- © 2008 Canadian Medical Association
The World Health Organization says that improving access to important and lifesaving medicines could save as many as 10 million lives a year. Yet in a world where a billion people live on less than $1 a day, and important medicines consume a growing portion of the incomes of the planet's most destitute, there are no benchmarks that reveal the accessibility of medicines to the most poor. The impact of company policies on the availability of patented products in poor countries is largely unknown and it's all but a total mystery as to how much of a company's research budget is spent on discovering cures for diseases that affect the poor.
Until now, that is.
At least, that's the hope of the developers of a recently minted social responsibility index (http://atmindex.org/) that will track and measure the efforts of individual drug companies in ensuring that access to effective and affordable medicine is part of their corporate business plan.
Launched in June 2008, the index was established by the Access to Medicine Foundation, based in the Netherlands, which aims to raise awareness of the vital issue of global access to medicine by ranking 20 of the world's largest drug companies by how well they perform around 28 key indicators grouped into 8 main criteria. Those include patents, philanthropy, research and development, and pricing (Box 1). The upshot will be an “at-a-glance” snapshot of a company's social responsibility record.
Wim Leereveld, the founder and chief executive officer of the index, sees his initiative as being all about transparency. “What gets measured gets managed,” he told CMAJ in an email interview. As each company becomes “transparent in what they do, or don't do, their roles will be much clearer and they will hopefully set and achieve goals for access to medicine for all.”
Leereveld adds that encouraging companies to meet these goals requires the involvement of many stakeholders including governments, experts, non-governmental organizations and others.
Vancouver-based corporate responsibility expert Coro Strandberg is impressed by the index's comprehensiveness and user-friendliness.
But as with other efforts to weigh corporate social responsibility, she cautioned that if the index is to grow into a trusted measuring tool, it will have to be based on data that is current and verifiable by third parties. For now, though, Strandberg stresses that it's a valuable step that the index has been launched and is freely available on the Internet to those wanting to compare the progress of major drug manufacturer's in achieving the criteria.
Leereveld forecasts that “the criteria will be sharper every year. … I know that we have achieved goals if all measured companies have adapted their policy to the policies of leading companies.”
Strandberg notes that such indices can help socially minded investors and consumers make ethical purchasing decisions and ultimately those decisions will affect the corporate behaviour of the manufacturers.
But some fear it could evolve into little more than a public relations tool for big pharma.
Tim Reed of the Amsterdam-based Health Action International is concerned that the index may just be “scratching the surface of corporate social responsibility.” The bulk of the data used to construct the index is self-reported, he notes, adding that robust data provided by local consumers and patients would be a valuable addition. Yet, many would maintain that simply establishing the index has the potential to aid in drugs becoming more accessible in the developing world.
The first index identifies UK-based GlaxoSmithKline as the current industry leader when it comes to improving access to drugs and vaccines.
Footnotes
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Dr. Alan Cassels is a drug policy researcher at the University of Victoria and a self-described pharmaceutical skeptic. His most recent book was The ABCs of Disease Mongering: An Epidemic in 26 Letters (CMAJ 2008:179[1]:58-9).