Insulin in my country: national perspectives on a life-saving discovery

Centennial celebrations of insulin’s discovery have, with good reason, tended to dwell on progress and innovation in its design and usage. But what about the more basic challenges still faced by so many users of this medical miracle?
A new series launching simultaneously today on Horizons and on EASD TV at the virtual Annual Meeting, focuses on some of the more problematic aspects of the insulin usage in various parts of the world.
Extreme variations in national insulin experience are a stark reminder of the precarious nature of national healthcare systems. Poverty, war, political instability, climate, underfunding – all these plus a myriad of other cultural and political factors can leave deep impressions on the pattern of insulin usage in a particular country.
Accessibility, cost, storage – all may prove particularly vulnerable in underfunded healthcare systems. Education in insulin’s use is another important factor in many different settings, as are issues relating to climate and energy supply.
Whilst national economic conditions are often a decisive factor, problems with insulin supply are not restricted to lower income countries. In one study based on online self-reporting on out-of-pocket expenses presented at last year’s EASD Annual Meeting people from two countries stood out as chief among those struggling to access insulin – those two countries were Pakistan and the USA. (Timothee Froment, Economic burden associated with diabetes technologies: a cross-national comparison of out-of-pocket expenses, EASD Annual Meeeting 2020. See https://easd-elearning.org/counting-the-cost-of-diabetes/)
To launch the series, in a film recorded before recent events led to a regime change in Afghanistan, Dr Mohammad Wali Naseri, Associate Professor of Endocrinology, Metabolism and Diabetes and President of the Afghanistan Endocrine Society, shares his country’s experience of insulin.
The opinions expressed in this article are those of the author, Dr Eleanor D Kennedy.