Strategic approach

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.

Discussions at the global level

In 2013 and 2014, we engaged in numerous discussions at the global level:

  • In November 2014, at a reception celebrating the 3rd anniversary of WIPO Re:Search, Stefan Oschmann, Vice Chairman of the Executive Board, formally announced that Merck KGaA, Darmstadt, Germany was joining this initiative.
  • In October 2014, more than 100 healthcare professionals from different African countries attended the Africa Luminary in Darmstadt. There, they benefited from medical education on disease management in the areas of diabetes, fertility and oncology, as well as sessions on improving supply chain integrity, pharmacovigilance, and fighting counterfeits.
  • In May 2014, at the 67th World Health Assembly (WHA), Stefan Oschmann and the Permanent Representative of Germany to the UN in Geneva hosted a meeting on the topic of “Addressing Accessibility Challenges in Developing Countries”. The company also organized a reception with Stefan Oschmann, the then prime minister of Madagascar Roger Kolo, and Dr. Hiroki Nakatani, Assistant Director-General Neglected Tropical Diseases of WHO.
  • In April 2014, Stefan Oschmann attended a meeting with other pharmaceutical industry heads to celebrate the second anniversary of the London Declaration as well as to further discuss and accelerate the industry’s commitment to fight neglected tropical diseases (NTDs).
  • In September 2013, we participated in the EFPIA Global Health Initiative Debate at the EU Parliament on "Access to Medicines: Supply Chain & Delivery Systems - The Last Mile Challenge".
  • In August 2013, the company participated in the “Global Post-2015 Development Agenda: Challenges and Opportunities for the German Business”, organized by the German Federal Ministry for Economic Cooperation and Development in cooperation with the German Global Compact Network.
  • During the 66th World Health Assembly held in Geneva, Switzerland in May 2013, Karl-Ludwig Kley, Chairman of the Executive Board, met with Muhammad Ali Pate, at that time the Nigerian Minister of Health, and Dr. Hiroki Nakatani, WHO Assistant Director-General, to discuss the next steps in the fight against schistosomiasis.

Discussions at the local level

We also participated in numerous discussions in 2013 and 2014 at the local level as well. Below are several examples:

  • In September 2014, Merck KGaA, Darmstadt, Germany participated in the European Head and Neck Cancer Awareness Week in Russia as part of the Make Sense Campaign. This is an international effort led by the European Head and Neck Society to raise awareness on head and neck cancer symptoms among the general population and healthcare workers. As part of an information campaign, various media were used, including TV, internet, social media, radio, and printed material. In 2014, the campaign covered 32 clinics in 17 cities, and over 6,000 patients were examined. 609 patients were diagnosed with cancer or a pre-cancer state.
  • In December 2013, our subsidairy in North & West Africa organized a symposium during the first African Pharmacovigilance Congress, held in Rabat, Morocco. The symposium was entitled "La Pharmacovigilance, un enjeu africain" and focused on European pharmacovigilance guidelines.
  • In August 2013, Biopharmaceuticals India co-organized a round table on "Access to Rural Health" in collaboration with the Rural Marketing Association in India and the Organization of Pharmaceutical Producers of India.
  • In Venezuela, our subsidairy, a member of the over-the-counter chamber there, regularly engages with the national government as part of its efforts to ensure the country’s supply of life-saving medicines.

Goals: Access to health














Status in 2013 and 2014


Monitor and assess the progress and efficacy of our Access to Health programs.

Create quantitative and qualitative performance indicators for the 4 A's: Availability, Accessibility, Affordability, and Awareness.

End of 2016


Availability: Address unmet needs through the research, development and refinement of health solutions

Expand our R&D portfolio for neglected tropical diseases within the scope of the Global Health Innovation Platform. We have created a three-year plan for our focal areas of developing a pediatric formulation to treat schistosomiasis in preschool-aged children and developing a new anti-malarial drug.

End of 2017


Affordability: Address inability to pay

Through our WIPO Re:Search membership, engage in a collaboration agreement to share our intellectual property and knowledge to catalyze the development of medical products against infectious diseases.

End of 2016


Awareness: Empower health workers, communities and patients

Develop an integrated initiative of our Healthcare and Life Science business sectors to raise awareness and empower people to make informed decisions.

End of 2016


Accessibility: Strengthen supply chains and provide localized solutions

Develop an initiative to reach patients, regardless of their geographic location, and ensure they have access to health solutions.

End of 2016


Legend: Achieved In progress Not achieved New goal