Addressing Barriers to Health

Through partnerships, investment and innovation, we apply our expertise and invest our human and financial resources to address systemic barriers to access to health where we believe our company can make the strongest contributions to health systems, communities and our patients around the world.

Highlights

In 2019, 10 percent of our investment in partnerships and programs to strengthen health care capacity and address barriers to access supported by our company’s Foundation was allocated to impact evaluation

Our commitments
  • 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.
  • We will evaluate and address public health needs by working with local health care providers globally, to increase knowledge of product need and use. We will invest in activities to improve patient awareness and education.

To be most effective in strengthening health systems, where appropriate, we align our investments in health systems and addressing barriers to access with country-led priorities and partner with governmental, multi-lateral or non-profit organizations.

As acknowledged in the United Nations Sustainable Development Goals (UN SDGs), ensuring healthy lives and promoting wellbeing is a global priority and, specifically, achieving universal health coverage is an important objective to attain equitable and sustainable health outcomes for individuals and communities. Health system strengthening is a means to progress towards universal health coverage. Addressing health inequity ensures no one is left behind as progress is made.

Our approach

We are committed to measuring the impact of our efforts on improving access and therefore provide support to evaluate the impact of many of our investments. In 2019, 10 percent of our investment in partnerships and programs to strengthen health care capacity and address barriers to access supported by our company’s Foundation was allocated to impact evaluation.

Our investments in health systems strengthening and addressing inequity are guided and approved by internal and external expert advisory bodies, including an internal advisory board for our company’s Foundation, an internal Impact Investing Council, and an external expert advisory committee for the MECTIZAN® (ivermectin) Donation Program.

Programs and initiatives

Strengthening health systems

We support capacity building for health systems and care delivery where our support can make a meaningful difference. We provide this support in several ways, including through philanthropic social investments, key initiatives, and impact investing.

Philanthropic social investments
Our social investments through philanthropy address underlying barriers to access to health and help advance health equity around the world. Our approach to these investments is guided by several key principles: addressing critical global health needs where we can have a meaningful impact; promoting health equity by addressing health disparities in vulnerable, underserved communities; collaborating with diverse partners to build healthier, stronger communities; and leveraging our range of resources (financial, product, and expertise) to achieve greater impact on population health outcomes. Learn more about our philanthropic social investments.

Key initiatives
In addition to our targeted philanthropy, we have made substantial contributions to strengthening health systems through long-standing key initiatives that address significant gaps and barriers to health care access. Two prominent examples are MSD for Mothers and the MECTIZAN Donation Program.

MSD for Mothers is our company’s $500 million global initiative focused on strengthening health systems to sustain the delivery of high-quality maternity care services that benefit women and their communities. With our partners, we are improving health systems for women today and for the long term by advancing quality standards, helping make life-saving products available and generating evidence.

The MECTIZAN Donation Program is the longest-running disease-specific drug donation program and public-private partnership of its kind and is widely regarded as one of the most successful public-private health collaborations in the world. In addition to providing direct access for communities in need of treatment, the program has made significant impacts on health systems in some of the hardest to reach communities. The development of CDTI (community-directed treatment with ivermectin) programs has trained community volunteers to distribute medicines and the system now is also used to distribute other health interventions.

Impact investing
Impact investing is one of our core approaches to strengthening health systems. Through impact investing, we are able to deploy financial resources in ways that may generate not only improved access to health care for underserved populations, but also financial returns and commercial opportunities—all while growing a sustainable global health ecosystem and attracting additional capital and partners.

Addressing health inequity

In addition to our efforts to strengthen health systems, we address underlying barriers to access, including social determinants of health, that lead to 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. We have a history of advancing equity through our support of philanthropic programs to reduce health disparities and improve the health of people in underserved communities as well as advance health literacy and support access to care. Across the enterprise, health equity is viewed as an opportunity to drive sustainable business and societal value.

As part of our approach to addressing social determinants of health, we have initiated several initiatives. Two such examples are the documentary film A Touch of Sugar focused on raising awareness about socially detrimental factors that impact type 2 diabetes outcomes in the United States, and the Nobody Left Outside initiative in Europe aimed at reaching marginalized populations and connecting them to health services they need.

A Touch of Sugar
Using our platform as a leader in diabetes, we developed the documentary film A Touch of Sugar as an educational initiative to draw greater attention to the public health issue of type 2 diabetes (T2D) and the social, economic, and environmental factors that lead to disparities in prevalence and health outcomes.

More than 30 million Americans have diabetes (that’s about one in 8 adults); 90-95 percent of them have type 2 diabetes.1 A Touch of Sugar delves into the role of health literacy, food deserts, access to care, cultural competency, and stigmas associated with diabetes while also sharing critical resources to address barriers to treatment.

Since debuting in early 2019, the film has been viewed by nearly six million people, including more than 1.5 million health care professionals, and there have been more than 1,300 community screenings. The film has also been utilized with stakeholders such as the American Diabetes Association, the U.S. Department of Veterans Affairs, the Congressional Black Caucus Foundation, the Lion’s Club, Walmart/Sam’s Club, universities, community groups, insurers, advocacy groups and faith-based organizations.

Nobody Left Outside (NLO)
Marginalized and underserved groups are often described as ‘hard to reach’ with respect to health services, whereas, from the perspective of users, it is frequently the services that are hard to reach. Recognizing the many barriers to access to health care faced by the most marginalized communities in Europe–including homeless people, undocumented migrants, LGTBI people, sex workers, people who use drugs, and prisoners—our company initiated and supports the ‘Nobody Left Outside’ initiative. Through this initiative, organizations representing these groups in Europe work together and act as a unified voice to identify shared challenges, share lessons learned and seek integrated solutions to improve access to health and support services.

Activities to date include: creation of NLO website; development of a novel health service redesign checklist to improve access (published in the peer-reviewed BMJ Open journal); two policy events at the European Health Forum Gastein, together with the Sabre award-winning ‘Point of view’ exhibition of self-taken photographs and testimonies by marginalized people; engagement with EU policymakers via open letters and a pilot project application. In 2019, the NLO initiative was granted the status of a Thematic Network under the European Commission’s Health Policy Platform and published a Joint Statement in October, which was further publicized via a BMJ Opinion article.

Most recently, the NLO coalition has collaborated with the World Health Organization (WHO) European Office for Investment for Health and Development to provide WHO with a briefing paper on COVID-19 impacts from the perspective of marginalized groups, with recommendations to improve pandemic responses, recovery and preparedness measures.

We work in partnership with others, including:
  • European Commission
  • The Carter Center
  • U.S. Agency for International Development
  • World Health Organization

Performance data

Addressing barriers to health20152016201720182019
Health care workers trained through major programs and partnerships (estimate)119,00032,00074,00067,00068,000
Annual investment in partnerships, programs and impact investments that support health care capacity-building and address underlying barriers to access to health (in millions)1$21$28$40$37$63
People reached through investment in partnerships, programs and impact investment that support health care capacity-building and address underlying barriers to access to health1 (estimate in millions)188293311357422
Percentage of investment in partnerships and programs to strengthen health care capacity and address barriers to access, that is allocated to impact evaluation2NRNRNRNR10%
"Investment in patient- and provider-education programs (in millions)$80$80$90$115$102
NR: Not reported
1Represents investments by our Office of Social Business Innovation, including our Office of Corporate Responsibility, MSD for Mothers and our company’s Foundation.
2Percentage calculated based on total investments in partnerships and programs to strengthen health care capacity and address barriers to access supported through our company’s Foundation.