India has acknowledged concerns over limited insulin availability, even as global shifts in the pharmaceutical industry raise fresh questions about the future supply of the life-saving drug.
India accounts for one of the largest populations of people living with diabetes in the world, and global pharmaceutical companies are increasingly shifting focus to newer therapies such as GLP-1 drugs.
The issue has gained policy attention after it was raised by Dr. Niti Pall, President-elect of the International Diabetes Federation (IDF), during her recent visit to India. In a meeting with Union Minister Dr. Jitendra Singh, she flagged the risk of emerging supply constraints in insulin, a life-saving therapy for millions.
India’s diabetes burden continues to rise steadily, driven by lifestyle changes, urbanisation, and ageing. While a large proportion of patients are diagnosed with Type 2 diabetes, a significant number, particularly those with Type 1 diabetes, depend entirely on insulin for survival. Any disruption in supply, experts warn, could have serious public health implications.
At the heart of the concern is a structural shift in the global pharmaceutical market. Dr. Pall pointed out that insulin production is currently concentrated among a limited number of multinational manufacturers. At the same time, many of these companies are prioritising the development and marketing of GLP-1 receptor agonists—newer drugs used for diabetes and weight management that are seen as more commercially lucrative.
This shift, she cautioned, could gradually affect insulin production volumes and supply chains, particularly for low- and middle-income countries that rely on affordable access.
Against this backdrop, the discussion with the government focused on strengthening India’s domestic manufacturing capacity, especially in bio-similar insulin. These are cost-effective alternatives to existing insulin therapies and are seen as a viable way to improve both availability and affordability.
Responding to the concerns, Dr. Jitendra Singh acknowledged that while India has established strengths in pharmaceuticals, domestic insulin production remains limited. He described this as a critical gap, particularly in view of the country’s growing diabetes burden.
He said the Department of Biotechnology (DBT) is supporting initiatives to scale up insulin manufacturing, including efforts by Indian companies to expand production capacity. Enhancing insulin availability, he noted, is both a national necessity and a global responsibility.
Dr. Pall underlined that several countries in Asia and Africa are increasingly looking toward India for affordable diabetes care solutions, drawing parallels with its role in supplying low-cost vaccines. However, she pointed out that high insulin prices continue to limit access in many regions, reinforcing the need for alternative manufacturing hubs.
The conversation also extended to the broader ecosystem of diabetes care, including technologies such as continuous glucose monitoring (CGM) systems and insulin pumps, which are becoming essential for effective disease management.
Dr. Pall highlighted the rapid growth of low-cost diabetes devices from countries such as China, which are gaining market share due to competitive pricing. She cautioned that without timely scaling up of domestic innovation and manufacturing, India risks falling behind in this segment as well.
Dr. Singh, however, observed that Indian companies possess the technological capability to develop comparable devices, including CGMs, and stressed that scaling up production would require stronger industry participation and targeted support. He indicated that efforts are underway within the domestic ecosystem to develop cost-effective monitoring technologies.
Both sides discussed the need for closer collaboration between government agencies, research institutions, and industry stakeholders. Areas such as clinical research, technology development, and financing mechanisms were identified as crucial for building a resilient diabetes care ecosystem.
To take the discussions forward, the Minister proposed convening a stakeholder meeting during Dr. Pall’s next visit to India, expected later this year, to chart a road-map for scaling up production and strengthening global outreach.
