Can Eli Lilly Close the GLP-1 Access Gap in LMICs?
Despite landmark progressions in care, global rates of diabetes and obesity continue to rise: in 2024, diabetes caused a death every six seconds, the International Diabetes Foundation reports.
Four out of five adults with diabetes and seven out of ten with obesity live in low and middle-income countries (LMICs), where fragmented healthcare systems, limited resources, unreliable supply chains and regulatory barriers prevent millions of adults from receiving treatment.
“Today, for every four people with access to our diabetes and obesity medicines in a high-income country, only one person in a resource-limited setting can reach them,” explains Ilya Yuffa, Executive Vice President of Eli Lilly.
Following the success of its 30x30 initiative – which expanded healthcare access to 40 million resource-limited people in 2025, five years and 10 million people ahead of its initial target — pharmaceutical giant Eli Lilly has announced its goal of reaching treatment parity across global regions before 2040.
“For 150 years, Lilly has addressed some of humanity's most pressing health challenges by turning science into medicines that improve lives,” says David Ricks, Eli Lilly’s Chair and CEO.
“We are now going further.”
With plans to register its medicines globally and expedite distribution, the company’s ‘Lilly Change the Course Commitment’ shifts their global health strategy from expanding healthcare access to achieving concrete reach for diabetic and obese patients in LMICs.
- 1 in 9 adults worldwide live with diabetes – predicted to rise to 1 in 8 by 2050.
- 13% of the global population live with obese, with rates now rising faster in developing nations than in high-income ones.
- Over 70% of people living with obesity live in LMICs.
- Around 43% of adults living with diabetes are undiagnosed, with almost 90% of this number located in LMICs.
- Over the past 17 years, diabetes has seen a 338% increase in global health expenditure, while projections for obesity costs see numbers rising to an annual US$4.3tn by 2035.
Accelerating registration across Africa, Asia and Latin America
Streamlining regulatory approval processes forms a core pillar of Eli Lilly’s access strategy.
In LMICs, approval timelines for new pharmaceuticals can lag up to 36 months behind initial market approvals.
Harnessing strategies developed over the course of the Lilly 30x30 initiative, Eli Lilly plans to submit regulatory packages for its diabetes and obesity portfolio in additional countries across Africa, Latin America and Asia.
By investing in AI-based translation technology and centralised digital tools to compress and streamline the submission process, Eli Lilly has invested in a framework which makes numerous concurrent medicine submissions possible across a wide range of countries.
Within three months of the company’s first submissions of orforglipron, its groundbreaking non-peptide GLP-1, the drug had been submitted for approval in over 40 countries worldwide.
“People living with diabetes and obesity in resource-limited settings are often still waiting for diagnosis, care, and medicines that are available elsewhere,” says David.
Part of Eli Lilly’s solution starts with shifting development cycles, ensuring approval wait times do not delay the process of securing treatment parity.
“People living with diabetes and obesity in resource-limited settings are often still waiting for diagnosis, care, and medicines that are available elsewhere. ”
Cold-chain storage barriers: the Foundayo breakthrough
When it comes to reaching clinics in LMICs, logistical costs and pricing structures present significant barriers to medicine approvals and rollouts.
Injectable GLP-1 therapies require temperature-controlled supply chains, adding high overhead costs to distribution.
Eli Lilly is prioritising the global distribution of orforglipron, marketed under the name Foundayo, its diabetes and weight management medication.
Unlike other major GLP-1s based on semaglutide (Ozempic or Wegovy) or tirzepatide (Mounjaro), Foundayo is a small non-peptide molecule, allowing it to survive travel through the gastrointestinal tract.
Produced as an oral pill, the medication can be stored safely at room temperature: a distinction that eliminates the infrastructure requirements of cold-chain storage and lowers the expense and complexity of mass distribution across a range of climates.
To further expand affordability, Eli Lilly is building on its US-based LillyDirect self-pay pricing channel to open new purchasing pathways to consumers across the world.
Beyond philanthropy, closing the global gap in diabetes and obesity treatment must harness innovations that tangibly put treatment within resource-limited patients’ reach.
Eli Lilly - key partners
UNICEF
Executive Director: Catherine Russell | HQ: New York
Eli Lilly and UNICEF have expanded their partnership to improve non-communicable disease prevention and care across 21 low- and middle-income countries. A new six-year, US$50m commitment aims to reach more than 30 million young people and caregivers, strengthening primary healthcare systems and addressing conditions including diabetes and childhood overweight and obesity.
Boehringer Ingelheim
Chairman of the Board of Managing Directors: Shashank Deshpande | HQ: Ingelheim, Germany
Boehringer Ingelheim and Eli Lilly have maintained a longstanding global alliance covering the development and commercialisation of medicines for diabetes and related conditions. Their collaboration includes Jardiance, a major treatment for type 2 diabetes, heart failure and chronic kidney disease, with the agreement in significant markets currently extending through 2028.
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Executives
David Ricks
Chair and CEO
Ilya Yuffa
President Lilly USA and Global Customer Capabilities
