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How pharmaceutical companies are addressing global health inequities
As the 2024 Access to Medicine Index makes clear, the path to health equity is long, but the progress made so far offers a blueprint for a future where everyone has an equal chance to thrive. PHOTO/ COURTESY
What you need to know:
- This year's Access to Medicine Index once again casts a spotlight on the challenges and opportunities facing pharmaceutical companies as they grapple with global health inequities.
- While some companies have taken transformative steps, much work remains to be done to close the gap
The global health landscape remains deeply unequal. Millions in low- and middle-income countries (LMICs) struggle to access life-saving medicines, vaccines, and healthcare technologies.
While there have been incremental advances, pharmaceutical companies are not fully leveraging their potential to reach underserved populations, particularly in the poorest regions.
The overall industry performance in improving access has declined since the last Index in 2022, suggesting an urgent need for acceleration in efforts.
This year's Access to Medicine Index once again casts a spotlight on the challenges and opportunities facing pharmaceutical companies as they grapple with global health inequities. While some companies have taken transformative steps, much work remains to be done to close the gap.
The 2024 Access to Medicine Index evaluates how the world’s leading pharmaceutical companies contribute to improving access to medicine in LMICs. Key disparities persist, especially in access to medicines for noncommunicable diseases (NCDs) such as cancer and diabetes, which disproportionately affect underserved populations. According to the Index, over two billion people still lack access to essential medicines, and limited availability in rural areas, high out-of-pocket costs, and infrastructure deficits exacerbate the issue.
Yet, the report is not all bleak. It highlights bright spots where pharmaceutical companies have made significant strides through innovative strategies, collaborative partnerships, and a stronger focus on inclusion.
Some companies, such as Novartis, Pfizer, and Sanofi, are adopting inclusive business models to prioritise access in low-income and least-developed countries.
These models cover 102 low and middle income countries, but their impact is uneven, and companies lack transparency in reporting how many patients are actually reached.
“There are significant opportunities to scale access and finally bridge the health equity gap for billions around the world. By using tried-and-tested mechanisms and new and innovative approaches, as well as leveraging their local partnerships, companies can meet their full potential in delivering their lifesaving treatments to patients, wherever they are needed,” Jayasree K. Iyer, CEO, Access to Medicine Foundation notes.
Novartis leading the way
This year, Novartis emerged as a standout in the Access to Medicine Index rankings. The company's comprehensive approach to addressing access barriers has set a new benchmark. From licensing agreements that make essential medicines affordable to investing in local research and development tailored to LMICs, Novartis exemplifies how a profit-driven model can align with social impact.
Notably, Novartis’ Novartis Access Program provides low-cost treatment bundles for NCDs to low-income populations, while their investments in local manufacturing partnerships ensure sustainability. Their efforts have directly improved access to care in regions like sub-Saharan Africa and Southeast Asia, proving that global health can benefit from inclusive business models.
While Novartis’ accomplishments are laudable, they are the exception rather than the norm. Many pharmaceutical giants still underperform in critical areas such as equitable pricing, IP sharing, and neglected disease research and developments.
Untapped potential
A vast portion of pharmaceutical research and development remains concentrated on diseases prevalent in high-income countries and many times the low and middle income countries are left out.
According to the Access to Medicine Index, only 43 percent of clinical trials take place in the 113 LMICs analysed, even though these countries house 80percent of the global population. Representation in clinical trials is particularly low in low-income countries (3.5 percent), perpetuating inequities in research and treatment availability.
To shift the needle, companies must prioritise diseases like malaria, tuberculosis, and emerging infections. The Medicines for Malaria Venture and Drugs for Neglected Diseases Initiative show what can be achieved when industry collaborates with global health stakeholders.
Tiered pricing and voluntary licensing are powerful tools for improving affordability. Companies like GSK have leveraged tiered pricing to make vaccines more accessible, but broader adoption across the industry could significantly expand impact.
Many companies pursuing technology transfers are concentrating their initiatives in upper middle-income markets, with efforts lagging in sub-Saharan Africa (except for South Africa). Only six companies namely Boehringer Ingelheim, Gilead, Merck, Novo Nordisk, Pfizer and Sanofi – report having established technology transfer initiatives in this region.
Licensing agreements and technology transfers, which are essential for improving local availability of medicines, have slowed significantly since the Covid-19 pandemic.
Dependence on imports leaves LMICs vulnerable to supply chain disruptions. Investments in local manufacturing such as Pfizer’s collaboration with BioNTech to build vaccine facilities in Africa are essential for long-term sustainability.
Licensing patents to generic manufacturers via the Medicines Patent Pool (MPP) allows LMICs to access affordable, high-quality drugs. Yet, fewer than half of the critical medicines identified by Access to Medicine Index are under voluntary licenses. Scaling such agreements would be a game-changer.
Success Stories
Beyond Novartis, smaller-scale successes offer hope.
ohnson & Johnson’s long-acting tuberculosis treatment, developed through partnerships with LMIC researchers, is now available at reduced prices in over 130 countries. Similarly, GSK’s malaria vaccine, distributed in partnership with Gavi, has saved thousands of lives in Africa.
These stories prove that industry-led efforts, when executed with intentionality, can drive meaningful change.
Call for collective action
Pharmaceutical companies have an untapped potential to transform global health, but they cannot act alone. Governments, NGOs, and global health institutions must co-create policies that incentivize equitable access. Meanwhile, investors and consumers can push for corporate accountability, rewarding companies that prioritize health equity.
The stakes are high, but the solutions are within reach. By scaling what works and addressing persistent gaps, the pharmaceutical industry can play a pivotal role in creating a world where no one is denied access to the medicines they need to live a healthy life.
As the 2024 Access to Medicine Index makes clear, the path to health equity is long, but the progress made so far offers a blueprint for a future where everyone has an equal chance to thrive.
“While individual pharmaceutical companies have advanced their efforts to expand access, overall industry progress remains uneven in key areas. Decisive action is now needed, with the 2024 Index highlighting clear steps companies can take to accelerate broad, impactful change,” Camille Romero, the research programme manager for the 2024 Index, Access to Medicine Foundation, notes.
