| Dokumendiregister | Sotsiaalministeerium |
| Viit | 1.4-2/2332-1 |
| Registreeritud | 16.09.2025 |
| Sünkroonitud | 17.09.2025 |
| Liik | Sissetulev kiri |
| Funktsioon | 1.4 EL otsustusprotsess ja rahvusvaheline koostöö |
| Sari | 1.4-2 Rahvusvahelise koostöö korraldamisega seotud kirjavahetus (Arhiiviväärtuslik) |
| Toimik | 1.4-2/2025 |
| Juurdepääsupiirang | Avalik |
| Juurdepääsupiirang | |
| Adressaat | WHO Regional Office for Europe |
| Saabumis/saatmisviis | WHO Regional Office for Europe |
| Vastutaja | Helen Sõber (Sotsiaalministeerium, Kantsleri vastutusvaldkond, Euroopa Liidu ja väliskoostöö osakond) |
| Originaal | Ava uues aknas |
Tähelepanu! Tegemist on välisvõrgust saabunud kirjaga. |
We sincerely apologize for the late notice.
Please see the attached correspondence sent from the World Health Organization, Regional Office for Europe. One or more attachments may be included.
The survey is available for completion at the following link: WHO Survey on the Security of Insulin Supply . (https://survey123.arcgis.com/share/4a04c7438e304dd1abf52a5258c361d0) .
Мы искренне извиняемся за позднее уведомление.
См. прикрепленное письмо от Европейского регионального бюро Всемирной организации здравоохранения (один или несколько прикрепленных файлов).
Опрос доступен для заполнения по следующей ссылке: WHO Survey on the Security of Insulin Supply . (https://survey123.arcgis.com/share/4a04c7438e304dd1abf52a5258c361d0) .
Best regards,
Access to Medicines and Health Products (AMP)
WHO Regional Office for Europe
Copenhagen, Denmark
UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Denmark
Fax: +45 45 33 70 01 Website: https://www.who.int/europe
WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ
WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ
Date: 08 September 2025 Ms Helen Sõber Adviser European Union Affairs and International Co- operation Department Ministry of Social Affairs Suur-Ameerika 1 10122 Tallinn Estonia
REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L’EUROPE
REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО
Head office:
UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark
Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected]
Website: https://www.who.int/europe
Our reference: Notre référence: Unser Zeichen: См. наш номер:
Your reference: Votre référence: Ihr Zeichen: На Ваш номер:
Dear Ms Sõber,
Global survey to collect current information on security of insulin supply
The World Health Organization's (WHO) Department of Noncommunicable Diseases and Mental Health (NMH), in collaboration with the Department of Policy and Standards for Medicines and Health Products (HPS), is currently conducting a crucial global survey to assess the extent of insulin shortages. This initiative is vital for identifying access challenges and preventing the potential discontinuation of human insulin formulations worldwide. We are reaching out to request your assistance in facilitating the completion of this important survey. We kindly ask you to nominate and share the online survey link with the most relevant national or sub-national focal points in your country. These individuals should be responsible for either pharmaceutical procurement or noncommunicable disease (NCD) health programs. The ideal respondents include Ministry of Health officials, national NCD program managers, procurement specialists, pharmacists, or other personnel with data on annual procurement volumes and national shortage mitigation strategies. A summary of the survey questions is attached to this letter to help you identify the most suitable person to complete the online questionnaire. The survey is available for completion at the following link: WHO Survey on the Security of Insulin Supply . (https://survey123.arcgis.com/share/4a04c7438e304dd1abf52a5258c361d0) . We would greatly appreciate it if the survey could be completed by 21 September 2025. Should you or your nominated focal point have any technical questions regarding the questionnaire, please direct them to [email protected] with a copy to Mr. Bashier Enoos ([email protected]) and Ms. Swathi Iyengar ([email protected]).
– 2 –
Thank you for your continuous support and collaboration. Your participation is essential to this global effort. Sincerely yours, Natasha Azzopardi Muscat Director Division of Health Systems WHO Regional Office for Europe Copy for information to: Ms Agne Nettan-Sepp, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1, 10129 Tallinn, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A, CH-1209 Genève, Switzerland H.E. Mr Andre Pung, Ambassador Extraordinary and Plenipotentiary, Embassy of the Republic of Estonia, Frederiksgade 19, 4th floor, 1265 Copenhagen K, Denmark Ms Kristina Köhler, Liaison Officer, WHO Country Office, Estonia, Paldiski Road 81, 10617 Tallinn, Estonia
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 1
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
Context: WHO previously shared a web link to complete the WHO Survey on the Security of Insulin Supply. Some users have
requested the ability to collect and submit data ‘offline’. While we cannot provide a paper version of the survey, users may refer
to the summary of questions to facilitate data gathering efforts (Annex). Additionally, users may use the smart phone version of
Survey123 to input data over time, save drafts, and submit responses via the mobile application.
Please note that because the survey is public, responses are not synced between the browser version of the survey and the
mobile version of the survey, so we recommend choosing one method of submission. Instructions to access the WHO Survey on
the Security of Insulin Supply on the Survey123 app for Apple iOS- and Android-based mobile phones or Windows-based laptops
are below:
Instructions: Get Started with Survey123 1. Download the App, “Survey123 for ArcGIS” for your smart phone using the App store, Google Play or the Windows App
Store
2. Click “Continue without signing in”
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 2
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
3. To access survey:
a. If using your smart phone, click the QR code button next to the search bar and scan the following QR code:
b. Alternatively, if you are using the Windows desktop version of Survey123 OR if you prefer a direct link on your
smart phone, click the following link https://arcg.is/8PC5a and select “Open in the Survey123 field app”
4. You will be taken to Survey Form. If you would like to leave the survey to complete later:
a. Click the X on the top left corner and select “Save in Drafts.”
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 3
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
b. To return to the survey form and complete submission:
5. You may collect data regardless of your connection to the internet.
a. If you are collecting data offline, use the following steps:
Screen 4. Click Save in Outbox
to save your completed survey. You will then be returned to your home screen
Screen 7. In the Outbox, click Send to upload your completed survey data.
Screen 6. When you are back in Wi-Fi range and would like to submit your survey(s), click Outbox.
Remember to submit any pending surveys
when you reconnect to the internet.
Screen 5. Click the WHO-Insulin supply survey icon to access the survey.
Screen 1. Click on the WHO-
Insulin supply survey icon in your “My Surveys” home screen
Screen 2. Click Drafts Screen 3. Click the survey draft you would
like to complete
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 4
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
b. If you have internet or data connectivity while completing the survey, use the following steps:
For any additional questions, please email [email protected]
Screen 8. Click Send Now to upload your survey.
WHO Survey on Security of Insulin Supply
Summary for Regional Office Colleagues Deadline: 30 August 2025
Departments: NMH & HPS, WHO Headquarters
Survey Format and Survey Type: Interactive online questionnaire (ArcGIS Survey123 platform)
Estimated Time: 45minutes with data collection requiring detailed procurement information for insulin
Key Requirement: Access to annual procurement volumes and shortage information for approximately
May 2023-2025
Background Context The number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022, with
prevalence increasing more rapidly in LMICs. More than half of people with diabetes did not take
medication for their condition.
WHO's report "Keeping the 100-year-old promise – making insulin access universal" identified key barriers
to insulin availability:
• Global market shift from human insulin to higher-priced insulin analogues, disrupting overall
supply
• Suboptimal regulation and pricing policies
• Weak procurement and supply chain management
• Insufficient financing, health system capacity, and infrastructure
Current challenges are intensifying due to recent discontinuation of certain insulin types and delivery
methods, potentially limiting patient choice and deepening health inequities. The situation is complicated
by growing demand for GLP-1RAs and increasing preference for pen devices.
Survey Background & Objectives
Insulin access and supply challenges persist in many low- and middle-income countries (LMICs). The
recent discontinuation of human insulin formulations has exacerbated these challenges, potentially limiting
patient choice and deepening health inequities. WHO is conducting this survey to assess the scale of global
shortages and current supply needs. All information will be treated confidentially and used to:
1. Map Shortage Patterns: Analyze frequency, duration, and types of insulin shortages globally
2. Identify Access Barriers: Pinpoint key obstacles hindering stable supply
3. Guide Policy and Action: Develop evidence-based recommendations for national governments
and global stakeholders
4. Assess the Supply Landscape: Understand current procurement practices and manufacturer roles
in meeting national needs
Target Respondents
Ministry of Health Officials, National NCD Program Managers, Procurement Specialists, or Pharmacists
with access to:
• Annual procurement volume data for insulin
• Shortage mitigation strategies
• Pharmaceutical procurement oversight and understanding of insulin requirements
Survey Structure & Data Requirements
Section 1: Basic Information
• Country identification and respondent role
Section 2: Insulin Procurement Assessment
Data Required:
• Annual procurement volumes (in International Units) for all insulin types:
o Human insulin (NPH, Regular, Premixed 30/70)
o Analogue insulin (Basal: Glargine, Detemir, Degludec; Bolus: Aspart, Lispro, Glulisine)
o Premixed analogues
• Procurement status for each formulation (10ml vials, 3ml cartridges, 3ml pens)
• Assessment of procurement adequacy vs. patient needs
Section 3: Shortages (May 2023-2025)
Data Required:
• Specific insulin types experiencing shortages
• Duration and mitigation measures
• Delivery mechanism shortages
Section 4: Access Barrier Analysis (Optional)
Rating of key factors affecting supply:
• Pricing barriers, supply chain weaknesses, financing limitations
• Infrastructure constraints, manufacturing discontinuations
• Market dynamics, procurement inefficiencies, manufacturer engagement
Section 5: Policy (Optional)
Data Required:
• National diabetes guidelines/policies status
• Insulin procurement guidance
• Current supply stabilization measures
• Recommendations for global supply improvement
Recommended Focal Points
Primary: National NCD Program Manager or Senior Procurement Specialist with:
• Direct access to insulin procurement databases and volume records
• Knowledge of shortage events and responses (May 2023-2025)
• Strategic oversight of diabetes supply chains
Secondary: Ministry of Health Officials with diabetes program oversight
Essential: Must have access to annual procurement volume data and shortage documentation.
Regional Office Action Required
Identify national focal points with:
1. Access to insulin procurement data and volume records
2. Knowledge of shortage events (May 2023-2025)
3. Understanding of national diabetes policies
4. Authority for official country responses
Technical Support
• Primary: [email protected]
• Copy: Mr Bashier Enoos ([email protected]), Ms Swathi Iyengar ([email protected])
UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Denmark
Fax: +45 45 33 70 01 Website: https://www.who.int/europe
WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ
WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ
Date: 08 September 2025 Ms Helen Sõber Adviser European Union Affairs and International Co- operation Department Ministry of Social Affairs Suur-Ameerika 1 10122 Tallinn Estonia
REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L’EUROPE
REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО
Head office:
UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark
Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected]
Website: https://www.who.int/europe
Our reference: Notre référence: Unser Zeichen: См. наш номер:
Your reference: Votre référence: Ihr Zeichen: На Ваш номер:
Dear Ms Sõber,
Global survey to collect current information on security of insulin supply
The World Health Organization's (WHO) Department of Noncommunicable Diseases and Mental Health (NMH), in collaboration with the Department of Policy and Standards for Medicines and Health Products (HPS), is currently conducting a crucial global survey to assess the extent of insulin shortages. This initiative is vital for identifying access challenges and preventing the potential discontinuation of human insulin formulations worldwide. We are reaching out to request your assistance in facilitating the completion of this important survey. We kindly ask you to nominate and share the online survey link with the most relevant national or sub-national focal points in your country. These individuals should be responsible for either pharmaceutical procurement or noncommunicable disease (NCD) health programs. The ideal respondents include Ministry of Health officials, national NCD program managers, procurement specialists, pharmacists, or other personnel with data on annual procurement volumes and national shortage mitigation strategies. A summary of the survey questions is attached to this letter to help you identify the most suitable person to complete the online questionnaire. The survey is available for completion at the following link: WHO Survey on the Security of Insulin Supply . (https://survey123.arcgis.com/share/4a04c7438e304dd1abf52a5258c361d0) . We would greatly appreciate it if the survey could be completed by 21 September 2025. Should you or your nominated focal point have any technical questions regarding the questionnaire, please direct them to [email protected] with a copy to Mr. Bashier Enoos ([email protected]) and Ms. Swathi Iyengar ([email protected]).
– 2 –
Thank you for your continuous support and collaboration. Your participation is essential to this global effort. Sincerely yours, Natasha Azzopardi Muscat Director Division of Health Systems WHO Regional Office for Europe Copy for information to: Ms Agne Nettan-Sepp, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1, 10129 Tallinn, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A, CH-1209 Genève, Switzerland H.E. Mr Andre Pung, Ambassador Extraordinary and Plenipotentiary, Embassy of the Republic of Estonia, Frederiksgade 19, 4th floor, 1265 Copenhagen K, Denmark Ms Kristina Köhler, Liaison Officer, WHO Country Office, Estonia, Paldiski Road 81, 10617 Tallinn, Estonia
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 1
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
Context: WHO previously shared a web link to complete the WHO Survey on the Security of Insulin Supply. Some users have
requested the ability to collect and submit data ‘offline’. While we cannot provide a paper version of the survey, users may refer
to the summary of questions to facilitate data gathering efforts (Annex). Additionally, users may use the smart phone version of
Survey123 to input data over time, save drafts, and submit responses via the mobile application.
Please note that because the survey is public, responses are not synced between the browser version of the survey and the
mobile version of the survey, so we recommend choosing one method of submission. Instructions to access the WHO Survey on
the Security of Insulin Supply on the Survey123 app for Apple iOS- and Android-based mobile phones or Windows-based laptops
are below:
Instructions: Get Started with Survey123 1. Download the App, “Survey123 for ArcGIS” for your smart phone using the App store, Google Play or the Windows App
Store
2. Click “Continue without signing in”
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 2
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
3. To access survey:
a. If using your smart phone, click the QR code button next to the search bar and scan the following QR code:
b. Alternatively, if you are using the Windows desktop version of Survey123 OR if you prefer a direct link on your
smart phone, click the following link https://arcg.is/8PC5a and select “Open in the Survey123 field app”
4. You will be taken to Survey Form. If you would like to leave the survey to complete later:
a. Click the X on the top left corner and select “Save in Drafts.”
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 3
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
b. To return to the survey form and complete submission:
5. You may collect data regardless of your connection to the internet.
a. If you are collecting data offline, use the following steps:
Screen 4. Click Save in Outbox
to save your completed survey. You will then be returned to your home screen
Screen 7. In the Outbox, click Send to upload your completed survey data.
Screen 6. When you are back in Wi-Fi range and would like to submit your survey(s), click Outbox.
Remember to submit any pending surveys
when you reconnect to the internet.
Screen 5. Click the WHO-Insulin supply survey icon to access the survey.
Screen 1. Click on the WHO-
Insulin supply survey icon in your “My Surveys” home screen
Screen 2. Click Drafts Screen 3. Click the survey draft you would
like to complete
WHO Global Survey on the Security of Insulin Supply: Additional Survey Access Options Quick Guide 4
Additional Survey Access Options
Quick Guide
WHO Global Survey on the
Security of Insulin Supply
b. If you have internet or data connectivity while completing the survey, use the following steps:
For any additional questions, please email [email protected]
Screen 8. Click Send Now to upload your survey.
WHO Survey on Security of Insulin Supply
Summary for Regional Office Colleagues Deadline: 30 August 2025
Departments: NMH & HPS, WHO Headquarters
Survey Format and Survey Type: Interactive online questionnaire (ArcGIS Survey123 platform)
Estimated Time: 45minutes with data collection requiring detailed procurement information for insulin
Key Requirement: Access to annual procurement volumes and shortage information for approximately
May 2023-2025
Background Context The number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022, with
prevalence increasing more rapidly in LMICs. More than half of people with diabetes did not take
medication for their condition.
WHO's report "Keeping the 100-year-old promise – making insulin access universal" identified key barriers
to insulin availability:
• Global market shift from human insulin to higher-priced insulin analogues, disrupting overall
supply
• Suboptimal regulation and pricing policies
• Weak procurement and supply chain management
• Insufficient financing, health system capacity, and infrastructure
Current challenges are intensifying due to recent discontinuation of certain insulin types and delivery
methods, potentially limiting patient choice and deepening health inequities. The situation is complicated
by growing demand for GLP-1RAs and increasing preference for pen devices.
Survey Background & Objectives
Insulin access and supply challenges persist in many low- and middle-income countries (LMICs). The
recent discontinuation of human insulin formulations has exacerbated these challenges, potentially limiting
patient choice and deepening health inequities. WHO is conducting this survey to assess the scale of global
shortages and current supply needs. All information will be treated confidentially and used to:
1. Map Shortage Patterns: Analyze frequency, duration, and types of insulin shortages globally
2. Identify Access Barriers: Pinpoint key obstacles hindering stable supply
3. Guide Policy and Action: Develop evidence-based recommendations for national governments
and global stakeholders
4. Assess the Supply Landscape: Understand current procurement practices and manufacturer roles
in meeting national needs
Target Respondents
Ministry of Health Officials, National NCD Program Managers, Procurement Specialists, or Pharmacists
with access to:
• Annual procurement volume data for insulin
• Shortage mitigation strategies
• Pharmaceutical procurement oversight and understanding of insulin requirements
Survey Structure & Data Requirements
Section 1: Basic Information
• Country identification and respondent role
Section 2: Insulin Procurement Assessment
Data Required:
• Annual procurement volumes (in International Units) for all insulin types:
o Human insulin (NPH, Regular, Premixed 30/70)
o Analogue insulin (Basal: Glargine, Detemir, Degludec; Bolus: Aspart, Lispro, Glulisine)
o Premixed analogues
• Procurement status for each formulation (10ml vials, 3ml cartridges, 3ml pens)
• Assessment of procurement adequacy vs. patient needs
Section 3: Shortages (May 2023-2025)
Data Required:
• Specific insulin types experiencing shortages
• Duration and mitigation measures
• Delivery mechanism shortages
Section 4: Access Barrier Analysis (Optional)
Rating of key factors affecting supply:
• Pricing barriers, supply chain weaknesses, financing limitations
• Infrastructure constraints, manufacturing discontinuations
• Market dynamics, procurement inefficiencies, manufacturer engagement
Section 5: Policy (Optional)
Data Required:
• National diabetes guidelines/policies status
• Insulin procurement guidance
• Current supply stabilization measures
• Recommendations for global supply improvement
Recommended Focal Points
Primary: National NCD Program Manager or Senior Procurement Specialist with:
• Direct access to insulin procurement databases and volume records
• Knowledge of shortage events and responses (May 2023-2025)
• Strategic oversight of diabetes supply chains
Secondary: Ministry of Health Officials with diabetes program oversight
Essential: Must have access to annual procurement volume data and shortage documentation.
Regional Office Action Required
Identify national focal points with:
1. Access to insulin procurement data and volume records
2. Knowledge of shortage events (May 2023-2025)
3. Understanding of national diabetes policies
4. Authority for official country responses
Technical Support
• Primary: [email protected]
• Copy: Mr Bashier Enoos ([email protected]), Ms Swathi Iyengar ([email protected])