Reaching the base of the pyramid

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.

Around a half of the world’s population lacks access to essential health services including essential medicines like insulin.1,2 This is especially an issue in low- and middle income countries which also is home to eighty percent of people living with diabetes today.2?However, diabetes and other non-communicable diseases continue to be under prioritised in development assistance for health (DAH).3

The Base of the Pyramid project?targets?the more than one billion people globally with low incomes, the working poor, who have difficulties accessing health services.4?These people have some disposable income and could contribute to financing their own treatment.

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 living in low- and middle-income countries as well as provide value to the business of Novo Nordisk.?

The BoP project works to ensure:

  • Increased awareness of diabetes
  • Early diagnosis of diabetes
  • Access to quality care by trained health care professionals?
  • Stable and affordable supply of insulin
  • Improved self-management through patient education

The project was?initiated in 2010

Geographical reach: Ghana, Kenya, Nigeria and Senegal

Partners: Primarily local health authorities and health care organisations


Patients reached in 2018

  • Kenya:19,500
  • Nigeria: 5,000
  • Ghana: 5,564
  • Senegal: 1,200


See programme overview & results (Aug 2016)


Improving access in Kenya

Four out of five people with diabetes live in low and middle income countries.5?In Kenya, the Base of the Pyramid project is identifying cross-sector collaboration to ensure good diabetes care for the thousands of people with diabetes in the country.

The diabetes epidemic is a global emergency in slow motion, where low and middle income countries carry the largest burden. This film zooms in on challenges and progress made in Kenya to improve access to diabetes care.


Learn more

Impact report

Impact report?by UCL on the Base of the Pyramid programme in Kenya.

Download the report (PDF)

How to improve access
to NCD care

A public-private partnership has significantly improved supply of insulin in Kenya and established a price ceiling.

Feature article: How to improve access to NCD care



ASHA - Rural India

BoP in Kenya

Comfort and the empty shop - Ghana?

Launch of two new clinics in Ghana?

Kenya - A new era of diabetes care

A new business model to make insulin more accessible - Kenya



1. Tracking universal health coverage: 2017 global monitoring report. World Health Organization and International Bank for Reconstruction and Development / The World Bank; 2017. Licence: CC BY-NC-SA 3.0 IGO.

2. International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation, 2017.

3. IHME. Financing Global Health 2015: Development assistance steady on the path to new Global Goals. Seattle, WA: Institute for Health Metrics and Evaluation (IHME). 2016.

4.?The World Bank. Ending poverty and sharing prosperity: global monitoring report 2014/2015. Washington, DC: The World Bank, 2015.

5. International Diabetes Federation. IDF Diabetes Atlas, 8 ed. Brussels, Belgium: International Diabetes Federation;2017.