Fair and equitable access to medicine

Over the past 18 months, the importance of effective health care has been brought into sharp focus. However, today two billion people cannot access the medicine they need due to price and accessibility among other factors. 

Stethoscope and globe

A further 100 million people have been pushed into poverty due to their health care expenses. This struggle is being exacerbated as donor countries are tightening their budgets, reducing development aid for health. This is hitting low-income countries the hardest as they are having to pay more for healthcare.

Fair and equitable access to medicine is a crucial step in achieving universal healthcare and enabling people to access the care they need, despite financial constraints. The Access to Medicine Foundation (AtM) strives to achieve this by encouraging pharmaceutical companies to embed access within their strategy, research and pricing. At Rathbone Greenbank Investments we are committed to overcoming the inequity in healthcare and have collaborated with AtM since 2010.

What does the Access to Medicine Foundation do?

AtM has developed an index which seeks to stimulate change in the pharmaceutical sector, by benchmarking how the world’s 20 largest pharmaceutical companies are addressing access to medicine in 106 low-or-middle income countries. 82 pathogens, diseases and conditions, including communicable diseases, non-communicable diseases, neglected tropical diseases and maternal and neonatal health conditions fall into the scope of the index. The index can therefore be used to inspire competition between companies on priority areas, provide guidance on how to improve access and offers a framework for investors to engage with companies for positive change.

The Access to Medicine Foundation’s role in the Covid-19 vaccine rollout

"In February 2021, over 75% of vaccines had been delivered to just 10 countries, whilst 130 countries, home to 2.5 billion people, were yet to administer a single dose."

In February 2021, over 75% of vaccines had been delivered to just 10 countries, whilst 130 countries, home to 2.5 billion people, were yet to administer a single dose. This has caused the virus to proliferate in low-and-middle income countries, causing more deaths and increased economic loss.

Investor action has been fundamental in facilitating a global vaccine rollout. Coordinated by AtM, to tackle the potential impact of unequal vaccine deployment, almost 150 investors issued a call to governments for a “fair and equitable” global response to Covid-19. 

The signatories, with assets under management of over US $13 trillion, committed to engage with healthcare companies to promote bolder action, stimulate investee companies to support AtM, and urge governments to explore innovative finance mechanisms, including encouraging them to finance the Access to Covid-19 Tools (ACT) Accelerator in full. 

This ACT Accelerator is an initiative established during the Covid-19 pandemic to accelerate the development, production and deployment of Covid-19 tools, such as vaccines, protective personal equipment (PPE), therapeutics, diagnostics and medical oxygen. One key element of the ACT Accelerator is the COVAX scheme to broaden timely access to Covid-19 vaccines.

The COVAX scheme

G7 countries purchased a third of the global Covid-19 vaccine supply despite only housing 13% of the population. To tackle this inequity and ensure low income countries are not left behind during the vaccine rollout, the World Health Organisation and Unicef established the COVAX initiative. 

Under this scheme, many G7 and G20 governments have pledged to donate doses of Covid-19 vaccines to low-and-middle income countries, in addition to establishing funding for vaccine efficacy trials in different population groups, support for the evaluation and registration of vaccines across different markets, and R&D partnerships focused on Covid variants endemic in lower income countries. It aims to protect at least 20% of the population in these nations, starting with healthcare workers and the most vulnerable groups.  

Between March 2020 and September 2021, the scheme has enabled 323 million doses to be shipped to 142 countries. Nevertheless, the ambition to vaccinate 20% of the population is far from achieving a protective level of immunity for a community, therefore a continued push to ensure equitable vaccine access is needed. 

This target was aided by AstraZeneca and Johnson & Johnson, which pledged to sell their vaccines at cost price for the duration of the pandemic. 

How can investors help? 

"Greenbank has collaborated with Access to Medicine since 2010, and was a signatory of the global investor statement in support of an effective, fair and global response to Covid-19."

Greenbank has collaborated with Access to Medicine since 2010, and was a signatory of the global investor statement in support of an effective, fair and global response to Covid-19. 

To support the ambition of globally accessible Covid-19 vaccines, Rathbone Greenbank worked closely with AtM and spoke directly to the senior management of their investee healthcare companies, to inspire the rapid development of essential Covid-19 tools. 

Additionally, we have been encouraging the deployment of funds through innovative finance mechanisms that support the implementation of public and private programmes dedicated to the pandemic response and preparedness, helping to support the global economic recovery. Furthermore, Greenbank urged G7 and G20 countries to finance the ACT Accelerator in full. 

Together, we will have greater impact and can make strides in achieving universally accessible medicine. Therefore, we call on investors to join Rathbone Greenbank Investments in supporting AtM and helping to ensure equitable access to healthcare for all.