Access to Health Overview
We recognize that, in collaboration with key stakeholders, we have a role to play in helping to ensure our science advances health care, and our products are accessible and affordable to those in need.
Millions of people worldwide are living longer, more productive lives today thanks, in part, to breakthroughs in science, better health care, and access to innovative medicines and vaccines. However, targeted and coordinated action from all stakeholders is needed to ensure greater access to health around the world both today and for future generations.
As a research-intensive biopharmaceutical company, our company’s role is first and foremost to discover and develop, in a responsible and economically sustainable manner, innovative medicines and vaccines that address unmet medical needs.
The primary responsibility for managing a health system that ensures the health of its citizens resides with government. Our industry has a substantial role to play in working with governments to ensure the health of their citizens.
We also recognize there are underlying barriers, including social determinants of health, that lead to unequal access to care and health inequities. We have advanced our efforts to make health care more equitable among underserved populations by examining disparities across conditions and geographies and identifying sustainable, scalable solutions to improve patient and population health outcomes.
Our company is committed to establishing relationships with communities to understand how socioeconomic inequity, bias and structural racism have impacted their ability to manage their health and co-creating local solutions to address these issues.
Our enterprise-wide approach to access is guided by our Access to Health Guiding Principles and is responsive to internationally recognized standards and priorities. Recognizing the significant access barriers that exist within sub-Saharan African countries in particular, we are also committed to a specific set of principles to guide our strategy in the region.
Strategies and actions to enable access are embedded across our company. Our Access to Health Guiding Principles span the areas of research and development, manufacturing, marketing and commercialization, and philanthropic investments.
Our Public Policy and Responsibility Council (PPRC), an internal forum of senior leaders across the company, provides strategic input and guidance on our social business investments, corporate responsibility approach and public policy issues and positions. The PPRC makes decisions on policy and corporate responsibility issues and recommendations to the Executive Committee, as necessary.
Our Human Health Product Approval Committee (HHPAC), a cross-divisional committee, provides oversight for the development and registration of products within the human health portfolio.
Access to Health Guiding Principles
Since 2010, our global approach to access has been guided by our Access to Health Guiding Principles (Access Principles). The objectives of our Access Principles are to ensure we continue to fulfill our commitment to access as a core company value, and we are measuring and reporting on our progress and performance in a meaningful way. As demonstrated through our key performance indicators (KPIs), we are committed to measurable action to advance our Access Principles and to transparently report on our progress.
We recognize the need to continuously update our approach to access and associated principles to ensure we remain focused on the most critical issues. To do so, we conduct periodic strategic re-evaluations of the Access Principles and corresponding KPIs. Since our last Corporate Responsibility Report, we once again undertook a company-wide strategic re-evaluation of our principles. We are pleased to come forward with a refreshed set of principles and KPIs that reflect our company-wide approach to access and addressing unmet medical needs.
Discovery and invention
Pursuing the most promising science, our company discovers and invents medicines and vaccines that address vital global health needs where we can have the greatest impact, now and in the future.
We will evaluate and reflect global unmet medical need in the research and development of our products
- KPI: Percentage of top 20 global burdens of disease addressed by our products and pipeline
We will invest in research and development to address infectious diseases that have a significant global public health burden, including in low- and middle-income countries, and where emerging science suggests opportunities to substantively reduce this burden through medicines or vaccines
- KPI: Narrative of our R&D investments in infectious diseases
We will collaborate with diverse partners to expand our research and development capacity to address unmet global health needs and pursue opportunities to provide access to compound libraries and molecules to spur discovery and development of new products
- KPI: Number of established significant external licenses and collaborations
We will conduct our clinical trials, including trials in low- and middle-income countries, in accordance with the global standards of Good Clinical Practices / Pharmacovigilence (GCP/PV), applicable local regulatory requirements and following the ethical principles that have their origin in the Declaration of Helsinki
- KPI: GCP/PV inspections by regulatory agencies of the company or clinical trial investigators that led to significant fines, penalties, warning letters or product seizures
Our company makes available a reliable, safe global supply of quality medicines and vaccines and invests in solutions to enable timely access to our products in a responsible and sustainable manner.
We will maintain strict quality standards and effective supply chain management to ensure the safety of our products no matter where they are manufactured
- KPI: Percentage of sold units recalled during a given year (recall rate globally)
We will sustain an interdependent, flexible supply chain to take into account global and local market supply needs
- KPI: Number of local and regional manufacturing partnerships to enable access
We will engage and invest in local and regional partnerships to enable market access
- KPI: Number of products available through local and regional partnerships
We will work to register our products where there is a need and the infrastructure to support their safe delivery to patients. When appropriate, we will work to have our products prequalified through the World Health Organization (WHO) prequalification process.
- KPI: New product and device registrations (annual)
- KPI: Products that have achieved WHO prequalification (cumulative)
Grounded in a deliberate systematic approach, our company develops, tests and implements innovative solutions that address barriers to access and affordability of our medicines and vaccines. This enables us to serve the greatest number of patients today while meeting the needs of patients in the future. Where appropriate, we pursue these solutions in partnership with private, governmental, multi-lateral or non-profit organizations.
We will expand access to our products through dedicated market-based affordability solutions that allow flexibility to reach at-need populations and patients –including those in low- and middle-income countries –taking into consideration public health need, economic conditions, and health care infrastructure
- KPI: Number of countries where dedicated affordability solutions have been initiated
In low-income countries, we will continue our long-standing policy of not filing for product patents
- KPI: Number of patents filed in low-income countries, as defined by The World Bank in its country and lending groups classifications (annual)
When market-based solutions are inadequate or unavailable, we will pursue programs to provide direct access to our medicines and vaccines, including product donations and patient assistance programs
- KPI: People reached globally through product donation and patient assistance programs and partnerships (in millions)
Strengthening systems and addressing inequity
Through partnerships, investment, and innovation, our company applies its expertise and invests its human and financial resources to address systemic barriers to access to health where we believe we can make the strongest contributions to health systems, communities and our patients around the world.
In partnership with local communities and other stakeholders, we will support capacity building for health systems and care delivery where our support can make a meaningful difference. We will address underlying barriers to access, including social determinants of health that lead to health inequities. We will measure the impact of our investments.
- KPI: Annual investment in partnerships, programs, and impact investments that support health care capacity-building and address underlying barriers to access to health (in millions USD)
- KPI: People reached through investment in partnerships, programs, and impact investment that support health care capacity-building and address underlying barriers to access to health (in millions)
- KPI: Percentage of investments in partnerships and programs to strengthen health care capacity and address barriers to access that is allocated to impact evaluation
We will evaluate and address public health needs by working with local healthcare providers globally to increase knowledge of product need and use. We will invest in activities to improve patient awareness and education.
- KPI: Investment in patient- and provider-education programs (in millions USD)
We recognize that access is a shared responsibility and we cannot fulfill these principles on our own. Therefore, in applying these principles, our company works through several initiatives and partnerships. We also manage and measure the fulfillment of these principles through a series of metrics, targets and examples that we include in our corporate responsibility reporting.
Institutional Business Africa (IBA) Principles
Recognizing the significant health needs and barriers to access in sub-Saharan Africa, we have a group dedicated to ensuring access to medicines in the region, called the Institutional Business Africa (IBA) unit. IBA consists of a dedicated team of public health and medical specialists based across sub-Saharan Africa that fosters strategic collaborations and provides policy and technical guidance to countries focused on the areas of family planning and vaccines to achieve sustainable benefits for people and communities in Africa.
IBA is guided by four important principles, represented by the abbreviation PASS:
P: Public health outcomes, guided by leading global alliances focused on reproductive health (RHSC, FP2020) and immunizations (GAVI), aligned with country public health goals
A: Affordability, focusing on economic levels and optimization of available funding
S: Sustainability for countries, ensuring that a long-term perspective is in place for country programs using our products
S: Sustainability for our business, ensuring that we can maintain our commitment to long-term partnerships that leverage our innovative products and services
In the past year we supported Zambia, Kenya and Liberia on the successful launches and scale up of their National Immunization Programs through the provision of programmatic and technical support. Other countries that were supported in the implementation of their HPV National Immunization Programs (NIPS) through follow-up investments in advocacy, program review meetings, training and social mobilization included Tanzania, Uganda, Ethiopia, Malawi, Senegal, Nigeria and Rwanda. Efforts towards building resilient immunization systems saw four countries (Tanzania, Uganda, Senegal and Côte d’Ivoire) hosting successful vaccine confidence workshops in partnership with respective Ministries of Health.
Furthermore, IBA hosted its inaugural Africa HPV Summit, a first of its kind in Africa, which brought key vaccine stakeholders and partners to share best practices and find HPV programmatic resolutions. The event was attended by more than 74 delegates spanning government officials, public health specialists, academics, researchers and clinicians from 17 African countries and seven partner organizations.
Integrating social and business value
To further embed access strategies in our business, in 2017 we developed the Shared Value Toolkit, an internal resource to enhance our focus on using business solutions to address social issues of importance to customers and stakeholders.
Using lenses such as our CR materiality matrix and the UN Sustainable Development Goals, the Shared Value Toolkit complements existing planning and strategy tools as a way to encourage the exploration and deployment of business solutions that can address health-related social concerns and other development challenges.
Aligning with global goals and standards
Our commitments and efforts that focus on enabling access are responsive to international goals and standards, including the UN Sustainable Development Goals (SDGs) and the UN Universal Declaration of Human Rights.
In addition to our efforts to advance targets under SDG 3, our commitment to access includes respecting and promoting health as a universal human right, as defined by the United Nations Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights.
While the primary responsibility for managing a health system that ensures the health of its citizens resides with government, pharmaceutical companies have a substantial role to play in working with governments to ensure the health of their citizens. As we pursue our core mission of inventing, developing and delivering medicines and vaccines, we have an ethical duty to support governments in their efforts to protect the right to health by “doing no harm.” We do this in several ways, including:
- Monitoring and reporting on the safety of our products
- Providing health care workers and consumers with important information on the benefits and side effects of our products
- Safeguarding the health, safety and privacy of patients involved in our clinical trials
In addition, we are helping to improve access to new medicines and vaccines, address deep-rooted and multifaceted barriers to access, and, through partnerships and public policy, advocate for health care capacity strengthening in ways that are aligned with our business mission and core capabilities.