Executive Summary

At the end of 2020, 61 active access programs operating in 104 countries were registered in the Access Observatory. Programs were geographically clustered in sub-Saharan Africa and Southeast Asia. Consistent with previous years, 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 (61%), followed by general NCD care (18%) and diabetes (15%). Thirty-two programs (52%) submitted data for at least one indicator, nearly all of which were an input or output indicator. Very few programs submitted documentation of a needs assessment. More information is needed to understand whether programs are appropriately designed for the context in which they are implemented.

This is the final Access Observatory annual report. In 2017, the first year of the Observatory, 62 programs were registered by 17 different companies. The number of registered active programs increased to 73 in 2018 and to 75 in 2019. The reduction in active programs this past year is largely due to fewer new programs compared with previous years. The unprecedented global health challenge caused by COVID-19 has undoubtedly affected companies’ ability to initiate and implement new programs. We hope to see a set of new innovative programs being introduced by companies in the coming years.

The COVID-19 pandemic has exacerbated global inequities in access to affordable and safe, quality-assured medicines. We have seen the importance of data in identifying inequities in the impacts of the virus, and we are now seeing similar inequities in access to vaccines. The pharmaceutical industry’s commitment to measuring and reporting on their access programs is important now more than ever. In light of the pandemic, we encourage companies to explore novel partnership strategies for improving access, including voluntary licensing agreements to enhance manufacturing capacity. These strategies are part of the Access Observatory framework but have not yet been used by registered programs.