A baby receives vaccine by a nurse at the maternity ward of the Ewin Polyclinic in Cape Coast, Ghana, on April 30, 2019. - Ewim Polyclinic on April 30, 2019 was the first in Ghana to roll out the Malaria vaccine Mosquirix. After Malawi, Ghana is the second country to launch the vaccine. Known by its lab initials as RTS,S but branded Mosquirix, the vaccine has passed lengthy scientific trials, which found it to be safe and reduced the risk of Malaria by nearly 40 percent -- the best-ever recorded. It was approved by European regulators in 2015. (Photo by CRISTINA ALDEHUELA / AFP) (Photo credit should read CRISTINA ALDEHUELA/AFP/Getty Images)
Access to Medicine said that new medicines for priority diseases are supported increasingly by initiatives to help patients obtain treatment in poorer countries © AFP

Pharmaceutical companies have made good progress in promoting global health over the past 10 years by providing more and better medicines to the developing world, according to an independent assessment of their performance.

The study by the Amsterdam-based Access to Medicine Foundation comes at a time when the pharmaceuticals industry is facing widespread criticism from campaigners who say that companies’ overwhelming priority is to maximise returns to shareholders at the expense of public health.

Access to Medicine, funded by the UK and Dutch governments and the Bill & Melinda Gates Foundation, analysed the world’s 20 largest drug companies, including their corporate strategy, research and development activities, pricing and patent policies. The so-called Big Pharma companies account collectively for 70 per cent of global pharmaceutical revenues. 

Jay Iyer, Access to Medicine executive director, said: “Our data show that the industry is moving beyond just scratching the surface and making a real effort to provide access for everyone to the medicines they need. But we need to build further on what has been achieved. There is still a long way to go.”

Although the industry has been accused of neglecting diseases that mainly affect the developed world, the report found a big improvement in the research and development pipeline for a set of 47 conditions that the foundation regards as having the highest priority because they cause the most ill health and suffering.

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They include infections such as HIV/Aids, malaria and tuberculosis; neglected tropical diseases caused by parasites such as sleeping sickness and river blindness; and non-communicable conditions including diabetes, stroke and heart disease.

The number of R&D projects has more than doubled in just four years from 327 in 2014 to 673 in 2018. Of those 673 projects, 285 were already being tested in patients and 388 had yet to reach clinical development. Maternal and neonatal health was the only area where R&D fell, to nine projects in 2018.

Over the wider 10-year period, 171 new medicines for priority diseases have already emerged from the industry’s R&D pipeline and received marketing approval. The largest number treat diabetes, followed by HIV/Aids. Cancer was not included in the analysis.

A frequent charge against the industry is that it inflates drug prices to unaffordable levels. But the foundation reported that these new medicines are supported increasingly by initiatives to help patients obtain treatment in poorer countries. These include “equitable pricing strategies” to hold down drug costs, “voluntary licensing” of intellectual property to enable local companies to produce cheaper versions, and direct “donations” of subsidised products.

All three initiatives are gaining support from the industry, the report showed. In 2018, for example, 447 products evaluated in the report were covered by equitable pricing strategies, up from 230 in 2014, although a further 589 were not covered last year.

The pharma industry have come to recognise access to medicine as a strategic issue in a way that was not the case only a few years ago. In 2010 just eight Big Pharma companies had an access strategy for low and middle income countries; today 17 of the 20 do.

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The report identified several reasons for the shift. One was the emergence of a significant market for the industry’s products in these countries; AstraZeneca and Sanofi generate about 30 per cent of revenues from emerging markets.

In addition, the reports said, “the social license to operate — society’s ongoing acceptance of a company’s way of doing business — rests on addressing access to medicine for the people who need it, regardless of income”.

Ms Iyer said: “We were really surprised by the way these drivers of progress are energising the industry.” She added: “We now have a workable and scalable approach for good practice in this area but we need it to be adopted in more countries by more companies for more diseases.”

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