New Insulin Production Deal is a Boost for Africa’s Diabetes Challenge
South African President Cyril Ramaphosa visits Aspen Pharmacare manufacturing facility in Gqeberha.

A new deal between Danish company Novo Nordisk and South African generic manufacturer Aspen will massively expand the supply of insulin in sub-Saharan Africa and also transfer the production rights and technology to the African company.

The deal will more than double Novo Nordisk’s production within just one year.  Currently, the pharma company’s insulin products reach 500,000 people living with diabetes in sub-Saharan Africa.  Through the partnership, expanded production will be able to meet the insulin needs of 1.1 million people across the continent by 2024. 

By 2026, the two companies will be able to meet the insulin needs of 4,1 million people living with type 1 and type 2 diabetes across the African continent.

According to the agreement, Novo Nordisk has a minimum purchase obligation from Aspen of €195.5 million for the period 2024-2028.  

“The human insulin will be distributed at low cost to health authorities and non-governmental organisations through government tenders as part of Novo Nordisk’s sustainable business integrated model, iCARE. With iCARE, Novo Nordisk will guarantee a ceiling price of human insulin at $3 per vial,” according to a media release from the company.

“The expanded commitment supports the African Union’s Pharmaceutical Manufacturing Plan for Africa. The collaboration between the partnership allows for local production, storage, and distribution of human insulin in vials in the African continent and means more equitable access to lifesaving care to people with diabetes,” the company added.

Intense engagement with industry based on the Global Diabetes Compact 

The deal was announced jointly by the pharma companies and the World Health Organization (WHO) on the sidelines of a series of high level health-related meetings at the United Nations General Assembly in New York last week. 

The past two years have seen a period of intense WHO engagement with pharma leaders to rev up insulin production following the launch of a WHO Global Diabetes Compact two years ago. 

In 2021, WHO estimated that half of the 63 million people living with Type 2 diabetes could not afford or access insulin, which controls their blood glucose levels. Around 90% of the insulin market is controlled by just three pharma companies: Novo Nordisk, Eli Lilly, and Sanofi.

“Diabetes is on the rise in low- and middle-income countries, but access to insulin has not kept pace with the growing disease burden,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, addressing an event in New York where the deal with announced. 

“Currently, 24 million adults are living with diabetes in Africa, and that figure is projected to more than double to 55 million by 2045.”

Bente Mikkelson, WHO’s director of the Department of Noncommunicable Diseases, added: “The unmet need for insulin is a stark reminder of the health inequalities that persist in our world today.

“Manufacturers have a pivotal role to play in filling this critical gap, not just with their products but also with their commitment to affordability, accessibility, and sustainable production. This event marks a significant milestone in our collective work to make diabetes treatment and care accessible to those who need it the most, in Africa and around the world,” Mikkelsen said.

“It underscores the power of dialogue and collaboration, where governments, international organisations, and private sector entities come together for a common cause – the cause of humanity.  Together through the Global Diabetes Compact, and with unwavering determination, we’ll script a healthier future for millions in Africa and beyond.”

The Novo Nordisk deal follows on the heels of a partnership announced in May by another leading insulin producer, Eli Lilly with Egypt’s Eva Pharma. As part of the deal, Eva will produce another 1 million “fill and finish” doses of Eli Lilly’s insulin products a year by 2030.

Enabling more local insulin production by Africa

Welcoming the Novo Nordisk partnership with Aspen, South Africa’s Minister of Trade and Industry Ebrahim Patel said that it “will enable the local production of human insulin in South Africa through the conversion of insulin into finished dose vials.”

“This is an excellent first step that we hope will pave the way for both licensing and additional manufacturing opportunities, in areas such as sterile cartridge production and the production of high-demand and the new classes of drugs, such as the glucagon-like peptide-1 (GLP-1), which is largely inaccessible at present to African patients,” Patel said.

The production of insulin will utilise Aspen’s sterile infrastructure in the city of Gqeberha in South Africa, using some of the infrastructure introduced for Aspen’s ill-fated COVID-19 vaccine manufacture.

“We firmly believe that access to quality healthcare is a fundamental human right,” said Katrine DiBona, corporate vice president for Global Public Affairs and Sustainability at Novo Nordisk. 

“We are committed to providing affordable human insulin to ensure access to quality treatments for even more people with diabetes in the African continent. At the same time, it is equally important for us that we are doing it in a sustainable way by focusing on local production.”

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