Global Expansion Opportunities in Weight-Loss Drug Markets: Emerging Demand in Lower-Income Countries

The global obesity crisis is shifting its epicenter. While high-income nations have long grappled with rising obesity rates, lower-income countries are now bearing the brunt of this epidemic. Over 70% of the 1 billion people affected by obesity globally reside in low- and middle-income countries (LMICs), a figure projected to rise to 79% by 2035, according to a World Economic Forum analysis. This demographic shift has positioned weight-loss drugs-particularly GLP-1 receptor agonists like Novo Nordisk's Wegovy and Eli Lilly's Mounjaro-as critical tools in combating non-communicable diseases (NCDs). The Bill & Melinda Gates Foundation and the Pan American Health Organization (PAHO) are now spearheading efforts to make these medications accessible in LMICs, creating a unique investment opportunity at the intersection of public health and pharmaceutical innovation.

A Strategic Shift in Global Health Priorities

The Gates Foundation, historically focused on infectious diseases and vaccine access, is expanding its portfolio to address obesity as a root cause of NCDs. In 2025, the foundation announced collaborations with PAHO to explore strategies for reducing the cost of weight-loss drugs in lower-income countries, according to a Reuters report. These initiatives align with the foundation's broader $200 billion, 20-year funding strategy, which emphasizes innovations to "save lives and improve health outcomes," per a PAHO press release. Meanwhile, PAHO's Strategic Fund-a pooled procurement mechanism for 35 member states-is being leveraged to negotiate bulk purchases of anti-obesity medications, potentially slashing prices through economies of scale, as reported in an SRN News report.

The urgency of this work is underscored by the World Health Organization's (WHO) impending endorsement of GLP-1 agonists for obesity treatment in adults, a move that could legitimize these drugs as essential medicines in LMICs, the World Economic Forum analysis notes. This regulatory shift, combined with the Gates Foundation's emphasis on pairing pharmacological interventions with behavioral programs, signals a paradigm shift in how global health systems address obesity, as SRN News has reported.

Market Potential and Affordability Strategies

The market for weight-loss drugs in LMICs is poised for explosive growth. However, affordability remains a barrier: Wegovy, for instance, costs up to $1,300 per month in the U.S. To address this, the Gates Foundation is partnering with Indian generic drugmaker Hetero to develop low-cost alternatives. Semaglutide, the active ingredient in Wegovy, is expected to go off patent in countries like China and India by 2026, enabling the production of generics priced as low as $40 annually-mirroring the foundation's successful HIV prevention drug model reported by SRN News.

PAHO's role is equally pivotal. By coordinating regulatory approvals and streamlining procurement across Latin America and the Caribbean, the organization aims to reduce costs and ensure equitable distribution. Nine countries-Argentina, Brazil, Chile, Mexico, and others-are already piloting obesity reduction programs under PAHO's guidance, with weight-loss drugs integrated into broader NCD management strategies, according to the PAHO release.

Investment Opportunities and Risks

For investors, this landscape presents opportunities across multiple sectors:
1. Pharmaceutical Innovation: Companies developing GLP-1 agonists or biosimilars stand to benefit from expanded access in LMICs. Novo Nordisk and Eli Lilly have already seen revenue surges, but generic manufacturers like Hetero could capture significant market share post-2026.
2. Health Systems Strengthening: Partnerships with PAHO and the Gates Foundation could fund infrastructure upgrades, such as AI-enabled diagnostics and point-of-care testing, to support obesity management programs.
3. Public-Private Collaborations: Investors in platforms facilitating pooled procurement or tiered pricing models may profit from the Gates Foundation's and PAHO's emphasis on scalable solutions.

However, risks persist. Obesity treatments require long-term adherence, and LMICs may lack the healthcare infrastructure to sustain these programs. Additionally, the Gates Foundation has not yet disclosed specific funding amounts for 2025, leaving some uncertainty about the pace of implementation, according to the Gates Foundation page.

Conclusion: A New Frontier in Global Health

The Gates Foundation and PAHO's initiatives represent a seismic shift in how the world addresses obesity. By prioritizing affordability and accessibility, these organizations are not only tackling a public health crisis but also unlocking a $100+ billion market in LMICs. For investors, the key lies in aligning with entities that can navigate regulatory, logistical, and cultural barriers-while ensuring that these life-saving drugs reach the populations that need them most.