The two organisations commit to working together to improve affordable access to SGLT2 inhibitors in low- and middle-income countries (LMICs).

Geneva – The International Diabetes Federation (IDF) and the Medicines Patent Pool (MPP) welcome the inclusion of SGLT2 inhibitors – oral medications used to lower blood glucose levels – to the 2021 World Health Organization (WHO) Essential Medicines List (EML), namely empagliflozin with canagliflozin and dapagliflozin as therapeutic alternatives. The WHO Expert Committee called on originators to license their medicines to MPP to scale up access in LMICs.

Nearly half a billion people live with diabetes worldwide, with four out of five living in LMICs^[1]. At least 90 percent of all cases of diabetes are type 2, for which metformin represents the first-line therapy. SGLT2 inhibitors are a second-line treatment to add to metformin to improve glycaemic control. They have been shown to be particularly effective in reducing overall and cardiovascular mortality, non-fatal myocardial infarction, kidney failure and hospitalisations for heart failure in patients with, or at high risk of, cardiovascular disease and/or renal disease, for whom they represent a reference treatment.^[2]

“IDF submitted SGLT2 inhibitors for inclusion onto the EML list. We are delighted that our request has been accepted. We will now work with countries towards including these medicines onto their national lists, as a first and crucial step towards making them available in LMICs,” said IDF President Professor Andrew Boulton. “As these are patented medicines, we will work further in partnership with MPP to make this treatment affordable and available to those in need.”

“At MPP, we have seen time and again that access to important treatments lags dramatically in LMICs,” said Charles Gore, Executive Director of MPP. “We hope originators will be willing to sit down with us as soon as possible to discuss how our public health-oriented licensing mechanism could contribute to making SGLT2 inhibitors accessible to those who need them in LMICs.”

More than 150 countries use the WHO EML to compile their own national essential medicines lists. Every two years, a WHO Expert Committee reviews the list. This year, the experts considered 88 applications, including 40 proposals to add 38 new medicines. The availability of the medicines included on the EML are regarded as minimum requirements for a functioning health system and should be available to all who need them. The addition of SGLT2 inhibitors in the 2021 EML increases the diabetes treatment options for countries and brings hope to the hundreds of millions of people who could benefit from these medicines.

Following the signing of a Memorandum of Understanding between IDF and MPP in August 2020, both organisations have been actively collaborating to apply MPP’s model to bring affordable generic diabetes treatments to LMICs.

Access the WHO EML

Access the WHO EMLc

^[1] International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels, Belgium: 2019.

^[2] Palmer S C, Tendal B, Mustafa R A, Vandvik P O, Li S, Hao Q et al. Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials BMJ 2021; 372 :m4573