EPISODE 3: Insulin Abroad

This is the Diabetes Discourse, keeping you updated on diabetes care, management and concerns. My name’s Hannah Gracy. I’m a third year Health Sciences student at the University of Florida and an aspiring physician. In this episode, we’re going to take a closer look at the lack of insulin access in developing countries. We’ll also be discussing the western companies that are working to solve this increasingly complex issue

 

As we’ve discussed in previous episodes, insulin injections are used to treat people with type 1 diabetes. As a result, anyone suffering from type 1 diabetes needs access to insulin and glucose-monitoring supplies. Unfortunately, there is a startling lack of access to insulin in developing countries.

 

Insulin for Life, an international outreach organization that’s actually based in Gainesville, estimates that “approximately 90,000 children with type 1 diabetes, from over 70 countries suffer and sometimes even die, for lack of insulin.”

 

Cost is a major barrier to insulin access in these countries. Although insulin here is significantly less expensive than in the U.S., it’s still far too expensive for families living under the poverty line. Additionally, many developing governments are extremely ineffective at distributing insulin and reaching type one diabetes sufferers in rural areas. 

 

Not only is insulin difficult to access in developing nations, it’s really difficult to store. Unused insulin needs to be kept between 36 and 46 degrees fahrenheit. As you can imagine, without a refrigerator, or even electricity, proper insulin storage in developing nations can be nearly impossible. 

 

Many organizations in the U.S. and Europe have responded to this need for insulin access. One of these organizations is Insulin for Life. Insulin for Life sends insulin and diabetes management supplies to families in over 15 different countries completely free of charge.

 

To get a better idea of how Insulin for Life successfully accomplishes this, we’re going to follow a vial of unused insulin from the moment it’s donated to the moment it’s received by a family in Gambia. 

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Unused insulin is donated by someone in the U.S. The unused vial of insulin is packaged with other diabetes supplies. Most organizations like Insulin for Life require that donated insulin be within three months of its expiration date. It’s placed in a styrofoam cooler or insulated bag that will keep it between 36 and 46 degrees during its journey to Insulin for Life’s office in Gainesville. 

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Here, it’s processed with other donations, organized and repackaged. Then insulin for life connects with healthcare providers in Gambia and ships the supplies there.

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I’d like to stop here for a second. This element of Insulin for Life’s process is crucial. They’ve connected themselves with existing healthcare organizations and formed relationships with in-country providers. This is a huge part of establishing any meaningful health outreach program in the developing world, and it’s a large part of why they’re so successful. 

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But back to our vial of insulin…

After it’s shipped from Insulin for Life, the package full of insulin and other diabetes management supplies arrives at the Pakala Clinic in Gambia. Here, it’s received by physicians like Dr. Alieu Gaye, who distributes the supplies to patients at the clinic who would otherwise die without them. 

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To watch the full documentary on Insulin for Life’s outreach work in Gambia and Belize, check out our sources page for Episode three.

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Now I’m going to play a clip from Insulin for Life’s documentary. This is Mark Atkinson, the president of Insulin for Life USA. Listen closely for his comments on access to diabetes management supplies in the U.S. :

 

“If you actually look at the last number of years, it’s been amazing the innovations that have come into the field. We have an array of tools in the United States to provide diabetes management. Now there’s the story of international and the developing world.”

 

Now, I agree with Mr. Atkinson, the insulin access issues facing the developing world are incredibly complex and really serious. They’re honestly not even comparable to those of the U.S. 

 

However, I think it’s unfair to say that the “array of tools” we here have in the United States are being allocated effectively by our government.

 

You can listen to Episode two for more detailed information on insulin access in the U.S. but I’m going to discuss it here briefly.  

 

The three or so companies that have essentially monopolized insulin production have inflated its price to a ridiculous degree. For example, in the past 17 years the price of the insulin brand Lantus has gone from $35 per vial to $270 per vial. I think we can all agree that that’s an insane amount of money.

 

So with that in mind, it’s easy to imagine how low and middle income families are struggling to afford insulin. 

 

Despite this, when I was doing research for this podcast, I found no organizations with the same scope as Insulin for Life that work here in the United States. 

 

As far as I can tell, Insulin for Life does provide insulin in U.S. disaster zones, but I couldn’t find any information about a regular program they run that helps everyday people in the U.S. who are struggling to afford insulin. 

 

In summary, the work that organizations like Insulin for Life do is really valuable. They’ve recognized the need for insulin in the developing world, and they’ve responded to it really effectively. Although this is incredible, we can’t forget to support the people in our own backyard who are struggling due to the ridiculous cost of insulin.

 

Once again, this is Hannah. Thank for listening to the final installment of the Diabetes Discourse.