Thursday, December 8, 2022

Big Pharma’s new CEOs must step up efforts to erase inequalities in access to medicines

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I’ve been asked time and time again: Does the CEO’s vision have the power to change a pharmaceutical company so that it can solve global health problems?

My answer is “yes”. The power of a top executive in the pharmaceutical industry to change the global healthcare landscape is real. On the other hand, he or she (and, let’s face it, they arestill almost all men) can cause a lot of damage by adopting bad policies. But if they are truly prepared to make the drastic changes this industry so desperately needs, they can also make a big difference for good.

The question matters more than ever. As the world grapples with the biggest health crisis in more than a century, the pharmaceutical industry has a crucial role to play in ensuring that medicines and COVID-19 vaccines reach those who need it most, be they rich or poor. We are counting on the industry’s infrastructure, production capacity and scientific know-how to throw the world a lifeline during this pandemic.

However, the question is also very relevant as a new generation of CEOs have recently taken the helm of some of the world’s largest pharmaceutical companies. Gilead, Sanofi, and Pfizer are among the drug manufacturers whose CEOs have been in office for two years or less. And all of us – from government ministers and stock investors to the children of rural Africa – need them to steer their businesses in the right direction.

I run the Access to the Foundation in medicine, where, for more than fifteen years, we have evaluated the contribution of the pharmaceutical industry to global health. During this period, we have seen progress, especially in R&D and in the way companies approach access to medicines. Our foundation also publishes the Drug access index, where we rank companies based on their ability to meet the health needs of the world’s population.

Historically, there have been important interventions, such as the decision in the 1980s of Roy Vagelos, then leader Merck, to distribute free ivermectin, a river blindness drug, setting the standard for industry engagement in the elimination of several neglected tropical diseases through donations.

But the activity of pharmaceutical companies is still focused on too few countries and too few diseases, and a handful of companies bear the brunt of the burden when it comes to expanding access. medicines in underserved areas of the world.

We have seen the likes of GlaxoSmithKline, under the leadership of former CEO Sir Andrew Witty, shifting from a volume-based approach to a margin-based approach to strengthen access to low-income markets, for example for vaccines. It led GSK to reduce drug prices in 50 of the poorest countries, freed up intellectual property rights in a patent pool to encourage the development of new drugs, and invested 20% of the profits of the least developed countries in the medical infrastructure of these countries. While some say it cost GSK money and maybe even contributed to Witty’s loss of her job, the company’s actions have saved the lives of many, which should matter.

It’s concrete steps like these – rather than warm words or corporate statements – that we evaluate. For example, how responsibly are operations governed? Where do companies deploy their R&D efforts? How do they deal with intellectual property issues? And, most importantly, how do they approach prices and improve the ability to make sure people around the world get the drugs they make? These are the factors that determine whether a business moves up or down in the Access to Medicine Foundation rankings.

In January 2021, we’ll be releasing the next Index, and I expect it to be reviewed more carefully than ever. This year has been a unique testing period for the industry, but the message to the pharmaceutical industry has been clear: ensuring equitable access to medicines is not only the right thing to do, but it is also the right thing to do. strategically and economically smart thing to do. COVID-19 has underscored the critical importance of access for the long-term sustainability of the pharmaceutical sector, and it has pushed the issue onto the agenda of investors who provide businesses with financial vitality.

A new guard of industry CEOs, different in their points of view and more public in their voice and vision, now has the opportunity to move the dial. We have already seen them speak out on several other important ESG (environmental, social and corporate governance) issues, including gender and race equity, work-life balance and the environment. . Unfortunately, they have also been far too reluctant about the need for better access to medicines.

This young generation of CEOs of the pharmaceutical industry is active on social media, which tells us that they are not afraid to make their opinion public. Yet they still face an industry that is greatly distrusted and better known for the high prices of its drugs than for the lives it can save. Now is the time to change that. To do this, we need CEOs who put people before profits and are ready to solve the industry’s chronic challenges. The price is that by taking a step forward, they will be able to rally like-minded investors and unleash the potential of like-minded employees, who will be incentivized into jobs with social and health impact. most important.

Making binding commitments to expand access to specific medicines is a great starting point for these new CEOs to show leadership and encourage others to follow. In areas such as maternal and child health, antimicrobial resistance, noncommunicable diseases and now COVID-19, we have seen that commitments made by a few actors can have a snowball effect, leading to promises and corresponding actions on the part of others.

But commitments in specific areas are just the start. More fundamentally, the industry must tackle the high cost of drugs by challenging the entrenched expectations of extremely high profit margins that underpin them. CEOs must convince shareholders that their companies should benefit citizens around the world, not just for altruistic reasons, but because expanding access to emerging markets and low-income countries can unlock untapped revenue streams. , although at lower margins. Until that happens, the simple fact is that many life-saving drugs invented by the pharmaceutical industry will remain out of reach for hundreds of millions of people.

We need a CEO to tackle these deeply rooted inequalities in the current business model of the pharmaceutical industry.

Who will take a step forward?

Jayasree K. Iyer is the Executive Director of the Foundation for Access to Medicine.

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