After 20 years, how much has Big Pharma changed on access?

In the article, Andrew reports that more companies are incorporating access into their corporate strategies, with targets for chief executives and accountability at board level. Planning is also starting earlier in research and development, and nearly 70% of late-stage products now have access plans.  
 
He also discusses the expansion of inclusive business models. Six companies have introduced these models to make products available in low- and middle-income countries at lower prices than in higher-income countries. Gaps remain, particularly for non-communicable diseases such as diabetes, where access plans often focus on emerging markets and overlook underserves communities.

The article also considers how companies’ withdrawal from African can leave access fragile. Jayasree emphasises that every company has opportunities to improve, regardless of its ranking, and calls for further increases in the scale of access. 

In addition to the article, Andrew also interviews Jayasree K. Iyer, CEO of the Access to Medicine Foundation in person at the 2026 World Health Summit. In honor of the tenth edition of the Access to Medicine Index, Jayasree reflects on how the pharmaceutical industry has changed over two decades.

She discusses the inception of the Index and the concept of creating competition among companies to expand access to their products, examples of how this strategy has sparked real change, and areas where progress is still needed: