Africa (AFR): Cameroon, Democratic Republic of Congo, Côte d'Ivoire, Kenya, Senegal, South Africa, Tanzania, Togo and Zambia.
Eastern Mediterranean and Middle East (EMME): Egypt, Libya, Pakistan and Qatar.
Europe (EUR): Albania, Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Georgia, Germany, Greece, Hungary, Ireland, Israel, Italy, Kazakhstan, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Serbia and Montenegro, Slovenia, Spain, Sweden, Turkey, United Kingdom and Ukraine.
North America (NA): Anguilla, Belize, Bermuda, British Virgin Islands, Canada, Commonwealth of Dominica, Guyana, Jamaica, Mexico and United States of America.
South and Central America (SACA): Argentina, Bolivia, Brazil, Chile, Cuba, El Salvador, Peru and Uruguay.
South-East Asia (SEA): Bangladesh, Mauritius and Sri Lanka.
Western Pacific (WP): Australia, China Hong Kong, Japan, New Zealand, Philippines, Singapore, Taiwan and Thailand.
A survey on 'Global Access to Insulin and Diabetes Supplies' was carried out by IDF in 2002. More than 70 countries participated in the survey, which was the second carried out to ascertain the magnitude of the problem posed by the lack of access to insulin and diabetes supplies in many countries. A summary of the results of this survey are presented in the e-Atlas. There are several shortcomings in drawing absolute conclusions from such a survey; however, the results do indicate the nature of the obstacles that have to be surmounted in order to provide continuous access to insulin, syringes and needles in all countries.
More than half of the countries surveyed reported that people with diabetes had continual and uninterrupted access to insulin. However, it is significant to note that people with type 1 diabetes in 30 countries did not have access to insulin 100% of the time (see data table on 'Access to insulin' for people with type 1 diabetes), while people with type 2 diabetes in 34 countries did not have access 100% of the time (see data table on 'Access to insulin' for people with type 2 diabetes).
Access to insulin varied from region to region (see figures below). None of the respondent countries in the African Region (AFR) had access to insulin 100% of the time. The countries with the lowest accessibility were the Democratic Republic of Congo where people with type 1 diabetes had access to insulin for less than 25% of the time and Zambia where those with type 2 diabetes had access only 26-49% of the time. In Europe (EUR), Ukraine had the lowest accessibility to insulin (less than 25% of the time); in South and Central America (SACA,) El Salvador and Peru (26-49%) and in North America (NA), Guyana (50-74%).
The most important causes, as shown in the figure below, preventing people with diabetes from accessing insulin were:
High cost was the most important reason for people with type 1 diabetes in most African countries (7 out of 9) for not being able to access insulin, but was less so in South and Central America (3 out of 8) and North America (2 out of 10) (see data table on 'Causes of lack of access' for people with type 1 diabetes ). Two countries, Zambia and Sri Lanka, reported poor quality of insulin as a cause of lack of access to insulin for people with type 2 diabetes (see data table on 'Causes of lack of access' for people with type 2 diabetes ).