Who can afford a human right? Access to insulin at the intersection of pharmaceutical market, global inequalities and the right to health

Abstract

Insulin is an essential medicine, but access to it remains deeply unequal across the world. This thesis investigates why a treatment that is indispensable for millions of people living with diabetes continues to be economically inaccessible in many contexts, despite its global health significance and its recognition as a component of the right to health. The research analyses the structure of the global insulin market dominated by a small number of actors and links this structure to differences in price and affordability between high-income countries and low- and middle-income countries. On this basis, the thesis assesses the compatibility of these inequalities with the normative content of the right to health, in particular with the requirement of economic accessibility outlined in General Comment No. 14 of the Committee on Economic, Social and Cultural Rights. Through the case of insulin, the thesis combines perspectives from international human rights law, political economy and global health, demonstrating how the effective enjoyment of the right to health depends not only on its legal recognition, but also on the economic conditions that make its realisation possible.