Access to Health (A2H) is a strategic priority for Merck KGaA, Darmstadt, Germany. Through our holistic A2H approach we aim to help improve sustainable access to high-quality health solutions for underserved populations and communities in low- and middle-income countries. Recognizing that access is a complex challenge, our programs and initiatives are tailored to global, regional and local needs. Furthermore, we realize that we cannot work alone to address all the access gaps and that partnerships, collaboration and dialogue are key to delivering sustainable access solutions.

Our A2H strategy leverages our interdisciplinary expertise and skills and is sponsored by Stefan Oschmann, Vice Chairman of the Executive Board. At the end of 2014, he became President of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), and has dedicated his two-year term to accelerating access to high-quality health solutions for people in low- to middle-income countries.

In 2013, we established an Access to Health Unit at Group level, which has identified access gaps and opportunities to better meet the needs of underserved patients and has become an integral part of how we conduct business.

In 2014, we revised our strategy and our Charter on Access to Health in Developing Countries. The Charter is composed of 6 position papers that include “Our Approach”, which defines our A2H strategy as well as covers the following priority thematic access issues: pharmaceutical donations and philanthropy, research and development for neglected tropical diseases (NTDs), pharmaceutical product pricing, intellectual property, and counterfeit medicines.

We leverage our core competencies and expertise across the health value chain in order to address access barriers through our A2H strategy, which focuses on the “Four As of Access”: Availability, Affordability, Awareness and Accessibility:

• Availability: Entails the research, development and refinement of health solutions that address unmet needs and are tailored to local environments. Examples include our engagement in the Pediatric Praziquantel Consortium , our partnership with Medicines for Malaria Venture , and the life science business Muse Auto CD4/CD4% system.
• Accessibility: Merck KGaA, Darmstadt, Germany promotes initiatives to strengthen supply chains and to develop localized health solutions in order to deliver and reach out efficiently at the point of care. In India for instance, we support the River Ambulance Project, and in Ghana we have launched a pilot of our Rural Pharmacy, which aims to serve remote areas of Africa.
• Affordability: We seek to provide assistance to those who are unable to pay for the health solutions they need. Examples include our Praziquantel Donation Program (MPDP), a partnership with WHO to fight the tropical worm disease schistosomiasis, and our membership in WIPO Re:Search .
• Awareness: The company contributes to raising awareness by empowering health workers, communities and patients so that they can make informed decisions. Take for example our Capacity Advancement Program (CAP), a diabetes awareness campaign in Africa, the Suswastha project in India and the Ghana WASH project.

We believe that it is important to monitor and evaluate our access to health programs in order to better understand how we are meeting patients’ needs. To help us assess our strengths and areas where we can further strengthen our efforts, we are working to develop quantitative and qualitative indicators across all Four As of Access, which will be evaluated regularly by the A2H steering committee that is currently being formed.

Our approach to delivering initiatives along our Four As of Access involves a four-step process:

1. Diagnose: We identify unmet needs of underserved populations and communities in low- and middle-income countries.
2. Design: We develop business-integrated approaches to provide support, utilizing our expertise and core competencies as well as our partners’ experience.
3. Implement: We implement innovative solutions in collaboration with our partners to meet needs in a sustainable way.
4. Evaluate: We regularly monitor and evaluate our programs to ensure that we achieve the outcomes desired, and where necessary, we reorient our program to optimize results. We report on results through our A2H website, Annual Report and Corporate Responsibility Report.

Access to Medicine Index

Every two years, the Access to Medicine Foundation releases the Access to Medicine Index , which ranks pharmaceutical companies in terms of their contributions to improving access to medicines in developing countries. Funded by the Bill & Melinda Gates Foundation as well as the UK and Dutch governments, the Index has been published every two years since 2008. Merck KGaA, Darmstadt, Germany ranked sixth in the 2014 Access to Medicines Index, two places higher than in 2012. In the 2014 Access to Medicine Index report, the company was recognized for its progression from a philanthropy-driven access strategy to a strategic pro-business access approach, as well as for leading examples such as:

• Pro-access approach to Intellectual Property (IP) management and policies, including its commitment to not filing patents in a broad range of Index countries;
• Piloting a pro-access business model in India through the Suswastha project;
• Alignment of R&D strategy with developing countries’ needs with regard to communicable and non-communicable diseases;
• Forward integration of our Global Manufacturing and Supply;
• Active approach to dialogue and knowledge sharing through the Access Dialogue Series , a multistakeholder platform for sharing information and best practices as well as discussing collaborative action to overcome access barriers;
• Adoption of a multi-dimensional approach to contribute to the elimination of schistosomiasis;
• Improved transparency through efforts such as the revised and broadened Charter on Access to Health in Developing Countries. 

Stakeholder dialogue

We believe that partnerships, collaboration and dialogue are key to delivering sustainable access results. Our partners include multilateral organizations, governments, non-governmental organizations, patient organizations, academia, healthcare professional associations, think tanks and private sector partners. We are committed to the Millennium Development Goals, and we will collaborate with partners on defining priorities and delivering on commitments and goals for the post-2015 sustainable development agenda.

Merck KGaA, Darmstadt, Germany has launched the Access Dialogue Series, which provides a platform for information exchange and best practice sharing among public and private sector stakeholders. These dialogues enable us to collaboratively address the access challenges for underserved populations and to inform our dedicated strategy and initiatives. In 2014, the Access Dialogue Series was recognized as a best practice in the first-ever “Guiding Principles on Access to Healthcare Report” released by  Business for Social Responsibility .

During 2013 and 2014, we sponsored a series of access seminars with the European Commission and Parliament hosted by the European Federation of Pharmaceutical Industries and Associations (EFPIA ). The seminars focused on important access issues in developing countries, including R&D for neglected diseases, clinical trials, technology transfer, and affordability. The debates demonstrated that, in order to sustainably tackle global health challenges, it is highly important for stakeholders from both developed and developing countries to proactively collaborate. The company also supports a European Commission initiative on access to medicines in developing countries, with a focus on Africa.