From dependency to leadership: Bangladesh’s success story in local insulin manufacturing

In 1921, Canadian researchers Frederick Banting and Charles Best discovered insulin and it transformed the medicine sector forever. Diabetes transformed from a rapidly fatal illness into a chronic but manageable condition. 

Before this breakthrough, patients with type-1 diabetes often survived only a few months after diagnosis, with treatment limited to strict starvation diets that offered only brief extensions of life. 

Soon after the discovery, multinational pharmaceutical companies began mass-producing insulin. This industrial-scale production made the medicine accessible to millions of patients worldwide. Over the decades, advancements improved its safety, purity, and delivery—from crude extracts to recombinant DNA-derived human insulin, and later to more sophisticated insulin analogues that more closely mimicked natural insulin profiles.

However, while this progress was groundbreaking, it came at a cost.

In developed countries, insulin remains an expensive therapy. The annual cost of treatment for a single patient in some Western nations can reach several thousand dollars, especially for newer analogues. While insurance coverage helps many patients in high-income countries manage these expenses, the situation is starkly different in lower- and middle-income nations, where the high cost of insulin continues to be a persistent barrier to consistent treatment.

For decades, Bangladesh relied heavily on multinational companies for its insulin supply. This dependency created multiple challenges: imported products were costly compared to local income levels, and patients often had to choose between affordability and continuity of treatment.

The distribution system, dependent on imports, was vulnerable to supply chain disruptions that occasionally caused stockouts of critical formulations. Cold-chain maintenance posed another challenge, since insulin must be stored and transported under strict temperature conditions. Together, these barriers meant that while insulin was technically available, it was not always accessible to those who needed it most.

The need for insulin in Bangladesh cannot be overstated. Bangladesh has one of the highest rates of diabetes in South Asia, and the number of people needing lifelong insulin is steadily increasing. 

The International Diabetes Federation (IDF) has consistently highlighted alarming increases in prevalence across the region, driven by urbanisation, lifestyle changes, and genetic predisposition. For millions of patients, insulin is not optional—it is a matter of survival. Ensuring uninterrupted access has therefore become a national priority.

The success of insulin manufacturing in Bangladesh is more than a healthcare milestone; it is a testament to resilience, innovation, and vision. Today, Bangladesh not only meets its own needs but also demonstrates the potential to serve the global community. What began as a struggle to ensure survival for diabetic patients has evolved into a narrative of leadership.

Recognising this urgent need, local pharmaceutical companies eventually started producing insulin within Bangladesh. This milestone marked a turning point in the nation's medical history. By manufacturing insulin domestically, Bangladesh reduced its reliance on multinational corporations and made treatment significantly more affordable for patients. 

At first, switching to locally made insulin was challenging. People worried about its quality and reliability, and doctors and patients were hesitant to try it. Transport and storage also needed improvements to keep the insulin effective. Over time, however, local insulin earned trust, delivering similar results while being much more affordable.

Today, a wide variety of insulin types are available in Bangladesh, including short-acting human insulin, intermediate-acting formulations, premixed combinations, and advanced insulin analogues that more closely replicate natural physiological release patterns. This diversity allows treatment to be tailored to patients' needs, lifestyles, and economic capacity. What was once a privilege confined to affluent nations is now accessible to the Bangladeshi population, thanks to local initiative.

While insulin remains central to diabetes care, the global landscape of metabolic disease treatment is undergoing a new revolution—one that Bangladesh is well positioned to embrace. 

In recent years, the world has seen the emergence of novel anti-obesity and anti-diabetic drugs, most notably glucagon-like peptide-1 (GLP-1) receptor agonists and dual agonists such as semaglutide and tirzepatide. These medicines have attracted extraordinary global attention, not only for their ability to control blood glucose but also for their remarkable effects on weight reduction.

For decades, the medical community has struggled to find effective therapies for obesity, a condition closely linked to diabetes and cardiovascular disease. The arrival of these new agents offers hope that obesity can finally be addressed at its biological roots, rather than solely through lifestyle interventions. Clinical trials have demonstrated significant weight loss, improvements in glycaemic control, and reductions in cardiovascular risk factors, driving a surge in global demand. 

Like insulin, these new medicines are very expensive in developed countries. Monthly costs are often too high for most patients without insurance coverage, creating inequality: wealthy people can access them, while millions in poorer countries cannot.

Bangladesh has already begun to chart a different path. By producing advanced anti-diabetic and anti-obesity drugs locally, the country is once again ensuring that revolutionary therapies are not confined to the elite few but are accessible to the wider population. 

This development mirrors the earlier journey with insulin: what began as dependency on imports has transformed into self-reliance and affordability. For patients in Bangladesh, the availability of locally produced semaglutide-like or tirzepatide-like medications represents not only improved health outcomes but also greater social equity in healthcare.

The impact goes beyond the border. The country is now in a strong position to supply affordable, high-quality medicines for metabolic diseases worldwide. By using its pharmaceutical expertise, Bangladesh can help reduce global gaps and ensure access to life-saving treatments, benefiting countries across Asia, Africa, and beyond.

The success of insulin manufacturing in Bangladesh is more than a healthcare milestone; it is a testament to resilience, innovation, and vision. Today, Bangladesh not only meets its own needs but also demonstrates the potential to serve the global community. What began as a struggle to ensure survival for diabetic patients has evolved into a narrative of leadership.

Sketch: TBS

Dr M A Samad is the Chief Executive Officer and Consultant Endocrinologist at National Healthcare Network.

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views and opinions of The Business Standard.