Svetlana Hutfles, Executive Director, Insulin for Life USA
Grantmakers In Health’s Maya Schane spoke with Svetlana Hutfles of Insulin for Life USA (IFL USA) about the organization’s model to improve diabetes supplies access across the country, and how philanthropy can engage on this issue. The interview has been edited for length and clarity.
Can you give an overview of the work IFL USA is doing to address the issue of insulin access?
IFL USA addresses insulin and diabetes supply access through a practical, systems-level intervention: recovering and redistributing surplus, unopened, unexpired, donated insulin and diabetes supplies as in-kind grants to clinic partners who are saving lives every day.
We operate at the intersection of two realities: widespread insulin insecurity and significant medical waste. Our model bridges that gap by collecting donated supplies from individuals, pharmacies, manufacturers, and healthcare partners, then safely inspecting and redistributing them through a trusted network of clinics and health organizations.
Today, we support 53 clinics across the United States and partners in more than 25 countries. Since 2012, we’ve redistributed over 277,000 pounds of supplies that would otherwise go to waste, including more than 90 million units of insulin, helping sustain the lives of more than 57,000 people.
What may seem like a simple concept requires robust infrastructure to ensure safety, reliability, and continuity of care, but when done well, it delivers immediate, life-saving impact at scale.
How does IFL USA leverage partnerships—with clinics, community-based organizations, and individuals—to improve insulin and diabetes supplies access, and what makes these partnerships effective?
Partnerships are the backbone of our model. IFL USA does not deliver life-saving insulin and supplies in isolation; we integrate into existing systems of trust and care.
Our clinical partners, particularly those serving vulnerable and underserved populations, ensure that insulin and supplies reach patients within a continuum of care, not as a one-time donation. International partners and community-based organizations provide critical local knowledge, from storage capacity to patient education and treatment, helping ensure supplies are used safely and effectively.
Equally important are individual donors, who play a direct role in reducing waste and expanding access.
What makes these partnerships effective is alignment around a shared goal: getting life-saving medicine to people with dignity. We emphasize trust, accountability, and responsiveness. Feedback loops from partners in the field continuously inform and improve our operations, making the system more adaptive, efficient, and resilient over time.
How is philanthropy currently engaging in insulin access, and where do gaps remain?
Philanthropy has played an important role in advancing insulin access, particularly through support for patient assistance programs, advocacy, and direct service delivery.
For example, philanthropic and cross-sector efforts have helped expand patient affordability programs such as the Eli Lilly and Company Insulin Value Program, which caps out-of-pocket insulin costs at $35 per month for many patients, including those without insurance. These types of initiatives, often supported by philanthropic partnerships, advocacy pressure, and nonprofit collaboration, have helped bring immediate financial relief to people facing prohibitively high insulin costs.
Philanthropy has also been critical in supporting advocacy organizations such as Breakthrough T1D, which work to advance policy solutions and ensure insulin affordability remains a national priority. Their efforts, alongside others, have contributed to growing momentum for policy changes, including legislation to cap insulin costs and expand access.
In addition, philanthropic funding has enabled nonprofit-led direct initiatives such as community-based distribution, emergency assistance, and mutual aid efforts that help individuals access insulin and supplies when they fall through traditional safety nets.
However, key gaps remain. Funding often prioritizes visible, front-end interventions, such as medication purchases or clinical services, while overlooking the operational infrastructure that makes access possible. Logistics, compliance, storage, and distribution systems are essential, but frequently underfunded.
There is also limited investment in waste-reduction and surplus recovery models, despite their demonstrated efficiency and scalability. Additionally, public awareness efforts around safe donation and redistribution to licensed nonprofits like IFL USA remain under-resourced.
In short, philanthropy is engaged, but there is a clear opportunity to think more holistically about the systems required to deliver equitable access while also reducing medical waste.
For funders who want to make a tangible impact, what are the most effective ways to get involved, and what types of investments or partnerships tend to deliver the greatest impact?
Funders can have immediate and measurable impact by investing in the infrastructure that connects surplus to need.
High-impact opportunities include:
- Supporting logistics and distribution systems that enable safe, large-scale redistribution;
- Funding partnerships with clinics and community health providers;
- Investing in awareness campaigns to increase donations of usable supplies; and
- Strengthening emergency response capacity for disaster settings.
Flexible, multi-year funding is especially valuable, as it allows organizations to build reliable systems rather than operate reactively.
Partnerships that combine philanthropy with health care providers, supply chain stakeholders, and community organizations tend to deliver the greatest impact because they address both supply and access simultaneously.
What role can philanthropy play in addressing the root causes of inequitable insulin access, and how can funders balance immediate needs with longer-term systems change?
Philanthropy is uniquely positioned to do both: respond to urgent needs while catalyzing systemic change.
In the short term, waste-reduction and supply-recovery funding models like IFL USA’s ensure that people have immediate and consistent access to life-saving insulin and supplies. At the same time, philanthropy can invest in policy advocacy, data systems, and cross-sector collaboration that addresses structural drivers of inequity, such as pricing, insurance gaps, and supply chain vulnerabilities.
Balancing these priorities requires a dual approach: meeting people where they are today while supporting innovations that reshape how systems function in the future. Importantly, solutions that reduce waste and improve distribution are not just stopgaps; they are part of building more resilient and equitable health systems.
What lessons from IFL USA’s work can be applied to other disease areas or broader health systems challenges?
One of the most important lessons is that access gaps are often not purely about scarcity, but also about disconnection.
Surplus-to-care models can be applied to other chronic conditions where usable supplies are routinely discarded. With the right safeguards and partnerships, these resources can be redirected to meet urgent needs.
Another key lesson is the importance of investing in “invisible infrastructure.” Logistics, coordination, and compliance systems may not be visible to patients, but they are critical to making care delivery work at scale.
Finally, integrating sustainability into health access efforts is not optional; it is essential. In practice, this means recognizing that large volumes of usable, unopened diabetes supplies are routinely discarded (often due to changes in prescriptions, insurance coverage, or device upgrades) even as patients struggle to access them. At IFL USA, we address this through a surplus-recovery model that captures and redistributes donated insulin and supplies before they become waste, channeling them through clinic partners to support ongoing, supervised care. This approach not only expands access, but also reduces the environmental impact of pharmaceutical waste and avoids the need for additional production. By treating surplus as a reliable resource, it strengthens supply continuity and reinforces system resilience, particularly in the face of climate-related disruptions and supply chain instability.
What is the biggest takeaway from IFL USA’s work for funders looking to make an impact in health equity and access?
The biggest takeaway is that meaningful impact doesn’t always require entirely new solutions. It often requires reconnecting what already exists.
Every day, life-saving insulin is both urgently needed and unnecessarily discarded. By investing in systems that bridge that gap, funders can unlock immediate, scalable, and dignified access to care.
Equally important, this work demonstrates that health equity and sustainability are deeply interconnected. Communities with the least access to insulin and diabetes supplies are often the most affected by system inefficiencies: where usable medicines are discarded in one part of the system while patients go without in another. Approaches that recover and redistribute surplus directly address both challenges at once: expanding access for underserved populations while reducing avoidable medical waste and the environmental burden associated with disposal and new production. Addressing these issues together not only improves outcomes today, but helps build more efficient, resilient systems that better serve patients over time.
Sometimes, transforming systems begins with something as simple yet powerful as ensuring that one vial of insulin reaches the person who needs it.