What is innovation in the area of medicines? The example of insulin and diabetes

Known Unknowns in an Era of Technological and Viral Disruptions—Implications for Theory, Policy, and Practice

Technology is composed of the words “Techne” and “Logos” that refer to the artistic/creative and the logical/scientific aspects of its dualism. And so inherent this Promethean concept lie the concepts of the Schumpeterian creative destruction and also the promise and potential for humanity’s better tomorrows. We live in an era of artificial intelligence–driven as well as viral disruptions that challenge the mind as well as the body. At the same time, the impact of our pursuit of prosperity at any cost on the environment triggers displaced people floods and viral pandemics undermining the standard of living and more importantly the foundations of trust in institutions and in a better tomorrow feeding populist movements and autocratic trends in democracies as well as emboldening dictators. This work discusses the concepts of Risk Management 5.0, Industry 4.0, Industry 5.0, Society 5.0, Digital Transformation, Blockchain, and the role of AI via the Internet of Things architectures that could enable “smarter as well as more humane solutions to our challenges.”

A global perspective on the issue of access to insulin

The discovery of insulin in 1921 changed the prognosis for people with type 1 diabetes. A century later, availability and affordability of insulin remain a challenge in many parts of the globe. Using the WHO's framework on understanding the life cycle of medicines, this review details the global and national challenges that affect patients' abilities to access and afford insulin. Current research and development in diabetes has seen some innovations, but none of these have truly been game-changing. Currently, three multinational companies control over 95% of global insulin supply. The inclusion of insulin on the WHO's Prequalification Programme is an opportunity to facilitate entry of new companies into the market. Many governments lack policies on the selection, procurement, supply, pricing and reimbursement of insulin. Moreover, mark-ups in the supply chain also affect the final price to the consumer. Whilst expenses related to diabetes are mostly covered by insurance in high-income countries, many patients from low- and middle-income countries have to pay out of their own pockets. The organisation of diabetes management within the healthcare system also affects patient access to insulin. The challenges affecting access to insulin are complex and require a wide range of solutions. Given that 2021 marks the centenary of the discovery of insulin, there is need for global advocacy to ensure that the benefits of insulin and innovations in diabetes care reach all individuals living with diabetes.