The 2024
Access to Medicine Index that drug manufacturers are not
fully leveraging their potential to expand access in underserved regions.
The report indicates that despite the industry's
evident potential to drive expansion of access to medicines, both product and
geographic coverage remain inconsistent, leaving millions of people with no access to lifesaving products.
According to the report, despite the pharmaceutical
commodities equity and access progress made during the COVID-19 pandemic, the
pace of ensuring universal access and equity change remains inadequate to meet
the needs of the world’s poorest populations.
The World Health Organization (WHO) in 2019 said nearly two billion people globally have no access to essential medicines. This is largely because medicine is not affordable, available or adapted to the needs of low-income countries.
Jayasree K. Iyer, CEO of the Access to Medicine Foundation said that during the pandemic, several
pharmaceutical companies demonstrated their ability to make medicines widely
available, signaling a potential shift in how the industry approaches access in
LMICs.
However, the latest Index finds that much of this momentum has
been lost.
“Despite the progress made, the opportunities to scale access and bridge the health equity gap remain largely untapped,” Jayasree said adding that, “By leveraging proven strategies, innovative approaches, and local partnerships, companies can fulfill their potential in delivering lifesaving treatments to patients wherever they are needed.”
The Index highlights the adoption of Inclusive Business Models (IBMs) by five leading companies – Bristol Myers Squibb, Novartis, Novo Nordisk, Pfizer, and Sanofi.
According to the index these models aim to prioritize low-income
and least-developed countries, covering 102 LMICs, including all 48 low-income
nations.
While these efforts show promise, their impact remains inconsistent. A key issue is the lack of transparency in reporting patient reach and product delivery outcomes, the report reveals.
“As companies increasingly adopt IBMs, transparent reporting on their progress and patient impact is vital for scaling solutions and closing persistent gaps,” the Index report states.
Another area of concern is the low representation of LMICs in clinical trials. According to the Index, only 43 percent of trials occur across 113 LMICs, with just 3.5 percent in low-income countries.
Pharmaceutical companies play a vital role in fostering local R&D capacity. As patent holders, they are uniquely positioned to collaborate with partners in LMICs to bridge gaps and build clinical trial capabilities in these countries.
Additionally, companies should develop comprehensive access plans that cover a wider range of countries and diseases, focusing on registration, affordability, local partnerships and reliable supply chains.
According to Camille Romero, Research Programme Manager for the Index Pharmaceutical companies often focus on markets where clinical trials are conducted, leaving resource-poor populations underserved.
However, she pointed out an example of positive effort which include Gilead’s trials in Uganda for an HIV prevention treatment and Novartis’s work on new antimalarials in collaboration with the PAMAfrica consortium. These initiatives, however, are the exception rather than the rule.
“Companies must prioritize building local R&D capacity and ensuring trials are inclusive of genetically diverse populations to meet unmet healthcare needs,” Romero said.
Industry needs to recommit to voluntary licensing and technology transfers
Voluntary licensing agreements and technology transfers have proven to be effective tools for expanding access. However, the Index reports a slowdown in such initiatives. Only two new non-exclusive voluntary licensing agreements were finalized during the latest analysis period, compared to six in 2022.
Moreover, technology transfer efforts remain concentrated in
upper-middle-income markets, with limited activity in sub-Saharan Africa,
except for South Africa.
Only six companies – Boehringer Ingelheim, Gilead, Merck, Novo
Nordisk, Pfizer and Sanofi – report having established technology transfer
initiatives in this region.
Companies now need to take deliberate steps to not only remain engaged in current efforts, but also to evolve them to encompass a broader range of products, include more countries – particularly in sub–Saharan Africa – and address a wider variety of diseases.
“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,” Romero observed.
Despite the challenges, some companies have shown exemplary
performance. Novartis ranks first in the 2024 Index, followed closely by GSK,
with both companies excelling across Governance of Access, R&D, and Product
Delivery. Sanofi, Pfizer, AstraZeneca, and Johnson & Johnson also rank
highly.
“The increased emphasis on assessing outcomes has highlighted uneven industry progress,” said Iyer. “Leading companies are making strides, but there is still considerable work to be done.”
The Index calls for decisive action, urging companies to implement scalable, sustainable access strategies that prioritize underserved regions. By improving transparency, expanding R&D efforts in LMICs, and enhancing licensing agreements, the industry can accelerate progress toward global health equity.
“Pharmaceutical companies play a vital role in closing the health equity gap,” Iyer concluded. “The time to act is now, with billions of lives depending on it.”