Insulin Thermostabilty Meeting: Access in Humanitarian Settings

Research event
28 September 2020 — 11:00AM TO 1:45PM

The nature of humanitarian crises is changing with increasingly urbanized displaced populations on the background of a global surge in mortality due to non-communicable diseases. The WHO 2013–20 Global Action Plan for the Prevention and Control of Non-Communicable Diseases reflects the importance of holistic health management in humanitarian settings. Even in the acute phase of a crisis, access to insulin is imperative for patients living with diabetes.

A Lancet series on diabetes care in humanitarian settings describes significant barriers to adequate treatment of diabetes. This is in part due to a lack of information about disease burden and lack of experience in managing the condition; and in part due to challenges with cost, transport and storage of insulin in resource limited settings. The impact of this is felt most keenly by those with insulin-dependent diabetes in whom even short interruptions to supply or fluctuating levels of drug activity can lead to potentially serious consequences, including death.

This conversation remains important at this time. The full impact of COVID on diabetes management in humanitarian settings is yet to be calculated, but the negative impact of COVID on the provision of Universal Health Coverage in fragile settings is keenly felt. Furthermore, diabetes is recognized as a risk factor for severe disease and COVID related mortality.

Insulins come in many different forms with several delivery mechanisms. They have in common the need for a cold chain up to the point of use and then storage at room temperature for relatively short periods of time. In humanitarian settings, there are risks and opportunity costs associated with travelling to collect medications which are exacerbated by providing only short-term supplies. Furthermore, high humidity and ambient temperatures are a challenge for low-tech storage solutions. This creates a tension between the risk of acquiring the medication and the risk of inadequate treatment. Therefore, understanding the thermal properties of insulin is key in informing operational policies.

The Centre on Global Health Security at Chatham House is planning a roundtable meeting focused on maximizing the use of currently available resources for the treatment of diabetes in humanitarian settings. The primary aims of this meeting are to bring together pharmaceutical companies, civil society organizations and leading academics to evaluate the available information and discuss how this can be shared and translated into changes in working practices.


  1. Discuss sources of information about insulin thermal stability and specify information gaps
  2. Identify strategies to facilitate sharing this information
  3. Establish a process whereby this information will be used to inform changes in operational policies

Proposed discussion topics

  • Currently available sources of information about biological potency of insulin following storage at different temperatures over time
  • The argument for transparent sharing of this information
  • Barriers to information sharing.
  • The need for international collective action to translate information to policy.
  • Barriers and facilitators to making changes to guidelines.
  • Optimal directions for future policy development


Chair: Robert Yates, Director, Global Health Programme; Executive Director, Centre for Universal Health, Chatham House

Co-Chair: Dr Farah Kidy, Consultant, Chatham House; NIHR Doctoral Fellow in Public Health; GP, Warwick Medical School, Division of Health Sciences

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