Pharmacist sells insulin at one of the hospitals engaged in
the Base of the Pyramid Project, Nyeri, Kenya.
reaching the base
of the pyramid in Kenya
The Base of the Pyramid project is an initiative by Novo
Nordisk to facilitate access to diabetes care for the
working poor in low- and middle-income countries.
The project was initiated in 2010.
Targeting the working poor
Around a third of the world’s population is lacking regular
access to health care including essential medicines like
insulin1. This is especially an issue in low- and middleincome countries which is home to four out of five people
with diabetes today 2.
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For many years, development aid has focused on
improving access to health care for people living in the
least developed countries. However, over one billion
people globally with low incomes, the working poor, also
have difficulties accessing health services. These people
earn between $1,500 and $3,000 per annum, have some
disposable income, are accessible and could contribute to
financing their own treatment.
1.1 BN
working poor
earning $1,500
to $3,000 / year
Novo Nordisk estimates that 46 million people in this
segment have diabetes and that the number will grow
to 73.5 million in 2030. Together with local health
authorities and other partners, Novo Nordisk has initiated
the Base of the Pyramid project which aims at improving
access to diabetes care and treatment for these people.
Purpose
The purpose of the Base of the Pyramid project is to
create shared value by developing scalable, sustainable
and profitable solutions that increase access to diabetes
care for the working poor as well as provide value to the
business of Novo Nordisk.
Different business models
The Base of the Pyramid project is using different business
models in different countries. The models are adapted to
address local barriers to care and to meet the needs of
people with diabetes at the base of the economic
pyramid.
In Kenya, Novo Nordisk has initiated a public-private
partnership with the Ministry of Health and faith-based
organisations who manage approximately 1000 health
facilities in Kenya. Novo Nordisk has worked with the
faith-based organisations and distributors to limit price
mark-ups and ultimately control the pricing that the
patient has to pay at the pharmacy. A Memorandum of
understanding has been signed with each link in the
distribution chain, and the price of a vial of insulin has
been stamped on the package, making it difficult for
distributors to exceed the target price.
Prior to the initiation of the Base of the Pyramid project in
Kenya, prices were as high as 1800 Kenyan Shillings to the
patient for a vial of insulin. This has now been reduced to
500 Kenyan Shillings. Novo Nordisk has since adapted this
pricing policy throughout the Kenya market, as all
pharmacies are expected to sell insulin to patients at 500
Kenyan Shillings.
The fact that insulin is consistently available, and at an
affordable price, is a novelty in Kenya, but Novo Nordisk’s
Base of the Pyramid efforts in Kenya go far beyond this.
In collaboration with faith-based facilities and Kenya
Defeat Diabetes Association Novo Nordisk has helped
establish 46 new diabetes patient support groups at
faith-based facilities since 2012. The diabetes support
groups serve as psycho-social support for patients, just as
they help generate awareness around diabetes and
treatment options in the community.
Finally, over 600 healthcare professionals have been
educated on basic diabetes care and another 500+
healthcare professionals have been trained in a more
advanced curriculum.
The project was launched in April 2012 by Kenyan Prime
Minister Raila Odinga, Danish Minister for Trade and
Investment Pia Olsen Dyhr and Novo Nordisk CEO Lars
Rebien Sørensen. As a project partner and advisors to
Novo Nordisk, the Danish Embassy played an integral role
in the development of the business model as learnings
from years of development work in the healthcare sector
were applied to make trade and development meet.
Novo Nordisk also operates Base of the Pyramid projects
in Ghana and Nigeria, where 4 Diabetes Support Centres
that offer comprehensive diabetes care under one roof
have been opened in 2013 and 2014 through publicprivate partnerships. Novo Nordisk aims to have a total of
10 centres across the two countries by the end of 2014.
Benefits for people
with diabetes
1
Increased awareness of diabetes
2
S creening and early diagnosis to prevent
complications of diabetes
3
ccess to quality care by healthcare
A
professionals trained in diabetes
management
4
Stable and affordable supply of insulin
5
Improved self-management
through patient education.
In 2014, the project is running in 28 of Kenya’s 47
counties.
Novo Nordisk is the world’s largest producer of generic human insulin. It is both a responsibility and a business
opportunity for Novo Nordisk to support local health authorities in making sure that the insulin reaches the hands of
those who need it globally.
Learn more about our efforts to improve global access to diabetes care at changingdiabetesaccess.com and
novonordisk.com/sustainability/sustainability-approach/access-to-diabetes-care
References:
1: David Beran, Policy Perspective, Access to insulin: what can be done? Diabetes Manage. (2011) 1(1), 67–76, Future Medicine Ltd.:
http://apps.who.int/medicinedocs/documents/s18773en/s18773en.pdf
2: International Diabetes Federation. IDF Diabetes Atlas, sixth edition, 2013.