Lilly Change the Course for Diabetes and Obesity in LMICs

On September 28, 2026, Eli Lilly and Company launched the Lilly Change the Course Commitment. The global health initiative sets one target: treating as many people with diabetes and obesity in resource-limited settings as in high-income countries by 2040.

The Indianapolis company (NYSE: LLY) states that the commitment covers clinical development, registration, and health system support. It follows the end of Lilly 30×30, an earlier program that reached 40 million people in resource-limited settings in 2025, five years ahead of the original goal of 30 million people a year by 2030.

What parity means in practice

Lilly measures success by parity in the number of patients treated. Today, for every four people in high-income countries who can access the company’s diabetes and obesity medicines, one person in a low- or middle-income country can do the same. The goal is to close that gap before 2040, with updates in the company’s annual Sustainability Report and at global health forums.

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The World Bank sets the income bands behind the low- and middle-income grouping by gross national income per capita: low-income economies at $1,175 or less, lower-middle-income from $1,176 to $4,635, upper-middle-income from $4,636 to $14,375, and high-income above $14,375.

Adults with diabetes and obesity in resource-limited settings have waited decades for medicines already standard elsewhere. The announcement makes no mention of a price mechanism. No price, license, or tiered-pricing schedule accompanies the target, and no external body will audit the patient count. Regulators, health technology assessment committees, national payers, and procurement agencies will continue to decide whether GLP-1 receptor agonists enter formularies or tenders.

Lilly Change the Course: three pillars

The program rests on three areas of work.

The first covers development. Lilly says its diabetes and obesity medicines should fit people in resource-limited settings from the start of clinical research. That includes trial populations, product presentation, and cold chain requirements.

The second focuses on registration. The company plans to file its diabetes and obesity medicines, including GLP-1s, in more low- and middle-income countries and to work with regulators and local health systems to shorten approval times. Africa, Latin America, and Asia are the stated priorities.

The third addresses health system support. Lilly intends to partner with global health organizations on primary care, community health worker training, digital tools, and earlier awareness, prevention, diagnosis, and treatment of both conditions.

Why the access gap has persisted

Four in five adults with diabetes live in low- and middle-income countries, and seven in ten adults with obesity do as well. Prevalence continues to rise in those markets. Patients there have historically waited decades for new medicines after their introduction in high-income countries. Fragmented health systems, limited infrastructure, and access barriers compound the question of whether a product reaches the market at all.

The economic burden of obesity in Europe now reaches as much as 1.4% of GDP. The cost curve has moved obesity higher on policy agendas even in countries that can afford the medicines yet still face the downstream expenses.

Ricks on innovation and reach

David A. Ricks, Lilly chair and CEO, linked the target to the company’s 150-year history.

“For 150 years, Lilly has addressed some of humanity’s most pressing health challenges by turning science into medicines that improve lives. That same commitment to scientific progress has transformed how we understand and treat diabetes and obesity, conditions that affect more than a billion people worldwide. But innovation only matters when it reaches the people who need it. That is why, as a medicine company that puts health above all, we are now going further. 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.”

Foundayo (orforglipron) and the room-temperature argument

Ricks singled out Foundayo (orforglipron) as the medicine best suited to wider distribution. Foundayo is FDA-approved for adults with obesity, or some adults with overweight who also have a weight-related medical problem, to reduce excess body weight and maintain weight loss with a reduced-calorie diet and increased physical activity. It is a once-daily small molecule rather than a peptide and can be taken at any time of day without regard to food or drink. Orforglipron was discovered by Chugai Pharmaceutical Co., Ltd. and licensed by Lilly in 2018. Lilly is also studying it in type 2 diabetes, obstructive sleep apnea, osteoarthritis knee pain, hypertension, peripheral artery disease, and stress urinary incontinence. The tablets are available in 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and 17.2 mg strengths.

Room-temperature storage removes one practical barrier to GLP-1 distribution in markets with unreliable cold chains. The regulatory path outside the United States has already begun: the MHRA authorized orforglipron as the first oral GLP-1 tablet in Europe, a step Syenza News reported in August 2026.

What the commitment means for payers and HTA bodies

For health economists, the announcement leaves open how parity will be reached. Parity in patients treated could come from volume growth in countries that already reimburse these medicines or from new registrations in markets that cannot pay today, yet the commitment does not specify the expected path. Sustainable pricing in diabetes has proved difficult in the very markets named in the target, and the announcement stops short of any pricing detail.

Procurement agencies in Africa, Latin America, and Asia have seen similar pledges before. The market-shaping strategy for childhood cancer medicines led by the WHO and St. Jude demonstrates how supply and pricing architecture can accompany a treatment goal. The parallel with the GLP-1 access debate, where campaigners have drawn from HIV response tactics, is clear. Both raise the same question: whether a target of this kind alters what a health ministry can buy or only what a company can report.

Source: Eli Lilly and Company, Lilly launches the Lilly Change the Course Commitment, PR Newswire, September 28, 2026