Every person has a fundamental right to health. This is the underlying premise of our efforts to improve availability, accessibility, affordability and quality of care. We also seek to contribute to the United Nations Millennium Development Goals, which address key challenges to overcome by 2015. These challenges include reducing child mortality, improving maternal health and combating diseases hampering social and economic development.
The goal of our long-term efforts is to generate the greatest health impact for people with diabetes and haemophilia, improve access to care for the most vulnerable and work in partnerships to build healthcare system capacity. We want to effect change in areas that affect current and future generations, with a long-term impact consistent with our role as a sustainable business.
Changing Diabetes® is Novo Nordisk’s global commitment to improve conditions for the millions of people who live with diabetes around the world today, and those who are at risk of developing diabetes tomorrow. It is a global advocacy and partner platform from which we advocate for the prevention and earlier detection of diabetes, as well as for improved treatment, care and health outcomes. It is also the framework for a series of partnership programmes for interventions and outreach activities, many of which address the specific needs of vulnerable groups such as those with low incomes, women and children.
For more information about our approach to access to diabetes care and health, click here.
Through our Changing Possibilities in Haemophilia® initiatives we partner with physicians, healthcare policy-makers and the wider haemophilia community to help build a better tomorrow for people with haemophilia. We seek to increase understanding of haemophilia and improve access to diagnosis.
As part of our approach to expanding access, we align with the United Nations declared right to health and the United Nations' Millennium Development Goals, which offer a common vision for tackling some of the major challenges facing the world.
Our focus areas support the United Nations Millennium Development Goals 4, 5, and 8:
- Treating children with type 1 diabetes
- Confronting diabetes in pregnancy
- Building partnerships and capacity through donations to support World Diabetes Foundation (WDF)
- Addressing affordability in lest developed countries through our differential pricing policy
- Addressing the significant need for improved access to haemophilia care through donations to the Novo Nordisk Haemophilia Foundation (NNHF)
- Collaborating with patient and medical organisations to advance treatment and care, e.g. through the Novo Nordisk Haemophilia Access to Insight programme
Part of our contribution to improving access to health is our continued long-term financial commitment to the World Diabetes Foundation (WDF). In 2002 and 2008 our shareholders voted to contribute a portion of net insulin sales to the WDF over 10 years. These donations are reported annually on our income statement.
The independent and non-profit WDF supports the prevention and treatment of diabetes where it is needed most, providing funding for local initiatives that improve healthcare system capacity. Since it was founded by Novo Nordisk in 2001, it has supported 279 projects in 100 countries. Our donations to WDF in 2011 amount to 65 million Danish kroner, bringing it to a total of 606 million Danish kroner since 2002.
For more information on WDF's activities visit its website at www.worlddiabetesfoundation.org
As our focus on haemophilia has expanded, so has our commitment to the global haemophilia community. We established the Novo Nordisk Haemophilia Foundation (NNHF) in 2005 to address the significant need for improving haemophilia care and treatment in developing countries. Our donation of 16 million Danish kroner to NNHF in 2011 supports partner-run projects and fellowships in developing and emerging countries.
For more information on NNHF's activities visit its website at www.nnhf.org.
Affordability of insulin in least developed countries
The cost of therapy still constitutes a significant barrier for better healthcare in low income countries. Through our long-standing differential pricing policy we sell insulin at or below 20% of the average prices for insulin in the Western world, in this case Europe (EU, Switzerland and Norway), the United States, Canada and Japan.
The differential pricing policy is part of the global initiatives to promote access to health for all least developed countries (LDCs) as defined by the UN. In 2011, Novo Nordisk offered the differential price to all of the 48 LDCs. Novo Nordisk operates in 38 of these countries and sold insulin to either governments or the private market in 75% (36 of 48 countries) of the countries according to the differential pricing policy compared with 67% (33 of 49 countries) in 2010. In 2011, Novo Nordisk operated in Mozambique and Angola but did not sell insulin at the differential price. The governments in these two countries were offered the opportunity to buy insulin at the differential price but the insulin sold here in 2011 was sold to the private market.
In a total of 10 LDCs Novo Nordisk had no sales in 2011 for various reasons. In several cases, the government has not responded to the offer, there are no private wholesalers or other partners to work with, or war or political unrest makes it impossible to do business. While Novo Nordisk prefers to sell insulin at the differential price through government tenders, the company is willing to sell to private distributors and agents. Novo Nordisk is unable to guarantee that the price at which the company sells the insulin will be reﬂected in the ﬁnal price to the consumer.
To improve the impact of our differential pricing policy, we have initiated a number of pilot projects (see Base of the pyramid below) to address barriers that may lead to higher final prices for the patients.
For more information about the differential pricing policy, click here.
Changing Diabetes® in Children programme
Today, there are 480,000 children under the age of 15 years with type 1 diabetes in the world. About half of these children live in resource-poor settings, often without necessary diabetes treatment facilities. Children with type 1 diabetes have high mortality rates, with life expectancies of less than one year in some countries in sub-Saharan Africa. This is the result of poor accessibility and affordability of medicines and diabetes care, especially in rural areas.
As a response, in 2009 Novo Nordisk established the Changing Diabetes® in Children programme for the improved delivery of care to children with diabetes.
Currently, the Changing Diabetes® in Children programme is active in 9 countries: Bangladesh, Cameroon, Democratic Republic of Congo, Ethiopia, India, Guinea, Kenya, Tanzania and Uganda.
Achievements in 2011 include:
- 41 clinics were established under the Changing Diabetes® in Children programme
- Over 3,434 children were enrolled in the programme bringing the total number of children to over 4,762 children since 2009
- 980 healthcare professionals were trained in the specialities of diabetes care for children
- Hosted a CDIC seminar on capacity building in developing countries at the 2011 annual ISPAD meeting in Miami
For more information on Changing Diabetes® in Children, click here.
Changing Diabetes® in Pregnancy
Worldwide, about 10 million women every year develop gestational diabetes affecting up to 15% of pregnant women. Correct treatment and lifestyle education effectively reduces both the immediate and long-term risks to mother and baby. But many cases of gestational diabetes mellitus (GDM) are undiagnosed, and most are in low- and middle-income countries. In response, Novo Nordisk has developed its Changing Diabetes® in Pregnancy programme to spread understanding of how diabetes in pregnancy needs to be identified, and how it can be controlled with lifestyle advice.
In 2011, within the framework of the Changing Diabetes® in Pregnancy programme, our achievements include:
- Three country projects were established in partnership with local health authorities, non-governmental organisations and universities in Nicaragua, Colombia and India to improve screening, diagnosis and management of gestational diabetes mellitus (GDM). Approximately 2000 women have been screened for GDM so far
- A literature review and country survey of GDM policies and practices was conducted and published in the Journal of Maternal-Fetal Medicine. This showed a widespread lack of policies and guideline implementation, in particular in low- and middle-income countries.
A health economic model (The GDModel) to assess the cost and impact of GDM screening and management was completed and first results published in the International Journal of Gynecology and Obstetrics
- A session on GDM in developing countries was organized at the 6th International Symposium on Diabetes in Pregnancy in Salzburg, Austria
For more information about the Changing Diabetes® in Pregnancy programme, click here.
Base of the pyramid
In 2011, Novo Nordisk established a corporate innovation project to address the needs of people with diabetes living at the base of the pyramid (BOP). This patient-centred project aims to deliver profitable, sustainable and scalable solutions to provide diabetes care to a large segment of people earning between 1,500 US dollars and 3,000 dollars annually.
Exploring new models addressing challenges such as access to care, significant price mark-ups, lack of trained physicians, awareness and availability of insulin, the BOP project will generate integrated solutions to product supply, diagnosis and treatment with the potential to create both commercial success and a positive social impact.
As part of these efforts we launched a pilot project in Kenya in December 2011. A public-private partnership involving the Kenyan government and other stakeholders, the project seeks to reduce direct and indirect costs of treatment by limiting price mark-ups in the supply chain and reducing travel costs and lost work days by distributing insulin at more locations. In our search for a sustainable business model for the base of the pyramid, additional projects will be launched in 2012 in rural India and Nigeria.