Insulin pens are a necessity, not a luxury: Addressing inequitable access to diabetes treatment in South Africa’s public sector

Abstract

Diabetes is a growing public health crisis in South Africa (SA), driven by urbanisation, sedentary lifestyles, poor dietary habits and an ageing population. The country has one of the highest diabetes prevalence rates in sub-Saharan Africa, with millions affected, many of whom remain undiagnosed. The disease disproportionately impacts low-income communities, where limited healthcare access and late diagnoses lead to severe complications and economic strain. While insulin pens improve glycaemic control and patient adherence, they remain largely inaccessible in the public sector owing to high costs and restrictive procurement policies. Government reliance on vials and syringes exacerbates treatment disparities, increasing the risk of medication errors and poor health outcomes. Addressing these barriers requires policy reform, expanded subsidies and improved procurement strategies to ensure equitable access to insulin pens. By prioritising patient-centred diabetes care, SA can reduce hospitalisations, enhance treatment adherence and alleviate the broader economic and healthcare burden of diabetes.