Tribune. The Canadian Frederick Banting, born November 14 in 1891, is, with Charles Best, the co-discoverer of insulin. It is therefore natural that this anniversary date was chosen to celebrate International Diabetes Day! It was in the summer of 1921 that their work enabled the preparation of purified insulins which could be used in the treatment of diabetes.
There are two forms of diabetes. In the so-called type 1 (T1D), the pancreas no longer produces, or no longer enough, insulin. This hormone helps regulate blood sugar. Patients must therefore inject insulin every day to regulate their blood sugar and survive. It concerns 10% of patients, particularly affecting children, adolescents and young adults. Type 2 diabetes (T2DM), in which the pancreas still produces insulin, but in inadequate amounts and the body has difficulty using, affects 90% of people with the disease, and especially adults with over 45, sedentary and overweight. It is treated with oral antidiabetics, but insulin can also become necessary after years of progress.
“Despite the fact that the production of this hormone does not involve any major difficulty, it focuses on three manufacturers”
We could therefore legitimately think that, a century after the first injection, the precious treatment of Banting and Best is accessible to everyone, everywhere on the planet. But unfortunately it is not! Today, and without counting the millions of people at risk, more than 460 million people live with this disease every day, which, in the absence of appropriate treatment, can cause serious complications.
Just two years after the discovery of insulin, the researchers behind this major scientific advance were selling their patent rights for only a symbolic dollar. However, this hormone remains today financially inaccessible for a majority of patients around the world. France must therefore necessarily be a driving force, particularly within the World Health Organization (WHO), to allow universal access to insulin.
Limited supply and high prices
This access faces two major obstacles: the limited supply of insulin and high prices, which has consequences, especially in low- and middle-income countries. According to a study carried out by the WHO in Accra, the capital of Ghana, the amount of insulin needed for a month would cost a worker the equivalent of five and a half days of monthly wages. According to data collected between 2016 and 2019 in 24 countries located on four continents, human insulin is only available in 61% of health facilities, and similar insulins in 13%. Despite the fact that the production of this hormone does not involve any major difficulty, compared to other biomedicines, it focuses on three manufacturers, Sanofi, Novo Nordisk and Eli Lilly, which control 96% of the world market. This low number of manufacturers results in high prices, effectively excluding many people and healthcare systems. Yet production costs are low and patents have been ceded by the discoverers of insulin almost a hundred years ago.
France, country of Pasteur, has shown its ambitions at the international level to raise the subject of universal access to insulin. The Member States of WHO, meeting in the spring for the 74e World Health Assembly, adopted a historic resolution, co-signed by France, in the fight against diabetes, and in particular for access to insulin. We must now transform this resolution into concrete actions, to allow the survival of patients, but also to help developing countries define and deploy their own strategies.
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