The Global Diabetes and Obesity Treatment Gap: A Pressing Health Equity Issue
Globally, diabetes and obesity have become major public health challenges affecting more than a billion people. However, there is a huge gap in access to innovative medicines between countries of different income levels. According to statistics, currently for every 4 patients in high-income countries who can access Lilly's innovative diabetes and obesity medicines, only 1 person in low- and middle-income countries (LMICs) can receive equivalent treatment. More alarmingly, 4 in 5 adults with diabetes and 7 in 10 adults with obesity live in LMICs, and prevalence continues to rise.
Lilly Launches the Change the Course Commitment: Aiming for Treatment Parity by 2040
Facing this stark reality, Eli Lilly and Company officially launched the Lilly Change the Course Commitment on September 28, 2026. This is a new global health initiative with a simple yet ambitious goal: to treat as many people in resource-limited settings, including LMICs, with Lilly's innovative diabetes and obesity medicines as in high-income countries before 2040.
This commitment follows the completion of the Lilly 30x30 global health initiative, which was originally set to help 30 million people annually by 2030 but actually helped 40 million people in resource-limited settings access quality healthcare in 2025 — five years ahead of schedule.
Why Launch a New Commitment Now?
Historically, people in resource-limited settings have waited decades to access innovative medicines, long after their availability in high-income countries. As a result, therapies capable of changing the trajectory of diabetes and obesity are still not reaching the people who need them most. As a medicine company with over a century of diabetes care experience, Lilly aims to ensure that access to medicines keeps pace with scientific innovation.
David A. Ricks, Lilly chair and CEO, said: "For 150 years, Lilly has addressed some of humanity's most pressing health challenges by turning science into medicines that improve lives. Innovation only matters when it reaches the people who need it. That is why, with the Lilly Change the Course Commitment, we aim to treat as many people in resource-limited settings as we do in high-income countries with our diabetes and obesity medicines. Innovative medicines like Foundayo (orforglipron), an oral treatment that can be stored at room temperature, will help us distribute and scale access across more LMICs."
How Will Lilly Close the Gap? Three Pillars
Barriers in resource-limited settings extend beyond the availability of treatment and include fragmented health systems, limited healthcare infrastructure and persistent access gaps. To address them, the Lilly Change the Course Commitment is organized around three focus areas:
- Developing medicines for people who need them: Lilly is working to ensure its diabetes and obesity medicines are suitable for people living in resource-limited settings from the earliest stages of clinical development, focusing on clinical trials, medical presentations and cold chain storage.
- Registering and expanding access to medicines to reach people sooner: Lilly intends to register its innovative diabetes and obesity medicines, including GLP-1s, in more low- and middle-income countries, working with regulatory agencies and local health systems to expand access sooner, with a focus on Africa, Latin America and Asia.
- Helping strengthen health systems: Lilly aims to collaborate with global health organizations to help strengthen primary health systems by training community health workers, leveraging technology and digital tools, and improving disease awareness, prevention, diagnosis, and care in resource-limited settings.
Together, these efforts aim to help more people extend their lifespan and enhance their quality of life by managing their diabetes and obesity earlier, reducing long-term complications, and, over time, preventing new cases of diabetes and obesity.
About Foundayo™ (orforglipron)
Foundayo™ (orforglipron) is a once-daily small molecule (non-peptide) oral glucagon-like peptide-1 receptor agonist that can be taken any time of the day with no planning around food or drink. It is FDA-approved for adults with obesity, or some adults with overweight who also have weight-related medical problems, to reduce excess body weight and maintain weight reduction long term, alongside a reduced-calorie diet and increased physical activity. In addition to chronic weight management, orforglipron is being studied as a potential treatment for type 2 diabetes, obstructive sleep apnea, osteoarthritis knee pain, hypertension, peripheral artery disease and stress urinary incontinence.
Indication and Safety Summary with Warnings
Foundayo™ may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. If you have any of these symptoms, tell your healthcare provider. Do not use Foundayo if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC). Foundayo should not be used with other GLP-1 receptor agonist medicines. It is not known if Foundayo is safe and effective for use in children.
How Will Lilly Measure and Report Progress?
Lilly will report progress in treatment reach against the Lilly Change the Course Commitment through its annual Sustainability Report and at key global health forums.
For users who want to track their own diabetes and obesity management metrics, the Xiaoshu Health App can sync with Apple Health to track relevant indicators, helping you better record and monitor blood glucose, weight, and other health data, combined with professional medical advice for more effective chronic disease management.