WHO Moves to Expand Global Access to Fast-Acting Insulin

Why Is WHO Pushing to Expand Access to These Medicines?

The World Health Organization has identified diabetes and obesity as among the fastest-growing chronic disease burdens of the 21st century. Recent global estimates suggest more than 800 million adults are living with diabetes, with the steepest rises occurring in low- and middle-income countries where access to modern insulins and newer therapies remains limited. WHO has long included human insulin on its Essential Medicines List and has more recently moved to recognize the importance of analogue insulins and GLP-1 receptor agonists in modern care.

Fast-acting insulin analogues offer more physiological glucose control than older human insulins, while semaglutide — a GLP-1 receptor agonist marketed as Ozempic, Wegovy and Rybelsus — has shown substantial benefits for blood sugar control, weight reduction and cardiovascular risk. WHO's policy direction reflects mounting pressure from clinicians and patient advocacy groups to bring these therapies within reach of public health systems globally, not only wealthy markets.

What Barriers Are Standing in the Way of Wider Access?

Insulin remains unaffordable for many patients despite being nearly a century old, largely because the global market is dominated by a small number of manufacturers. Semaglutide faces even steeper barriers: it is still under patent in most countries, supply has not kept pace with surging demand for both diabetes and obesity indications, and list prices in many markets place it out of reach for uninsured patients and public health systems alike.

WHO's strategies typically include prequalifying biosimilar versions of essential drugs, supporting voluntary licensing arrangements, and working with manufacturers to encourage tiered pricing for lower-income countries. For insulin, expanded prequalification of biosimilars from additional manufacturers could increase competition and reduce prices. For semaglutide, the situation is more complicated because the original patents have not yet expired in many jurisdictions, meaning broader access will require a combination of negotiated pricing, eventual generic entry and careful clinical prioritization of patients who benefit most.

What Could This Mean for Patients in Lower-Income Countries?

Most of the global increase in diabetes is occurring in low- and middle-income countries, where complications such as kidney failure, blindness, amputation and premature cardiovascular death are disproportionately common. Access to fast-acting analogue insulin can reduce hypoglycemia and improve glycemic control, particularly for people with type 1 diabetes and those on intensive regimens. Wider availability of GLP-1 therapy could meaningfully alter the trajectory of type 2 diabetes and obesity-related complications, including cardiovascular disease.

However, public health experts caution that medicines alone are not sufficient. Sustainable improvements depend on functioning primary care systems, diagnostic infrastructure, cold-chain logistics for injectable drugs, training for clinicians, and ongoing patient education. WHO has paired its medicines-access work with broader recommendations on strengthening non-communicable disease care, recognizing that newer drugs deliver maximum benefit only when integrated into well-functioning health systems.