INS and diabetes mellitus: In Zambia, type 2 diabetics can only access insulin 26%-49% of the times.[11] The major reasons presented for the nonaccessibility factor are insulin being too expensive, lack of availability in all regions, transportation difficulties, high demand and lack of supply, and its “very poor quality.” A few years ago, the Gambian government was spending almost 4% of its annual expenditures only for diabetes, but that is an exception in Africa.