By Monica Kayombo/Zambia, Lusaka,
DESPITE growing investment in diabetes research and the development of newer treatments, access to essential medicines, particularly insulin, remains a major challenge in low- and middle-income countries (LMICs), according to the 2026 Access to Medicine Index.
The latest Index reveals that pharmaceutical companies have 25 research and development (R&D) projects in diabetes across six companies, with innovation heavily concentrated on glucagon-like peptide-1 (GLP-1) medicines.
However, access to these newer treatments remains limited in LMICs, while many people living with diabetes continue to struggle to access insulin, an established and essential treatment.
The findings highlight persistent inequalities in access to medicines for diabetes and other non-communicable diseases (NCDs), despite advances in pharmaceutical research and development.
The 2026 Index further reveals that access plans now cover 69 per cent of late-stage pharmaceutical pipeline candidates, representing more than three times the proportion recorded in 2018.
However, progress remains uneven, particularly for some NCDs, with 43 per cent of access plans for NCD products focusing only on registration rather than addressing wider barriers such as affordability, availability and reliable supply.
The Access to Medicine Foundation says pharmaceutical companies need to move beyond securing regulatory approval and ensure that medicines can actually reach patients who need them.
While Eli Lilly, Novo Nordisk and Sanofi are taking steps to expand access to insulin, significant gaps remain, particularly in lower-income countries which includes Zambia.
The Index calls for stronger partnerships, sustainable delivery models and measurable commitments to expand affordable and reliable access to insulin, while ensuring that newer diabetes treatments and technologies do not widen existing inequalities.
Beyond diabetes, cancer continues to dominate pharmaceutical research and development, accounting for approximately half of all clinical candidates assessed.
Access strategies now cover 65 per cent of oncology pipeline candidates, with strategies identified for 74 per cent of assessed cancer products in lower-middle-income countries and 19 per cent in low-income countries.
The 2026 Index, which marks 20 years of tracking pharmaceutical companies’ efforts to improve access to medicines, also finds that six companies now operate inclusive business models spanning all 113 low- and middle-income countries covered by the assessment.
However, limited reporting on patient reach makes it difficult to establish the actual impact of these initiatives.
Novartis emerged as the leading pharmaceutical company for the second time, followed by GSK in second position. AstraZeneca ranked third, Sanofi fourth and Bayer fifth.
The Index assesses 20 of the world’s largest research-based pharmaceutical companies on their efforts to improve access to medicines for high-burden diseases in low- and middle-income countries.
Access to Medicine Foundation Chief Executive Officer Jayasree K. Iyer said that although significant progress had been made over the past two decades, more needed to be done to ensure that access to medicines matched the pace of innovation.
The Foundation says funding constraints, geopolitical instability and rising health needs are placing increasing pressure on the global health system, threatening progress in countries with limited resources.
This is contained in the statement shared by Head of Communications at Access to Medicine Foundation Divya Verma on Tuesday after the virtual meeting .
The 2026 Index analysed company performance between June 1, 2024 and May 31, 2026.
