Access to insulin is complex requiring global and national factors to be considered. The World Health Organization (WHO) proposes a framework to disentangle this. This includes: research & development and innovation; manufacturing; regulatory aspects; selection, pricing and reimbursement; procurement and supply; prescribing; dispensing; and use. For each of these, governments can play an essential role in guaranteeing an adequate allocation of resources as well as ensuring that diabetes care is properly structured within health systems. Concerted action is needed to guarantee access to affordable insulin and care and to ensure that the various needs of people with diabetes are included in government programs and interventions. Governments also have a role to play in being a counterweight to the private sector, working closely to establish networks and possibilities for exchanges between different actors including the civil society.