Since 2015, the Addressing the Challenge and Constraints of Insulin Sources and Supply (ACCISS) Study has aimed to address the barriers to access to insulin that impede optimal care for people with diabetes. Over the past seven years, we have built up an evidence base of knowledge and tools that can help to improve access to treatment and care, both globally and at the national level. Working with our partners in Kyrgyzstan, Peru, Mali and Tanzania since 2018 we have put into practice some of the tools to further our knowledge base.
Insulin, discovered in 1921, was first used in 1922. At the time, it was considered medical miracle that changed the
diagnosis for those living with type 1 diabetes from a death sentence to a manageable condition. Today, all those living with type 1 diabetes, and an estimated 63 million living with type 2 diabetes, use insulin. Despite the fact that insulin has been used for nearly 100 years, an estimated 1 in 2 people who need it cannot afford and/or access this much-needed medicine. Since its inception in 2015, HAI’s Addressing the Challenge and Constraints of Insulin Sources and Supply (ACCISS) Study has been working to identify and address the inequities and inefficiencies in the global insulin market.
The study is co-led by Dr Margaret Ewen and Molly Lepeska (HAI) and Dr David Beran (Geneva University Hospitals and the University of Geneva). It also brings together a large group of leading international experts as members of its Advisory Group. The study is funded by a grant from The Leona M. and Harry B. Helmsley Charitable Trust.
PHASE IV (2024-2027)
In Phase IV, the work of ACCISS will be guided by our long-term outcomes:
1. Awareness of solutions at global, regional and national levels to improve access to insulin and diabetes care in LMICs is increased
2. Individuals have guaranteed access to affordable quality-assured insulin and self-monitoring devices adapted to LMIC contexts as part of UHC packages
3. Health systems deliver person-centered diabetes care
PHASE III (2021-2024)
- Work in partnership, at the global and national levels, to advocate for improved access to insulin, diagnostics and care.
- Improve the availability, price and affordability of insulin for governments and people using insulin
- Ensure optimal use of insulin
- Identify barriers that exist in the diabetes diagnostics market and build evidence base to address these barriers
- Understand how technology might best suit the needs of people with diabetes monitoring their blood glucose in resource-constrained setting and develop next steps
- Promote our evidence-base, tools and other resources, on insulin, diagnostics and improving diabetes care at international, regional and national fora
- To meet these objectives we will implement activities at the global and national levels, and continue to monitor progress, adjusting as needed over the three years.
PHASE II (2018-2021)
The second phase focuses on piloting the tools and interventions developed in Phase I at country level, while continuing to work globally to address inequities and inefficiencies in the insulin market. Our Phase II work streams are:
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- Work with global partners to develop evidence-based tools that address worldwide barriers to insulin access, and strengthen tools already developed
- Develop, with national partners in four countries, comprehensive and contextualised national strategies to address the range of challenges that people requiring insulin face, and to pilot and evaluate the interventions
- Further expand the ACCISS network and develop civil society networks, amplified in international/regional/national fora, to reduce, or eliminate, the barriers to insulin access
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PHASE I (2015-2018)
In its initial phase, ACCISS produced a comprehensive, first-of-its-kind evidence base of the global insulin market. In doing so, it created innovative policies, tools and interventions to overcome barriers to insulin access globally, which have have been brought together under the ACCISS Toolkit.