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By RL Expert Leesa Soulodre

RL EXPERT Leesa Soulodre interviews Wim Leereveld, Founder and CEO of the Access to Medicine Foundation, about the Access to Medicine Index.
The concept that business is only in operations for profit is a fable that has long since lost its luster. Citizens around the world now hold drug companies to account over their willingness to provide access to medicine to the world’s poorest people.

Wim Leereveld, Founder and CEO of the Access to Medicine Foundation is one such citizen.
In 2004, Wim established the Access to Medicine Foundation in Amsterdam, with a core focus on the role of the world’s leading pharmaceutical companies in delivering access to medicine in low and middle-income countries. The Netherlands based non-profit organization aims to advance access to medicine in developing countries by encouraging the pharmaceutical industry to accept a greater role in improving access.
“My inspiration to set up the Access to Medicine Index was to support the two billion people who have no access to medicine to protect themselves against diseases such as tuberculosis, malaria and HIV/AIDS,” says Wim.
“Having worked with the pharmaceutical industry for more than 15 years, I knew these companies were willing to do something about this, but they needed to receive credit for their efforts and help. In my view the Pharmaceutical industry is not the problem; they are part of the solution. They have the know-how to create potentially life saving drugs. That’s why we need to help them perform better.”
Wim says the Index helps pharmaceutical companies to have greater awareness of what’s going on in the field of access to medicine.

“It helps to define their path in the world. Some companies do rather well and they have something to offer, something to show other companies. When that’s not seen, companies can’t learn from each other. When there is a list, where you can see exactly how companies deal with this problem, in pricing, in patents, in research and development, then other companies can learn from this increased transparency.”

The Access to Medicine Index (ATMI) is an independent initiative that provides insight into
what the world’s leading pharmaceutical companies are doing for the millions of people in developing countries who do not have reliable access to safe, effective and affordable medicines, vaccines and other health-related technologies.
The Index methodology was developed, and is continually refined, in consultation with
multiple stakeholders including the World Health Organization, NGOs, governments and universities, as well as 33 institutional investors. The Bill & Melinda Gates Foundation, the Dutch Ministry of Foreign Affairs, the UK Department for International Development and other charitable organizations fund the Index.

So, has the Index changed the issue of securing “sustainable access to medicines” to those 2 million people since its inception in 2004?
“Understanding the progress that has been made is quite complex, since these questions require ‘on the ground’ data, which some companies are now tracking themselves,” says Wim. “However, we feel it is too early to make a statement about this. With the new Index coming ın November 2014, we expect to have more data on these topics - because this is a question which we have put out to the companies we measure. We also expect to have a granular
overview of the R&D pipeline and products in the market, forthe 47 diseases with the highest burden.” 
In the meantime, the non-profit has started with a longitudinal analysis to see which areas companies are really improving in. This article was also published as a letter in the Lancet Global Health, which Wim says shows that the industry (or at least the 20 companies the Access to Medicine Index measures) have significantly improved their R&D efforts.
“This is, of course, the basis of getting life-saving products to the people most in need. More
companies are now developing more products for more diseases than in 2010. It will be interesting to see when the products get to the market, how they will reach the people who need them most.” 
The new 2014 ATMI scores companies on their commitments, performance, innovation and level of transparency across seven areas of activity considered key to improving access to medicine. The companies are graded on more than 100 factors covering these areas, including whether they are developing new drugs for neglected diseases, to what extent they facilitate or resist efforts to create generic versions of their drugs, and how they approach pricing in developing countries. Lobbying activities, marketing ethics, product donations and other philanthropic activities are also tracked. The survey for the 2014 Index captures companies’
policies and practices regarding access to medicine in 106 low-income and middle-income countries.
While key aspects of the Index methodology have remained the same to enable comparability over time, some strategic changes have been made to the 2014 Index. In order to capture efforts to meet patient needs, the 2014 Index will place greater emphasis on how companies assess and target local public health needs as part of their overall access strategy, R&D strategy, pricing strategies, capability advancement initiatives, product donations and philanthropic activities. 
The survey covers a broad range of areas: general access-to-medicine management; pricing,
manufacturing and distribution; public policy and market influence; patents and licensing; research and development; capability advancement; and donations and philanthropy.
The survey also requests details of company products that can be used to prevent, diagnose,
treat or manage a set of 47 high-burden diseases, namely all relevant medicines, microbicides,
therapeutic and preventive vaccines, diagnostics, vector-control products and platform
technologies. This includes information about both existing products and those currently
travelling along the R&D pipeline; as well as pricing strategies, patent status, and individual
access programs for each product. Wim says the ATMI is still in the process of being built.

“It’s still very young. It’s fascinating to see the pharmaceutical industry cooperating so well to
give all their data and to share their best practices with one another. It’s also good to see that the ATMI is also copied in other sectors like the food sector for malnutrition and obesity.
“The role of pharmaceutical companies in advancing access to medicine is changing; the
global health community and society as a whole have increased expectations of the private sector and are looking for more conscious capitalism,” says Wim. “The leading companies clearly understand this and since we began tracking their efforts in 2008, the Index has shown that they are moving forward, but the Index’s role is to provide the insight into industry-leading practices and a basis for comparison between peers so that companies can push themselves further.
This interview was published in the July 2014 issue of RepRisk Insight, an ESG Risk publication co-founded by RL Expert and its partner RepRisk AG for the financial markets and their investee multinational corporations.
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