Pharmaceutical companies fall short in expanding access to Low-and Middle-Income Countries

While some companies are adopting inclusive practices, the overall progress toward improving global health equity remains insufficient, according to the Access to Medicine Foundation.

“Pharmaceutical companies are not fully leveraging their potential to extend patient reach in LMICs,” the Foundation stated in its latest report.

Despite the industry's role in developing life-saving drugs, many populations in LMICs are left underserved due to a combination of declining licensing agreements, inadequate R&D prioritization, and a lack of transparency in patient reach.

Stagnation in Licensing and Clinical Trials

One of the most concerning findings is the sharp decline in licensing agreements that allow generic manufacturers to produce and distribute life-saving drugs at lower costs.

Voluntary licensing has long been seen as a key strategy to improve affordability in LMICs, yet fewer agreements have been made compared to previous years.

Additionally, only 43% of clinical trials are currently conducted in LMICs. This figure underscores the exclusion of these regions in critical stages of drug development, from testing to availability. The result is a widening gap in access to innovative therapies, particularly for diseases that disproportionately affect LMIC populations.

“Without meaningful clinical trial representation, LMICs will remain on the periphery of innovation,” the Foundation warned.

R&D and Product Accessibility Gaps

Research and development (R&D) targeting diseases prevalent in LMICs also remains an area of concern. Although some companies have made commitments to develop drugs for diseases such as tuberculosis and malaria, the overall investment in this area is not meeting the scale of need.

Equally troubling is the lack of transparency in data regarding the number of patients reached in LMICs. The Foundation emphasized that this opacity makes it difficult to measure the impact of pharmaceutical companies’ initiatives or to hold them accountable for their commitments.

“Data transparency is not just a nice-to-have; it’s essential for understanding whether efforts to improve access are effective,” the report noted.

A Shift in Leadership: Novartis Tops the Index

For the first time, Novartis has overtaken GlaxoSmithKline (GSK) to secure the top position in the Access to Medicine Index. This shift reflects Novartis' adoption of innovative business models and commitment to affordability programs.

The company's strong focus on expanding its reach in LMICs has been lauded, but the report stresses that no company is currently meeting its full potential in tackling global health inequities.

“Novartis has shown what can be achieved with clear strategies and commitments, but the overall industry needs to step up,” the Foundation remarked.

Recommendations for the Future

The Access to Medicine Foundation calls for immediate and robust action from pharmaceutical companies to address the identified shortcomings. These include:

Scaling Voluntary Licensing: Expanding agreements with generic manufacturers to lower drug costs and improve availability.

Increased R&D for LMIC-Specific Needs: Prioritizing diseases that disproportionately impact these regions.

Data Transparency: Publicly sharing patient reach data to allow for accountability and informed decision-making.

Inclusive Clinical Trials: Ensuring LMICs are adequately represented in the development and testing of new medicines.

“The lack of progress in patient accessibility is alarming, especially in a world where innovation should translate into inclusivity,” the Foundation stated.

The findings of the 2024 Access to Medicine Index underscore the need for pharmaceutical companies to re-evaluate their strategies and make healthcare access a central tenet of their operations. While progress has been made in certain areas, the overall pace remains too slow to address the pressing health challenges faced by billions of people in LMICs.