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At the end of 2019, 75 active access programs operating in 114 countries were registered in the Access Observatory. Programs were geographically clustered in sub-Saharan Africa and Southeast Asia. Most programs used a few common strategies: community activities that aimed to increase awareness of disease symptoms and treatment options; health service strengthening activities, most notably health provider training courses; and direct health service delivery. Cancer was the most common disease focus (63%), followed by diabetes (19%) and cardiovascular disease (16%). Across the 75 programs, there were 276 partnerships between companies and other organizations; more than half of programs had at least one public sector partner. Thirty-four programs (45%) submitted data for at least one indicator in 2019, nearly all of which were an input or output indicator. Very few programs submitted documentation of a needs assessment conducted prior to program implementation. More information is needed for local stakeholders to understand whether programs are appropriately designed for the context in which they are implemented.
Three milestones from the first three years of the Access Observatory illuminate critical aspects of a sustainable path forward for measurement and reporting on pharmaceutical industry-led access programs:
The Access Observatory has illuminated the scope and scale of industry engagement in access efforts. Several stakeholders have indicated that the Access Observatory’s standardized approach to reporting has facilitated the identification of synergies, redundancies, and gaps in investments for global access. The identification of synergies has led to new multi-company collaborations in specific disease areas (e.g., breast cancer) and geographies (e.g., Kenya).
Several companies significantly increased internal capacity to measure and report on their access programs. They have done this in a variety of ways, including training existing staff and hiring new staff with relevant prior training; and adapting management systems to integrate reporting on social and commercial key performance indicators.
Several companies revised agreements with implementing partners to require collection and reporting of program data. Most implementing partners are required to collect and report similar data to non-industry funders and have capacity to do the same for industry partners.