Diabetes is a life-long chronic condition. Herein lies one of the major challenges to addressing global inequalities in diabetes care. The costs of insulin and monitoring are often beyond the resources of people with diabetes or their country’s healthcare system. While it is easier to secure temporary price reductions or short-term financial support in the form of donations or grants than it is to find long-term ongoing support, diabetes needs in most countries are not temporary. These needs can only be met when systems and structures are implemented that make diabetes supplies both available and affordable on a long-term basis. The authors describe collaborations to provide answers at local, national and international levels.