2021 Access to Medicine Index: highlighting our progress in advancing access to healthcare

Top ten ranking and recognition for our strong performance in governance, compliance and health systems strengthening

Written by:

Ashling Mulvaney

Vice President, Sustainability and Access to Healthcare, Global Sustainability

Andrea Nance

Associate Director, Global Sustainability, Access to Healthcare

At AstraZeneca, health is not only our business, it’s our contribution to society. At the heart of this ethos is that removing barriers and creating sustainable solutions for access to healthcare is essential for global health.1

It’s why we are delighted that, once again, we have been recognised among the top-10 global pharmaceutical companies (7th overall, up from 9th place in 2018) in the Access to Medicine Index (ATMI), a biennial report by the Access to Medicine Foundation evaluating the contributions of 20 pharmaceutical organisations to develop and make certain medicines, vaccines and diagnostics more accessible for people in low- and middle-income countries (LMICs), with a number of examples of best practices.2

To us, access to healthcare extends beyond simply the provision of medicines, to investment in sustainable and resilient healthcare ecosystems. As a company we support the United Nations (UN) Global Compact and its principles and we recognise our responsibility to contribute to the delivery of the UN Sustainable Development Goals (SDGs).3 We measure our contribution to society by connecting our company targets to the SDG targets, and our Access to Healthcare approach supports SDGs 3, 8 and 17 relating to health and wellbeing, sustainable economic growth and partnerships.

The most recent Index results recognise substantial progress in key focus areas, with specific recognition for our work in governance and compliance, where we ranked 3rd in the category, and health systems strengthening – addressing local needs, working with local partners and aiming for sustainability and integration within local health systems. Our multi-country initiatives, the Young Health Programme (YHP), the Healthy Lung Initiative and Healthy Heart Africa, were mentioned as a best practice in helping to equip health systems for the fight against non-communicable diseases (NCDs).2

As Jayasree K. Iyer, Executive Director, Access to Medicine Foundation, notes, “In the face of the current pandemic, the resilience of our healthcare systems is being put to the test, as is the agility and leadership of the pharmaceutical industry. The global need for sustainable access to medicine is being felt more urgently than ever, as we face the consequences of health systems that are hampered by a lack of access.”4

Key areas of progress since the 2018 Index

· Expanding Healthy Lung initiative beyond Asia to eight countries in scope of the Index, including Mexico, Colombia and Egypt

· Growing our footprint in Africa, with Healthy Heart Africa now established in Kenya, Ethiopia, Ghana, Tanzania and Uganda. Two new countries (Ghana and Uganda) since the 2018 index and additional planned in 2021

· Young Health Programme expanded from 5 to 9 countries in scope of the Index and 3 more countries planned in partnership with UNICEF

· Engaging in new ways of sharing IP, a public access Next Generation Sequencing Microbial Surveillance Toolbox for viral and bacterial genomes and an Open Innovation Programme with unpublished, preclinical data sets shared ad hoc with research organisations

· Joining the Bill and Melinda Gates Foundation COVID-19 Therapeutics Accelerator

· Starting Project Heart Beats for acute coronary syndrome in India

· Launching Brazil Health Innovation Hub

· Launching the Take CaRE of Me pilot to improve the end-to-end management of type 2 diabetes in 4 Index countries

· Collaborating with the Vietnam National Cancer Hospital to enhance cancer research capabilities

Source: Access to Medicines Index 20212

Addressing public health concerns in LMICs and access in R&D

In addition to a high ranking for governance, we received recognition for our R&D pipeline for products deemed in scope, achieving 6th place for having a large proportion of late-stage pipeline products that address public health concerns in LMICs and for having a structured process for access in R&D.

While the Index identifies ‘priority R&D’ as products to largely treat communicable or infectious disease, neglected tropical disease, or maternal and neonatal health conditions – and the majority of our pipeline centres on NCDs – it was highlighted that 46 of our late-stage R&D projects target either a priority disease or address a clear public health need in LMICs. In fact, we are proud to say that more than 60% of our entire development pipeline (50/79; 63%) targets either a priority disease or addresses a clear public health need in LMICs. We’ve also filed 20% of our most recently registered products in more than half of the countries with the highest disease burdens.

It was also recognised that we have developed access plans for our R&D pipeline at Phase II clinical development, for both in-house and partnered projects – with access plans for 25% of late-stage clinical programmes – and we scored above average for investing in R&D capacity in LMICs. We also performed well in product delivery, achieving 6th place for sharing unpublished preclinical data in drug discovery, engaging in multiple health system strengthening initiatives and developing access strategies for certain products and markets. Despite these achievements, we aim to increase our contribution to addressing the public health needs of LMICs.

Why do we focus on NCDs?

According to the World Health Organization, NCDs are the number one cause of death and disability globally. They claim the lives of more than 41 million people each year, place a significant burden on health systems and disproportionately impact low- and middle-income populations.5

Our performance demonstrates strategic focus on partnering to build resilient health systems, embedding disease awareness, education and prevention initiatives. And it underpins our ambition to meet the needs of diverse patient populations on the journey toward access to healthcare for all, as well as considering the environment’s impact on health, and supporting healthy environments to benefit prevention and reduce the scale of disease globally.

Alongside these efforts, we continue to work on the affordability of our medicines and, where necessary, address barriers beyond price. Particularly in developing economies, barriers to healthcare can include a lack of basic infrastructure, difficulty in accessing primary care, limited opportunities for disease education, and varying rates and speeds of diagnoses for many conditions. Our approach is tailored to address local needs with the aim of both improving health system resilience and supporting sustainable access to, and affordability of, healthcare.

Above all, continuous innovation and a long-term perspective are essential if we are to address evolving public health needs. Our long-term vision to tackle NCDs focuses on prevention, screening, diagnosis and health system strengthening – but we know that no one company, partner, or organisation can do this alone. It requires unification around a global agenda with clear pathways for implementation applied at a local level, ensuring words are followed by decisive action.

Health systems strengthening has been thrown into sharp focus amid the ongoing coronavirus pandemic, revealing long-standing fault lines in health systems. Work in partnership is needed to build health systems that are both resilient to crises and sustainable in the longer-term.6 To get there, we will continue to adapt and respond to the needs of local health systems and take these learnings into our future strategies for improving access to our medicines and healthcare infrastructure for all.


1. AstraZeneca Sustainability Report 2019. Available at: https://www.astrazeneca.com/content/dam/az/Sustainability/2020/pdf/Sustainability_Report_2019.pdf. Last accessed January 2021

2. Access to Medicine Foundation. 2021 Access to Medicine Index. Available at: https://accesstomedicinefoundation.org/media/uploads/downloads/601180a36e2e0_2021_Access_to_Medicine Index.pdf Last accessed January 2021

3. United Nations Global Compact. Uniting Business for a Better World. Available at: https://www.unglobalcompact.org/what-is-gc/our-work/sustainable-development. Last accessed January 2021

4. Access to Medicine Index 2021: Methodology. Available at: https://accesstomedicinefoundation.org/media/uploads/downloads/5f08703db73dc_Methodology_Report_for_2021_Access_to_Medicine_Index.pdf. Last accessed January 2021

5. World Health Organization. NCDs. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Last accessed January 2021

6. Partnership for Health System Sustainability and Resilience. World Economic Forum. Available at: https://www.weforum.org/phssr. Last accessed January 2021

Veeva ID: Z4-30363

Date of preparation: January 2021

Date of expiry: January 2023