In a world where 80% of the population lives in low and middle-income countries, pharmaceutical industry leaders are redefining how access to medicine is approached, moving from philanthropy to sustainable business models that can withstand geopolitical pressures.
Content produced using generative AI technology to summarise the transcripts of recent conference sessions. Published 13 August, 2025.
Industry Transformation: From CSR to Core Strategy
The pharmaceutical industry has undergone a significant evolution in its approach to global health access. What was once relegated to corporate social responsibility departments has now become embedded in core business strategies at leading companies.
"What really made a big difference for us was the reframing of global health not as corporate social responsibility or philanthropy, but defining it as a business in its own right," explained Dr Lutz Hegemann, President of Global Health at Novartis. "That truly unlocks potential within the organization because that is what all of us know best in the pharmaceutical sector – how to make sure that we get our medicines to patients."
This shift represents a fundamental change in thinking. Rather than viewing access initiatives as charitable endeavors that flourish only when profits are strong, companies like Novartis, AstraZeneca, and GSK have integrated access considerations throughout their operations – from early R&D to market delivery.
Dr. Nazneen Rahman, Non-Executive Director and Chair of the Sustainability Committee at AstraZeneca, emphasized this point: "If it sits within philanthropy, if it's something you do when times are good, then it's not resilient. It's going to be the first thing to fall when you're under stress."
Access Planning Begins at Drug Development
A key insight shared by the panelists was the importance of considering access from the earliest stages of drug development.
Novartis has implemented an Access Framework that guides their efforts from the design phase. "In the R&D space already, we consider if the medicine is fit for purpose to be not only administered in high-resourced settings in the global north, but is the medicine fit for purpose also in resource-constrained settings," Hegemann explained.
This early planning extends to regulatory strategies as well. What used to be a lag phase of up to 10 years between regulatory approval in high-income countries versus low-income countries has been dramatically reduced through global submission strategies.
Nicola Cameron, Senior Strategy Director of Global Health at GSK, highlighted their approach to tuberculosis vaccine development: "The collaboration around GSK’s TB candidate vaccine underlines the importance of collaborating with multiple stakeholders at every step – from R&D through to access planning and engagement. The phase three trials for M72/AS01 are being conducted by Gates Medical Research Institutes, funded by the Gates Foundation and Wellcome Trust and supported by GSK. In parallel to this, we are working together on demand planning to ensure that, if the rial proves successful, the vaccine will have a clear and effective pathway to reach those who need it most.”
Partnerships as the Cornerstone of Access
All panelists emphasized that partnerships are essential to achieving meaningful access at scale.
"We can't do it alone," noted Cameron. "Partnership is really important to increasing access, and it's baked into every part of our global health model. We very much work with organizations who have complementary capabilities."
These partnerships span the entire healthcare ecosystem – from R&D collaborations to health system strengthening initiatives. AstraZeneca's work in early cancer detection demonstrates this approach.
"One of the programs that we've had has been a partnership bringing early detection for lung cancer through AI-driven chest X-rays – so much more cost-effective – that hopefully will roll out to about 5 million by the end of this year," shared Rahman.
Navigating Geopolitical Challenges
The panel acknowledged that current geopolitical tensions create additional hurdles for global access initiatives. However, they emphasized that embedding access into core business operations provides resilience during turbulent times.
"These are unsettled times, but in fact, times are always unsettled, and many parts of the world have been under extreme stress for many years," Rahman observed. "So I think that the expectation is that the company, what we're trying to deliver, will be under some kind of stress of some kind."
Hegemann highlighted fragmentation as a significant barrier: "What we are really struggling with is the fragmentation that exists in part of the world that stands in the way of leveraging economies of scale. If we have to register 52 individual registrations and bespoke packaging and bespoke labels for subscale markets, then that stands in the way of our ability to drive efficiency, scale, and also affordability."
Looking Ahead: Innovations for the Next Decade
When asked about innovations that will define the next decade of access, the panelists pointed to several promising developments.
Hegemann discussed how cutting-edge technologies might actually benefit resource-constrained settings: "If you think of siRNA technology where essentially now with a once-annual injection you can control your blood pressure or cholesterol, that is almost tailor-made for resource-constrained settings where you have a significant deficit of healthcare workers."
Rahman emphasized the need for more granular approaches to access: "The next wave of innovation I would really like to see is to be more granular about what access to that medicine actually involves. It's not just getting the medicine to the country or to the person. We need more people to continue taking the medicines."
By 2030, these companies have set ambitious goals – GSK aims to positively impact 2.5 billion people, including 1.3 billion in lower-income countries. But beyond numbers, Rahman hopes for a fundamental shift: "That we don't really have to talk about access separately, that it's really core to how we deliver our business."
Five Key Takeaways
1. Embed access in business strategy: "Reframing global health not as corporate social responsibility or philanthropy, but defining it as a business in its own right truly unlocks potential." - Dr. Lutz Hegemann, Novartis
2. Consider access from early R&D: Companies must design medicines that are "fit for purpose" in resource-constrained settings from the beginning of development.
3. Partnerships are essential: No single organization can solve access challenges alone – collaboration across the healthcare ecosystem is critical.
4. Regulatory harmonization needed: Fragmentation across markets creates inefficiencies that hinder affordable access at scale.
5. New technologies can leapfrog challenges: Innovations like siRNA therapies and AI-driven diagnostics may actually be more suitable for resource-constrained settings than traditional approaches.
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