Johnpeter Mwolo was 15 when he was diagnosed with Type 1 diabetes. His body, unable to produce the hormone critical for regulating blood sugar, would now rely on manufactured insulin. He learned to give himself the treatment — four injections a day.

But as he was growing up in Tanzania, insulin was expensive and not always available. Mwolo resorted to rationing his insulin, sharing a vial with his cousin, who also had Type 1 diabetes. “It was one vial to two people,” he says. “Many of the necessities that we are supposed to have are not there.”

It’s a global problem that the World Health Organization is now working to address. In November, the WHO launched a pilot program to boost the availability of insulin worldwide. The idea is to work with insulin manufacturers to increase the global supply — and in the process, potentially drive down the price of the treatment. Since then, seven pharmaceutical companies have shown interest in participating in the program.

“The simple fact is, that the prevalence of diabetes is growing, the amount of insulin available to treat diabetes is too low, the prices are too high, so we need to do something,” said Emer Cooke, the head of regulation of medicines and health technologies for the WHO, in a statement.

Insulin is one of the world’s essential medicines. For Type 1 diabetes patients, insulin is a rare example of a medication that’s absolutely necessary to live. Without insulin, sugar in the blood accumulates, which can lead to acute life-threatening complications, such as nerve damage or eye damage and, in the worst case, death.

However, 50% of the estimated 100 million people who are in need of insulin globally do not have reliable access, meaning either they can’t afford insulin or it’s not available. This is according to a 2017 study led by Health Action International, an independent research group.

The price of insulin is especially prohibitive in the developing world, where diabetes is growing rapidly — and governments are struggling to afford the medication to supply hospitals and pharmacies. A 2010 study in Lancet found that 10% of Mozambique’s expenditure on medications was for insulin.

These costs are often passed on to consumers, who also struggle to pay for the treatment. A WHO survey of 24 mostly low- and middle-income countries found that a month’s supply of insulin costs more than a fifth of take-home pay for a worker in Accra, Ghana.

Read the rest of Emily Kwong’s article at NPR