Does the world see a shortage of insulin?

Diabetes has become the "scourge of civilian life". Obesity and unhealthy lifestyles have led to a high prevalence of type 2 diabetes, which occurs when the body can not produce enough insulin to regulate blood sugar.

But scientists now believe that millions of diabetics worldwide will not be able to receive insulin in the next ten years or beyond.

About 400 million people worldwide, more than half of them in China, India and the United States, live between the ages of 20 and 79, the second type of diabetes, the most common type of disease. This number is expected to exceed 500 million by 2030.

The other type of diabetes is the first type in which the body itself attacks the pancreatic cell that produces insulin.

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According to a recent study published in the Lancet medical journal on diabetes and endocrinology, approximately 80 million people with diabetes will need insulin by 2030, with demand for this drug expected to increase by 20% at the time.

But about half of those who will need it, most of Asia and Africa, will not be able to get it. One in two people with type 2 do not have access to the insulin they need.

Sanjay Paso, a professor at Stanford University in the United States, who led the study, said the issue of getting insulin combines availability and affordability.

"In addition to the price, this also means that there must be a supply chain that will process the refrigerated medicine and distribute it safely, as well as its various supplies, such as sterile needles and injections that should be involved, "he said.

But why has insulin, which dates back 97 years and is one of the first "miracle drugs" discovered in the twentieth century, has kept its high price in those years?

According to scientists, one of the reasons is that three major global pharmaceutical groups, Novo Nordisk, Eli Lilly & Company and Sanofi, control 99% of the global insulin market, accounting for $ 21 billion. Value and 96 percent in volume. These three companies are the same that dominate the entire US market.

Universal control

Although more than 90 out of 132 countries do not impose tariffs on insulin, the drug remains very expensive for many patients. The taxes imposed, its high profitability margins and other costs in the supply chain would have led to an increase in the price of this drug and be accessible to all.

"Global control of the insulin market means that countries have few suppliers to choose from," said David Henry Biran of the University Hospital of Geneva. "This factor forces diabetics to change the type of insulin they take, as companies withdraw certain formulations of the drug." Market.

There are different types of insulin. The doctor tells the patient which type is right for him, based on his response to the medication, lifestyle and age, as well as the daily dose to be taken.

Countries with moderate to low income rates are particularly vulnerable to confusion between supply and insulin. A study on insulin and its availability showed a decrease in supply levels in six countries: Bangladesh, Brazil, Malawi, Nepal, Pakistan and Sri Lanka.

"Around the world, the high cost of insulin and lack of availability is a threat to life and a challenge to the fundamental concept of the human right to health," he said.

So why is not such a drug, discovered about 100 years ago, available at low cost, especially since the two scientists from the University of Toronto who discovered it sold their patent to the university for $ 1?

According to researchers Jeremy A. Green and Kevin Riggs, the cloning of insulin, a hormone produced from living cells, is more complicated and more difficult.

They said the brand-name pharmaceutical companies considered it "useless". Bioinsulin alternatives are available on the market at more competitive prices, but do not represent the drugs produced by these large companies.

It is clear that poor health systems, poor access to health facilities, inadequate access to diabetes care and high prices are all factors that prevent access to the drug.

Diabetes .. Bases

There are two main types of diabetes: types I and II, as well as other types, including gestational diabetes, related to the mother's pregnancy period.

In the first type, which is usually diagnosed at an early age and can be infected at any age, the dose of insulin must be administered to the body by injection, either manually or by tube, with no possibility of prevention or treatment. .

People develop type 2 diabetes when their insulin levels are low or insufficient. This can be related to obesity, lack of mobility or a history of infection in the family. What is the most common type compared to the first type because it affects about 90% of diabetics in the world. Some people receive insulin doses, while others control blood sugar levels through medication, exercise and a healthy diet.

Prolonged disruption of blood glucose can lead to complications, including problems with the nerves, kidneys, eyes, and feet. However, the risk of exacerbation can be reduced by appropriate care and treatment.