The status of insulin access in Middle East-North Africa region

Background and Objective: The current situation in the Middle East-North Africa (MENA) region makes it very difficult for many countries to have an effective policy to ensure the availability and affordability of different insulin types for many individuals with diabetes mellitus in any individual country. This article comprehensively reviews the possible barriers to insulin access in countries of this region and provides some solutions to mitigate these barriers. Materials and Methods: The framework for understanding the life-cycle of medicines of the World Health Organization (WHO) was adopted for this review with country-specific modifications. PubMed was used as an initial search builder using the country name and insulin as query terms in (title/abstract) for articles written in (English and French) which dealt with humans only between (2000-2022). Out of (578) published articles, only (42) articles were relevant and dealt with insulin access. Additional search through references of these articles and the websites of international health organizations added additional (32) references to have (79) references for the review. Review (Results): The countries in the MENA are lagging in the (Research, Development, and Innovation) and production of insulin and insulin delivery systems. There are some attempts by some countries to develop their national plan with the help of some big insulin manufacturers, with a suboptimal outcome. The local insulin production in some countries did not reach full national coverage. The difficult regional economic and political situations in many countries in the MENA imposed negatively on their citizens' insulin access, availability, affordability, cost, and insurance plans. Conclusions: There is a suboptimal level of insulin access for individuals with diabetes in the MENA countries, especially in the low-resourced countries. There is an urgent need to adopt country-specific healthcare policies to ensure uninterrupted insulin access and improved availability, with a lower affordable cost for individuals with diabetes from the public and private sectors.