The World Health Organization's new Global Diabetes Compact aims to bring a much-needed boost to efforts to prevent diabetes and bring treatment to all who need it ̶ 100 years after the discovery of insulin.

The Compact is being launched today at the Global Diabetes Summit, which is co-hosted by WHO and the Government of Canada, with the support of the University of Toronto. During the event, the President of Kenya will join the Prime Ministers of Fiji, Norway and Singapore; the WHO Global Ambassador for Noncommunicable Diseases and Injuries, Michael R. Bloomberg; and ministers of health from a number of countries as well as diabetes experts and people living with diabetes, to highlight the ways in which they will support this new collaborative effort. Other UN agencies, civil society partners and representatives of the private sector will also attend.

The risk of early death from diabetes is increasing

The need to take urgent action on diabetes is clearer than ever. The number of people with diabetes has quadrupled in the last 40 years. It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down. And a high proportion of people who are severely ill in hospital with COVID-19 have diabetes. The Global Diabetes Compact will help to catalyze political commitment for action to increase the accessibility and affordability of life-saving medicines for diabetes and also for its prevention and diagnosis."

Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization

"Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to one hundred years later, we continue working to support people living with diabetes," said the Honourable Patty Hajdu, Minister of Health, Canada. "But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives -; in Canada and around the world."

Urgent action needed on increasing access to affordable insulin

One of the most urgent areas of work is to increase access to diabetes diagnostic tools and medicines, particularly insulin, in low- and middle-income countries.

The introduction of a pilot program for WHO prequalification of insulin in 2019 has been an important step. Currently the insulin market is dominated by three companies. Prequalification of insulin produced by more manufacturers could help increase the availability of quality-assured insulin to countries that are currently not meeting demand. In addition, discussions are already underway with manufacturers of insulin and other diabetes medicines and diagnostic tools about avenues that could help meet demand at prices that countries can afford.

Insulin is not the only scarce commodity: many people struggle to obtain and afford blood glucose metres and test strips as well.

In addition, about half of all adults with type 2 diabetes remain undiagnosed and 50% of people with type 2 diabetes don't get the insulin they need, placing them at avoidable risk of debilitating and irreversible complications such as early death, limb amputations and sight loss.

Innovation will be one of the core components of the Compact, with a focus on developing and evaluating low-cost technologies and digital solutions for diabetes care.

Global targets to be agreed on

The Compact will also focus on catalyzing progress by setting global coverage targets for diabetes care. A "global price tag" will quantify the costs and benefits of meeting these new targets. The Compact will also advocate for fulfilling the commitment made by governments to include diabetes prevention and treatment into primary health care and as part of universal health coverage packages.

"A key aim of the Global Diabetes Compact is to unite key stakeholders from the public and private sectors, and, critically, people who live with diabetes, around a common agenda, to generate new momentum and co-create solutions," said Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases at WHO. "The "all hands on deck" approach to the COVID-19 response is showing us what can be achieved when different sectors work together to find solutions to an urgent public health problem."

People watching the Summit will hear from people living with diabetes from India, Lebanon, Singapore, the United Republic of Tanzania, the USA and Zimbabwe about the challenges they face in managing their diabetes and how these could be overcome. Part of the Summit has been co-designed with people who live with diabetes and will give them a global platform to explain what they are expecting from the Compact and how they would like to be involved in its further development and implementation.

"It is time to create momentum not just for living with diabetes, but thriving with it," said Dr Apoorva Gomber, a diabetes advocate living with type 1 diabetes who is taking part in the Summit. "We must grab the opportunity of the Compact with both hands and use it to ensure that we can look back in a few years' time and say that, finally, our countries are equipped to help people with diabetes live healthy and productive lives."