A research programme by the Access to Medicine Foundation

Capacity Building

Some of the biggest barriers to access to medicine relate to gaps in local pharmaceutical and health systems. Companies can draw on their capabilities and expertise to increase the availability of quality-assured, safe and effective medicine, while helping to build and strengthen future markets.

  • Commitments
  • Transparancy
  • Performance
  • Innovation
1 2 GlaxoSmithKline plc
4.40

GlaxoSmithKline plc

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2 3 Johnson & Johnson
4.24

Johnson & Johnson

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3 1 Novartis AG
3.75

Novartis AG

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4 7 Novo Nordisk A/S
3.26

Novo Nordisk A/S

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5 9 Pfizer Inc.
3.04

Pfizer Inc.

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6 = Merck KGaA
2.43

Merck KGaA

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7 10 Takeda Pharmaceutical Co. Ltd.
2.35

Takeda Pharmaceutical Co. Ltd.

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8 = Sanofi
2.29

Sanofi

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9 19 Roche Holding AG
2.24

Roche Holding AG

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10 4 AstraZeneca plc
2.16

AstraZeneca plc

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11 14 Eisai Co. Ltd.
2.00

Eisai Co. Ltd.

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12 17 Boehringer Ingelheim GmbH
1.97

Boehringer Ingelheim GmbH

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13 18 Gilead Sciences Inc.
1.55

Gilead Sciences Inc.

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14 13 Bayer AG
1.22

Bayer AG

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15 5 Merck & Co., Inc.
1.15

Merck & Co., Inc.

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16 12 AbbVie Inc.
0.86

AbbVie Inc.

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17 10 Astellas Pharma Inc.
0.85

Astellas Pharma Inc.

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18 16 Bristol-Myers Squibb Co.
0.74

Bristol-Myers Squibb Co.

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19 11 Daiichi Sankyo Co. Ltd.
0.51

Daiichi Sankyo Co. Ltd.

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20 15 Eli Lilly & Co.
0.34

Eli Lilly & Co.

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0 1 2 3 4 5

Leaders build diverse capacities, with more initiatives in line with expected standards

GSK and Johnson & Johnson overtake Novartis to gain the lead. Most top ten companies build diverse capacities around the world. Overall, the 20 companies are most active in health system strengthening in countries in scope and least active in pharmacovigilance. There are four groups: two leaders (GSK and Johnson & Johnson), three good performers (Novartis, Novo Nordisk and Pfizer) ahead of a middle group of seven (Merck KGaA to Boehringer Ingelheim) and a large group of laggards. Ranking in 2018 puts more emphasis on the quality of initiatives than in 2016. There is some movement up the ranks and a wider spread of scores than in 2016.


Leaders innovate and measure impact

The two leaders are active in all five areas of capacity building examined. In all five, they have initiatives that meet all good practice standards.* They are among only five companies measuring the impact of at least one capacity building initiative. 

GSK (1st) and Johnson & Johnson (2nd) both have 23 initiatives that meet basic criteria, including 18 and 11 initiatives respectively that meet all good practice standards.* They perform well in all areas, and both demonstrate innovative approaches to health systems strengthening. GSK works with partners to improve the health, wellbeing and productivity of garment workers in Bangladesh (see page 127). Johnson & Johnson is involved in the DREAMS partnership run by the President’s Emergency Plan for AIDS Relief (PEPFAR) and an HIV resistance- mapping project (see page 128). This initiative operates in ten sub-Saharan African countries.

Movement up the rankings reflects quality of initiatives

There is movement up and down the ranking due to the 2018 Index’s focus on the quality of a selection of capacity building initiatives (in previous years, the Index assessed the total number of initiatives companies run). Companies move up or hold on to higher rankings by showing that initiatives meet more good practice standards. 

Roche rises 10 (to 9th), with multiple capacity building activities aimed at improving cancer control and improved transparency compared to 2016. Gilead rises 5 (to 13th), with a strong philanthropic approach and initiatives in R&D capacity building and health system strengthening. Pfizer rises 4 (to 5th), possibly as philanthropic investment in global health is one of the pillars of its access-to-medicine strategy. It has multiple high-quality initiatives in manufacturing, supply chain and health system strengthening.

 Daiichi Sankyo falls 8 (to 19th) as the Index puts greater emphasis on initiative quality. It has fewer initiatives in 2018 that meet the criteria for assessment (two initiatives, both in manufacturing capacity building). Merck & Co., Inc. falls 10 (to 15th). It is less transparent than in previous years, particularly regarding capacity building activities in R&D, manufacturing and pharmacovigilance.

Middle ranked companies shine in one or two areas

Novartis, Novo Nordisk and Pfizer are the three good performers chasing the leaders. They all perform well in four out of five areas examined. Novo Nordisk also has an innovative new initiative to provide basic care and treatment to people with hypertension and diabetes during humanitarian crises. 

The seven companies in the middle group (Merck KGaA in 6th to Boehringer Ingelheim in 12th) typically perform well in one or two areas of capacity building. For example, Merck KGaA (6th) does well in manufacturing capacity building while AstraZeneca (10th) and Boehringer Ingelheim (12th) excel in health systems strengthening. 

The nine laggards (Gilead in 13th to Eli Lilly in 20th) each have between one and eight initiatives that met inclusion criteria, including a few that meet several good practice standards. Several companies are considerably less transparent than peers across several areas of measurement, namely Merck & Co., Inc. (15th), AbbVie (16th) and Eli Lilly (20th).


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View our detailed overview of each company’s performance in the Index, including breakdowns of their product portfolios and R&D pipelines.