On Monday, the 2014 Access to Medicines Index (ATMI) was released – an independent ranking of pharmaceutical companies’ efforts to improve access to medicine in developing countries.
Some good news…
This is the fourth edition of the ATMI, which has been published every two years since 2008. There’s plenty of encouraging news: .
- More and more, companies are “experimenting with innovative access-oriented business models.” The report highlights that GlaxoSmithKline (GSK), which leads the rankings for the fourth consecutive time, is engaged with Save the Children in an innovative, strategic global partnership that hopes to combine our expertise, resources and influence to help save the lives of 1 million children by 2018.
- The sector as a whole is “granting more licences to developing country companies to make and distribute generic versions of their medicines” (although the geographic scope of many of those should be expanded to include more middle-income countries).
- All of the companies on the AMTI also now have “established some form of board-level representation for access-to-medicine issues”.
…and some bad
There are, however, some critical areas in which the industry continues to lag behind:
- There’s not enough research and development (R&D) on neglected tropical diseases and on maternal and neonatal health– only half of companies are actively developing medicines for children.
- Companies continue to “give only qualified support to the flexibilities intended to protect public health set out in the internationally agreed intellectual property framework (TRIPS)” and there is “evidence of efforts to lobby against these flexibilities in private”.
- Bribery and corruption are persistent industry-wide problems with 18 of the 20 companies on the ATMI the “subject of settlements or decisions relating to breaches in ethical marketing, bribery or corruption standards or competition laws.”
A spur for change
So while it’s certainly important to acknowledge where pharmaceutical companies are improving access to medicines, the findings should also be a spur for other stakeholders to push companies to do more in those areas where they aren’t. Save the Children’s goal in partnering with GSK is to do just that. We hope that by working with the company in a dynamic and new way we’ll help transform its business to guarantee that:
- development of child-friendly formulations is a core commitment
- medicines and vaccines prices are not a barrier to access for the most vulnerable and marginalised
- health-systems are strengthened to ensure those medicines and vaccines are delivered in a timely and appropriate manner to communities in need.
One way we hope to encourage this is by pushing for companies to develop, expand and improve on equitable pricing policies in a way that really gets to the heart of problems of medicines and vaccines affordability. The ATMI indicates that companies only consider affordability for a third of their products.
I’ll have more to say on this later, but briefly, if companies start making medicines and vaccines prices and policies more transparent, focus much more on in-country equity and make sure that all the stakeholders have input into the process, they’ll begin to make real in-roads.
Not forgetting governments
All this talk about pharmaceutical companies doesn’t mean governments have no role. Countries must do all they can to make sure that medicines and vaccines affordable, particularly for the most vulnerable and marginalised. This may mean making use of intellectual property flexibilities to increase competition in medicines and vaccines markets, joining with other countries to enter into bulk procurement agreements or even promoting new systems of R&D that ‘delink’ the costs associated with R&D from the price of medicines and vaccines themselves.