The high scorers in the Index
The pharmaceutical companies that score highly in the Access to Medicine Index, including GlaxoSmithKline (GSK) and Johnson & Johnson, have well-established access strategies with wide-ranging initiatives in low- and middle-income countries. Indeed, GSK has remained the leader in the Index since its inception in 2008. The company has a comprehensive access strategy bolstered by a large R&D pipeline targeting priority diseases (defined by the World Health Organization) impacting people in low- and middle-income countries.
Interestingly, for the first time GSK’s Index score was only slightly higher than another company’s – Novartis. Since 2018, Novartis has taken some major steps forward, including creating a dedicated unit for sub-Saharan Africa, which has the largest underserved patient population in the world. We are encouraged by Novartis’ increased focus on access in low-income countries, because the Access to Medicine Foundation’s research has shown that they are consistently overlooked by pharmaceutical companies’ access strategies, which tend to target middle-income countries like Brazil and India.
The other end of the Index
At the other end of the Index, companies like AbbVie and Eli Lilly score relatively poorly due to a variety of factors. AbbVie, unlike the majority of its peers, does not have a clear access to medicine strategy embedded in its overarching corporate strategy, while Eli Lilly lacks a structured process for access planning during R&D. Furthermore, only a small percentage of both companies’ products are registered for use in countries where the burden of disease is high.
How are we engaging companies?
We will continue to engage companies at the lower end of the Index, encouraging the adoption of best practices and flagging opportunities identified by the Access to Medicine Foundation. We know that rapid progress is possible: Pfizer, for example, has risen from 16th in the 2014 Index to 4th in the 2021 Index. The company has strengthened its access strategy, which has measurable objectives, and is transparent about the outcomes of its access activities.
Overall, we find reasons to be optimistic about the outlook for access to medicine. However, the unequal distribution of Covid-19 vaccines shines a spotlight on the many barriers to progress. If the gulf in public health between high- and low-income countries continues to widen, then the path towards achieving SDG 3 by 2030 – already jeopardised by the pandemic – will be further undermined.
Against this backdrop, investors must continue engaging on access to medicine and the opportunities identified by the Access to Medicine Index, building on the positive momentum of the SDG 3 collaborative investor engagement last year. As a lead investor, we gained very valuable insights from this, which we are using to tailor our dialogue with pharmaceutical companies this year.
Get to know the author
Catherine joined the Responsible Investment team in 2018, and currently covers engagement on public health issues. She also leads work on BMO GAM’s Responsible product range. Outside of work, Catherine enjoys listening to podcasts about science and history, and hiking in the Alps. She speaks German and Italian because she studied both languages at university.