Through our tried-and-tested model for change, we guide the world’s most influential healthcare companies to act on opportunities to make essential medicines accessible to people living in low- and middle-income countries, creating real impact on advancing healthcare equity.
Today, geography continues to be a predictor of maternal health outcomes, child survival rates of preventable diseases, and quality of life for people living with chronic conditions. Addressing persistent gaps in access to lifesaving medicines is the key to tackling these disparities, but achieving real progress requires collective action.
The Access to Medicine Foundation’s multi-faceted model for change accelerates progress by setting evidence-based standards, activating companies, mobilising capital and holding the system accountable for progress. By bringing together key players in global health across the public and private sectors, we define clear expectations for the industry and turn commitment into action.
Impact by the numbers
In 2024, the Access to Medicine Foundation commissioned an independent evaluation of our progress in advancing access to medicine in LMICs, confirming the power of our model of change to drive transformation. The evaluation found that "the work of the Foundation is highly relevant and unique in the global health ecosystem, has a strong influence on corporate approaches to access, and has significantly contributed to improving access to medicines in low-and middle-income countries."
According to key informants, the Foundation has a unique role in the ecosystem because it guides companies on their access approaches and incentivises them to do better. There is no other mechanism in the ecosystem that fulfils this important function. As one stakeholder put it: “if the Foundation did not exist, there would be a strong rationale to create it.
The assessment shows that small investments in accountability and coordination in areas within the Foundation’s scope can unlock significant health and economic value.
* These estimates are based on the health and economic benefits of a small sample of examples of expanded access to five product types by six companies. The independent modelling was based on insights and data from key informant interviews with over 80 stakeholders of the Foundation worldwide, a document review, and a value for money assessment, which applied the “4E” framework (Economy, Efficiency, Effectiveness and Equity) and used benefit-cost modelling and benchmarking.
From board-level accountability to ensuring medicines are launched in LMICs, we fuel the effort to improve access to medicine through our multi-faceted approach. The case studies, below, highlight some examples of how our work has measurably changed the industry.
CASE STUDY 1: Embedding access in pharmaceutical strategy
Before the 2000s, pharmaceutical companies’ efforts to expand access to their products in LMICs largely took the form of corporate social responsibility (CSR)-led, philanthropic initiatives that lacked long-term sustainability and clear accountability. This resulted in unreliable access for people living in LMICs.
With the launch of the Access to Medicine Index – an investor-relevant, transparent measure of pharmaceutical company behaviour – the Foundation catalysed a shift from CSR-led access efforts toward corporate strategies with access initiatives embedded at their core. The Foundation’s impact is reflected in the rise in multinational companies with board-level accountability, which grew from 11 to 17 between 2018 and 2024.
CASE STUDY 2: Expanding access to innovative medicine in LMICs
In the 2010s, research from the Foundation's Access to Medicine Index Programme highlighted delays in the availability of new medicines in regions where access is most urgently needed. One key driver was identified: that pharmaceutical companies were not proactively planning to make new medicines available in LMICs, resulting in access delays.
To help prevent these gaps, the 2018 Access to Medicine Index recommended that companies begin access planning during research and development (R&D). This ensures that essential products become accessible to those in need more quickly once products are approved. Our impact is reflected in the rise in multinational companies with structured access planning frameworks, increasing from increasing from only one company in 2018 to 17 in 2024.
CASE STUDY 3: Pfizer expands equitable pricing strategies
Voluntary differential pricing models can help make essential medicines affordable in LMICs, but research from the Foundation’s Access to Medicine Index Programme found that many countries in need still did not benefit from these models. The 2021 Access to Medicine Index included recommendations for companies to improve their equitable pricing strategies, including a specific opportunity for Pfizer to expand the availability and affordability of key products in low-income countries such as palbociclib (Ibrance®) for breast cancer and the antibiotic, ceftazidime/avibactam (Zavicefta®).
In 2022, Pfizer launched ‘An Accord for a Healthier World,’ with the aim to provide all of Pfizer’s patented, high-quality medicines and vaccines available in the US or the European Union on a not-for-profit basis in 45 lower-income countries, with both Ibrance® and Zavicefta® included in the scope of the Accord. As of 2024, Pfizer had signed agreements with 10 countries, including Ghana, Malawi, Rwanda and Senegal to enable access to its medicines and vaccines on a not-for-profit basis.
CASE STUDY 4: Sanofi launches Global Health Unit
The 2021 Access to Medicine Index found that less than half of key products are covered by pharma companies’ access strategies in poorer countries. To guide the industry to improve in this area, the report made specific recommendations for companies to improve their access strategies, including a specific opportunity for Sanofi to apply an equitable pricing strategy in low-income countries to improve access and affordability of its products.
Later that year, Sanofi launched a Global Health Unit (GHU) aiming to increase access to 30 products across 40 countries with a focus on non-communicable diseases (NCDs). The medicines included insulin glargine, a long-acting analogue that had recently been added to the World Health Organization’s Model List of Essential Medicines, which is also a product directly referenced in the 2021 Index’s recommendation to Sanofi. Thibaud Lefort, Head of Operations of Sanofi Global Health, directly acknowledged the Index's impact on the company’s creation of the GHU in September 2021 at a high-level event. In 2025, the company reported having reached over one million patients with NCD treatments through the GHU.
“The insights gained through the Access to Medicine Index really serve as a bit of a North Star in terms of best practice and what could be done to expand our work in access to medicines and in global health equity”
Carissa Vados
Vice President Social Responsibility, Novo Nordisk
“The Foundation has had a huge impact, and has really driven change in the company. We pride ourselves that by improving in many areas [in the Index] we’ve improved our ranking, from 16 to 9 in two iterations, but we know we can’t rest.”
Claus Runge
Global Head of Public Affairs, Sustainability & Internal Engagement, Bayer Pharmaceuticals
“[The Index] clearly shows us what the best practices are, and also, what the opportunities to improve are for us as a company. We use these insights when we plan and implement new programs and initiatives, and simply to continuously improve what we do.”
Ina Witte
Associate Director Sustainability at Boehringer Ingelheim
