Bibliographic record
Abstract
Biotechnology has had a dramatic impact on how insulin is manufactured, and how much it costs to produce it. This paper examines the political, economic and social impact of biotechnology on the global insulin market. It provides an assessment of claims made by manufacturers since the early 1980s that insulin produced using recombinant DNA technology would enhance affordability, safety, effectiveness, and access to this vital medicine. This study utilises primary and secondary sources, historical and current, over the period 1921 to 2024 including academic and medical journals, archival databases, legal opinions, government reports, newspaper and magazine articles and books, and personal files. The study finds that biotechnology has failed on each of the counts claimed by the manufacturers, ie, affordability, safety, effectiveness, and access. Instead, it has transformed the global insulin market, leading to a collapse of domestic manufacturing in many countries and the emergence of a powerful oligopoly composed of three corporations: Novo Nordisk, Eli Lilly, and Sanofi. This has jeopardised the welfare of those who need secure access to safe and affordable insulin, particularly - but not only - those in low- and middle-income countries. A growing movement of diabetes activists around the globe is demanding changes to the global insulin market and to government policies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".