SDG SERIES: The Access to Medicine Index and Accountability of Pharmaceutical Companies

SDG Goal 3: Good Health
SDG Goal 3: Good Health

Damiano de Felice and Danny Edwards

The United Nations summit for the adoption of the post-2015 development agenda will be held in New York later this week. The draft outcome document, titled “Transforming our world: the 2030 Agenda for Sustainable Development”, includes 17 Sustainable Development Goals (SDGs) and a “revitalized” Global Partnership to ensure their implementation.1 Formal inclusion of the private sector (in addition to governments, civil society, the UN system and other actors) is one of the defining features of this Global Partnership.

Official involvement of the private sector in global development efforts is welcome. Plenty of studies have shown how corporate actions can have significant impacts, positive and negative, for vulnerable people and for marginalised communities.2 However, it also raises an important question. How will the private sector be held accountable for its contribution to the Global Partnership?

The pivotal role that accountability plays in ensuring the full implementation of the SDGs has been stressed by the Committee for Development Policy of the United Nations, and many other actors with a stake in the development of these goals.3 For instance, Paul Hunt (former Special Rapporteur on the Right to Health) expressly noted the important work of independent actors “analysing … whether pledges, promises and commitments have been kept by countries, donors and non-state actors.”4

The Access to Medicine Index is one of the few existing examples of a mechanism focused on holding private sector actors accountable to development-oriented goals. It is a biennial ranking of the top 20 research-based pharmaceutical companies, based on their efforts to improve access to medicine for people living in developing countries.5 The Index uses a weighted analytical framework of 95 indicators to consistently capture and compare company data across 106 countries, 47 diseases, and 6 product types (not only medicines, but also vaccines, diagnostics, etc.).

The Index was already widely perceived as a strong accountability mechanism for the Millennium Development Goals (MDGs). In 2013, the MDGs Gap Task Force reported the results of the 2012 Index because it recognized that “[i]t is important to monitor and evaluate what pharmaceutical companies themselves, as the producers and suppliers of medicines, are doing to increase access to their products”.6

In April 2015, the organization behind The Index, Access to Medicine Foundation, published a landscape report mapping how the pharmaceutical companies it tracks had responded to global calls for action on MDG 5.7 The report enabled relevant actors to identify where more action was needed, and triggered some companies to do more.

The Index will become even more relevant after the adoption of the SDGs. To start with, it will provide important information to track the contribution of pharmaceutical companies to SDG 3, which is dedicated to “ensure healthy lives and promote well-being for all at all ages”. For instance, target 3.8 aims to “achieve universal health coverage (UHC), including … access to safe, effective, quality, and affordable essential medicines and vaccines for all”. Since access to medicine is not just a price or supply issue, The Index adopts a holistic perspective to measuring the responsibilities of pharmaceutical companies in promoting better health outcomes in low and middle-income countries. Its framework of indicators is constructed along seven areas of focus: governance, compliance, research and development (R&D), pricing, intellectual property management, capacity building and product donations.

The Index also includes indicators that are relevant for other actions covered by the SDGs. Just to offer a few examples:

Capacity building. SDG 9 (target 9.5) aims to “enhance scientific research, upgrade the technological capabilities of industrial sectors in all countries, particularly developing countries”. The Index assesses whether pharmaceutical companies assist local manufacturers or in-house manufacturing facilities to achieve relevant international standards of manufacturing practice through training or technology transfer. In addition, it gauges whether companies participate in local partnerships with public sector research institutes or universities to increase local capacity for health research, including clinical trials, and product development.

Participatory processes. SDG 16 (target 16.7) aims to “ensure responsive, inclusive, participatory and representative decision-making at all levels”. The Index investigates whether pharmaceutical companies have systems in place to incorporate external and local market perspectives into the development and implementation of access strategies.

Multi-stakeholder partnerships. SDG 17 (target 17.16) aims to “enhance multi-stakeholder partnerships that mobilize and share knowledge, expertise, technologies and financial resources to support the achievement of sustainable development goals in all countries, particularly developing countries”. The Index incentivizes pharmaceutical companies to participate in collaborative R&D initiatives to develop products or formulations that would overcome access issues in low and middle income countries.

The latest draft of the 2030 Agenda for Sustainable Development provides that a High Level Political Forum (HLPF) under the auspices of the General Assembly and the Economic and Social Council will have the central role in overseeing follow-up and review at the global level. Interestingly, the HLPF will be tasked to carry out regular reviews that will include relevant stakeholders, including the private sector.8

This is promising. Efforts to track progress towards the MDGs focused mainly on government action rather than corporate contributions. However, measuring businesses is as fundamental as measuring governments. As we head into the SDG era, rigorous benchmarking of pharmaceutical companies will be crucial to incentivize responsible behavior and identify what works in the long-term.

Damiano de Felice is Strategic Adviser to the CEO of the Access to Medicine Foundation.

Danny Edwards is Senior Researcher at the Access to Medicine Foundation. Please address correspondence to or



1 “Transforming Our World: The 2030 Agenda for Sustainable Development” (Finalised Text for Adoption, 1 August), available at:

2 See, for instance, United Nations Industrial Development Organization and United Nations Global Compact, “Engaging the Private Sector in the Post-2015 Agenda” (2014), available at:; Business & Human Rights Resource Centre,

3 José Antonio Ocampo, “A Post-2015 Monitoring and Accountability Framework” (CDP Background Paper No. 27, August 2015), available at:

4 Paul Hunt, “SDG SERIES: SDGs and the Importance of Formal Independent Review: An Opportunity for Health to Lead the Way” (2 September 2015), available at:

5 Access to Medicine Foundation,

6 MDG Gap Task Force, “Report 2013: The Challenge We Face” (2013), p. 63, available at:

7 Access to Medicine Foundation, “Improving maternal health and access to contraceptives: pharmaceutical companies’ contribution to MDG 5” (April 2015), available at: 8 See note 1, para. 84.