the registries in many of the world’s poorest countries.

In 208 clinics across 14 low- and middle-income countries, our Changing Diabetes® in Children programme ensures care and life-saving insulin for children with type 1 diabetes. Today, the programme is providing medical care, insulin and supplies to more than 26,000 children. Our next ambition is to expand the programme to reach 100,000 by 2030.

In the video above, meet a type 1 super star, Bilguissa from Guinea. Bilguissa is part of a new generation of children and young adults living with type 1 diabetes in Guinea. With the support of doctors and nurses at the Changing Diabetes® in Children clinic, today she is a reflective community leader full of hope, capable of managing her own diabetes well, and of guiding and inspiring her younger peers.

In low- and middle-income countries, we put extra focus on the most vulnerable people living with diabetes. In more than two-thirds of the countries where we operate, we have established affordability and access programmes to help patients in need. 

These programmes are working to answer tough questions, like:

  • How do we encourage more patients to enroll in affordability programmes?

  • How do we design insulins that don’t require cooling and can therefore travel further?

  • How can we simplify medicine supply chains to drive down price?

We are working on these questions with a strong commitment to making insulin available to all. Read on and learn more about our commitment to affordable treatment and access to diabetes care. 

We have made a commitment to continue to have a low-cost insulin in our product portfolio and produce and make human insulin available for years to come. This is our Access to Insulin Commitment. 

With our Defeat Diabetes strategy, we are lowering the ceiling price for low- and middle-income countries, and at the same time working to expand affordability programmes in the US and elsewhere in the world.

Affordable insulin in low- and middle-income countries

In 2001, we launched a ground breaking policy to lower the cost of human insulin in the most resource-constrained countires. Today, our policy covers a total of 76 countries, home to a third of the world’s diabetes population, as well as selected humanitarian organisations.

Our commitment builds on the following principles:

  • We will continue to be the leading supplier of low-priced human insulin in the world.
  • We will guarantee to provide low-priced human insulin in the poorest parts of the world for many years to come, including Least Developed Countries (LDCs) as defined by the UN, other low-income countries as defined by the World Bank and middle-income countries where large low-income populations lack sufficient health coverage, as well as selected humanitarian organisations where the commitment is global.
  • We will guarantee a ceiling price of human insulin at USD 3 per vial.
  • We will address challenges in insulin distribution and healthcare capacity that often prevent low-cost insulin from reaching the most vulnerable people.

Part of Novo Nordisk’s contribution to promoting access to care is our continued long-term financial commitment to the  World Diabetes Foundation. 

The World Diabetes Foundation was established by Novo Nordisk in 2002 as an independent trust dedicated to the prevention and treatment of diabetes in developing countries. The Foundation supports sustainable partnerships and acts as a catalyst to help others do more.

Our current commitment to the Foundation is DKK 1.69 billion (USD 277 million) covering the period up to 2024.

Learn more about the World Diabetes Foundation.

In some countries, people living with haemophilia may be in a situation where they are not able to store their haemophilia medication at home. For example, during the COVID-19 crisis, many patients have not been able to visit hospitals to seek treatment. 

When people living with a rare blood disease face these situations, we work with local health authorities and partner organisations to provide financial support for medicine and treatment home delivery. 

To ensure clear and transparent relationships, our initiatives are designed in dialogue with policy makers, for support services related to patient training, delivery and medicine storage.

Learn more about our foundation helping people living with haemophilia get access to care. 

The Novo Nordisk Haemophilia Foundation is a grant-making, non-profit organisation that strives to improve access to care for people with haemophilia and rare bleeding disorders in developing and emerging countries.

Haemophilia is a hereditary bleeding disorder affecting one in 10,000 people. With three out of four people with haemophilia living in the developing world, there is urgent need to ensure they have access to diagnosis and adequate care.

Learn more about the Novo Nordisk Haemophilia Foundation