Just as basic technologies for diagnosis and monitoring of diabetes in low-income and lower middle-income countries are less accessible, so too is insulin, the WHO says.
Limited competition between a small number of multinational manufacturers can increase prices, with low-income countries generally paying the most for the treatment, it says.
"Governments' decisions about insulin purchasing-- tendering practices, choice of supplier, choice of products and delivery devices -- can have a huge impact on budgets and on costs to end users.
"Governments may recoup high costs by charging mark-ups to patients. In Mozambique, for example, insulin purchased from local wholesalers was 25% to 125% more expensive than that purchased through international tenders," the WHO says.
It says while insulin is reported as available in 72% of countries it varied widely by region and country.
"Only 23% of low-income countries (six countries) report that insulin is generally available, in contrast to 96% of high-income countries (54 countries).
"Further, the reported general availability of insulin in the WHO Region of the Americas and the European Region is more than double that of the WHO African Region and South-East Asia Region," the report says.
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