Feb 13, 2026
3 min read
The growing popularity of GLP-1 drugs shows that access to innovation is no longer dependent on price or clinical evidence alone, but on geopolitical factors that determine who receives treatment.
For decades, access to medicines was understood primarily as a clinical and economic problem.But today it has also become a geopolitical problem.International tensions, industrial concentration, and state power strategies increasingly influence which treatments will be available first, at what cost, and to whom.GLP-1 receptor agonists used to treat diabetes and obesity (of which Ozempic is the best-known brand) clearly illustrate this transformation.
The Covid-19 pandemic marked a turning point.Vaccines show the extent to which health depends on decisions made outside the health sector: patent control, industrial capacity, international diplomacy and trade policy.Since then, concepts such as "sovereignty in health", "strategic autonomy" or "security of supply" have fully entered the public agenda.It is no longer just an innovation, but a guarantee of access in a more fragmented and uncertain world.it's about giving.
Health technology is key to geopolitics
This change in context affects all health technologies, but is particularly evident in medicine.The concentration of pharmaceutical innovation in a few countries and companies creates structural inequalities: those who control research, production and intellectual property are better able to set the conditions for access.
In this scenario, the health system is forced to negotiate not only on prices, but also on volumes, supply schedules and treatment priorities.Although the assessment of health technologies - traditionally focused on effectiveness and efficiency - today faces new dimensions, such as supply chains or regional equity responses.
The GLP-1 phenomenon: Innovation under pressure
GLP-1 drugs, which mimic the action of natural hormones to control blood sugar, were born as a treatment for type 2 diabetes, but their effectiveness in weight loss made them a global phenomenon.
Demand has risen in just a few years, driven by medical evidence, media coverage and social media.Rapid growth has also created risks of overexploitation and unrealistic expectations as health systems try to balance innovation, safety and sustainability.
This situation highlighted a structural problem: innovation is developing faster than the capacity to ensure product access.The production of these drugs is complex, concentrated in a few production sites and protected by patents that limit competition.When demand suddenly rises, the market does not respond quickly enough.
The consequences are visible: shortages, supply delays and the prioritization of individual markets.Patients with diabetes have seen interruptions in treatment, while people with obesity face economic and administrative barriers to accessing this therapy.
Access to geopolitics
This is where geopolitics becomes crucial.Countries with greater economic strength and bargaining power secure preferential agreements;others are reduced to waiting.This reproduces the pattern already observed for vaccines: access depends on both clinical need and position in the international system.
In Europe, the debate on strategic autonomy in essential medicines gained momentum.However, much of production and technological control remains concentrated outside the realm of decision-making in many countries, limiting the ability to ensure stable supply.
At the same time, innovative medicines have become instruments of industrial policy.Where production facilities or research centers are located, jobs, tax revenue and bargaining power are created.The line between health and economic policy is becoming more and more blurred.
Social Dilemma: Innovation and Inequality
The GLP-1 case raises a fundamental question: What happens when an innovation with high potential for public health is used unevenly and without appropriate clinical prioritization?If these drugs consolidate their role in the fight against obesity - one of the great health challenges of the 21st century - but are only available to those who can pay for them or live in countries with greater bargaining power, this could lead to an increase in health inequalities.There is an additional risk: if access is extended without clear criteria, effectiveness in the population may be limited by adherence problems (the patient's follow-up to prescribed treatment), side effects or inappropriate use.
This crisis takes on an even larger dimension in the realm of geopolitical divisions.disputes;Economic sanctions and trade tensions directly affect pharmaceutical supply chains, with particularly strong impacts on low- and middle-income countries.
Outside the market
Recent experience shows that relying only on market logic does not guarantee efficiency or fairness (remember the masked price at the beginning of the epidemic).The key question is not just how to finance innovation, but how to control it.This means exploring a broader view of health technology assessment that includes public procurement mechanisms, value-based pricing agreements, incentives for local production, and social and geopolitical dimensions.
GLP-1 is a paradigmatic case in this sense.They anticipate the challenges that will be brought by other advanced treatments: personalized medicine, genetic medicine or data-based digital solutions.All will depend on global infrastructure and decisions made outside of the clinical setting.
Look ahead
The big lesson is clear: access to health innovation can no longer be thought outside of geopolitics.If we do not include this dynamic in health planning, we risk building increasingly complex, but also more unequal, systems.
After all, the GLP-1 debate is not just medical.It is a debate about what kind of health model we want in an interdependent but fragmented world and whether scientific advances will really reach the whole population.
