At least half of the world’s population does not have adequate access to health. Therefore, we are striving to innovate, make health solutions affordable and accessible, raise awareness about diseases, and help people learn how to manage them. We work with partners to tackle these complex challenges.
Our approach to improving health for all
Our overarching aim is to create a healthier future for all. We are committed to advancing global health and to using our scientific and technological innovation to improve the health of underserved populations in low- and middle-income countries.
Our Global Health strategy focuses on diseases that disproportionally impact underserved populations. These include neglected tropical diseases (NTDs) that are largely unknown in industrialized nations and attract little attention or funding. Our strategy also aims to improve patient access to medicine in low- and middle-income countries, including for non-communicable diseases. The goals of our Global Health strategy are:
- To eliminate schistosomiasis as a public health problem.
- To prevent and control malaria to the point of elimination.
- To prevent and control high-burden non-communicable diseases (NCDs), such as diabetes and hypertension, in low- and middle-income countries.
Our strategy is designed to improve health and overcome access barriers in an economically viable and sustainable way, thereby creating shared value for patients, society and our company. For us, this means developing business models that increase our company’s value and competitiveness by solving unmet health needs and strengthening local health systems.
We follow three core operating principles:
- Developing innovative solutions: We develop new medicines, diagnostics, and vector control solutions for schistosomiasis and malaria through an integrated science and technology approach.
- Engaging with cross-sector partners: We participate in multi-stakeholder global health platforms to help achieve our goals and support the UN Sustainable Development Goals. We define partnerships for the implementation of treatment programs on the ground, for research and development programs and use access alliances.
- Creating sustainable business models and opportunities via a shared value approach: We strive to ensure that investments reach underserved populations. We leverage our portfolio from across our three business sectors to help sustainably improve health.
We also engage in building capacity and expertise across the value chain, with the intent of strengthening health systems and making them more resilient to health crises.
Eliminating schistosomiasis as a public health problem
Schistosomiasis, also known as bilharzia, is a tropical disease caused by parasitic worms. It is one of the most prevalent parasitic infections in sub-Saharan Africa and places a significant burden on public health systems and local economies. The disease affects almost 240 million people worldwide, with more than 90% of cases occurring in sub-Saharan Africa. It kills an estimated 200,000 people every year.
The ultimate aim of our schistosomiasis-related work is to eliminate the disease as a public health problem in accordance with the WHO NTD roadmap 2021-2030. We remain committed to the objectives of the London Declaration and support its successor, the Kigali Declaration on NTDs, through which participating companies, governments and private organizations commit to helping control and ultimately eliminate the twenty most prevalent NTDs, including schistosomiasis.
To achieve this goal, we adopted an integrated schistosomiasis strategy, which we are implementing in close collaboration with multiple partners worldwide. The approach focuses on five pillars:
- Treatment: We donate up to 250 million tablets of praziquantel to endemic countries every year in partnership with WHO. Nearly 50 years after its development, praziquantel remains the standard of care for the effective treatment of schistosomiasis around the world.
- Research and Development (R&D): We advance R&D to support the global fight against schistosomiasis. In particular, we drive collaborative R&D programs for innovative health solutions, new drug discovery activities, the development of new treatment options for children under the age of six, and new and more sensitive diagnostics. We are also strengthening research expertise and capacity through our collaborations with institutions in endemic countries.
- WASH (Water, sanitation and hygiene): Since schistosomiasis is transmitted through contaminated water sources, we also support WASH projects that aim to prevent transmission of the disease by providing a sanitary infrastructure and new access-to- water technologies.
- Health education: We believe prevention is the most effective health intervention. Therefore, we invest in education and behavior change initiatives to raise awareness of the causes and dangers of schistosomiasis and teach people how to prevent it.
- Advocacy and partnerships: We are accelerating the progress towards schistosomiasis elimination by collaborating with partner organizations for our programs and initiatives as well as with the wider stakeholder community through the Global Schistosomiasis Alliance (GSA).
Preventing and fighting malaria to support elimination
According to World Health Organization (WHO) estimates, nearly half of the world’s population is at risk of contracting malaria. More than 200 million cases of malaria and over 400,000 related deaths are recorded every year, with almost 70% occurring in children under the age of five. Over 90% of cases and deaths occur in Africa. Around the world, a child dies from the disease every two minutes.
There is a need for new products to overcome the problem of increasing drug resistance and to achieve the goal of elimination. Through our “As One Against Malaria” program, we are helping to deliver integrated and sustainable health solutions involving treatments, diagnostics and preventive measures to fight malaria in endemic countries.
Our Access to Medicine approach
We implement and support global health partnerships and shared value initiatives that improve access to our health solutions in low- and middle-income countries. By delivering quality health solutions, our Access to Medicine approach addresses local needs and helps to create long-term value for patients, our business and our stakeholders.
We continually seek to create sustainable business model opportunities that address gaps in public health systems. We recognize that we cannot eliminate the complex barriers to health access in emerging markets alone, which is why we form and enter partnerships for initiatives that complement our strategy. We apply this approach to neglected diseases, such as schistosomiasis and malaria, as well as to NCDs with high prevalence in these countries, such as diabetes and hypertension.
Roles and responsibilities
Our Global Health organization leads the implementation of our strategy regarding innovative solutions for infectious diseases and access to health in underserved populations. This unit is also responsible for Group-wide initiatives, programs and sponsorships relating to global health topics. Our experts collaborate closely with the Life Science, Healthcare and Electronics business sectors to leverage their strengths and competencies effectively.
Our Schistosomiasis Elimination Program guides our efforts to eliminate schistosomiasis in close collaboration with external partners, such as the World Health Organization (WHO).
Our Global Health Institute translates science, technology and digital approaches into integrated solutions to strengthen health systems. It uses a portfolio of projects for transformative treatments, diagnostics, technologies, and preventive measures against neglected tropical diseases, focusing on schistosomiasis and malaria.
Our Access to Health unit enables access to our company’s health portfolio in low- and middle-income countries through shared value initiatives that it implements in collaboration with our country teams.
Our commitment: Providing a solid basis for access to health
Our commitment to expanding health access is summarized in our Access to Health Charter. It sets out the following guidelines on:
- Our approach
- Pharmaceutical product donations and philanthropic activities
- Falsified medicines
- R&D for infectious diseases
- Equitable pricing in low- and middle-income countries
- Intellectual property rights
- Sustainable supply chains
Every two years, the Access to Medicine Foundation publishes the Access to Medicine (ATM) Index. It benchmarks 20 of the world’s largest research-based pharmaceutical companies on activities and initiatives that experts consider most relevant for access to medicine in low- and middle-income countries, ranging from research & development and intellectual property sharing to capacity building and donations. We use this ranking system to inform and guide our access to health strategy.
The latest Index was published in January 2021. We ranked eighth and remain among the top ten companies, confirming our commitment to continuously improving sustainable access to high-quality health solutions for all. In addition, the ATM Index for 2021 recognized us for our performance in research & development, where we ranked fifth. The index also acknowledged our leading role in intellectual property sharing.
Fighting the global Covid-19 pandemic
Our Global Health unit is spearheading a wide range of initiatives to combat the SARS-CoV-2 virus and its impact on the world’s most vulnerable countries. These efforts include direct measures, such as donating masks and protective equipment to Ethiopia and Zimbabwe, as well as more long-term sustainable initiatives (such as in Ghana) that strengthen the overall resilience of health systems against current and future health crises.
Read more about our contribution to this global challenge here.
Eliminating schistosomiasis: Five pillars
To contribute to the elimination of schistosomiasis, we adopted an integrated approach based on five pillars: Treatment, Research & Development, WASH, Health Education, and Advocacy & Partnerships.
Treatment
As part of our long-standing partnership with WHO, we are committed to donating up to 250 million praziquantel tablets every year. The donation is a major part of the integrated and coordinated approach we have adopted towards treating and eliminating schistosomiasis. Since 2007, we have provided more than 1.5 billion tablets to WHO for the treatment of schistosomiasis. To date, our tablets have been distributed in 47 endemic African countries to treat school-aged children. In 2021, we donated around 182 million tablets for distribution in 32 countries, 30 of which are in sub-Saharan Africa. Moreover, we maintain our commitment by ensuring we have sufficient production capacity to manufacture up to 250 million tablets per year.
Our efforts are showing very promising results. Data published by the Swiss Tropical and Public Health Institute (Swiss TPH) in December 2021 show that the estimated prevalence of schistosomiasis in school-aged children in sub-Saharan Africa decreased by almost 60% between 2000 and 2019.
Decreasing estimated prevalence of schistosomiasis on the African continent
Research and development
Working in partnership with the Pediatric Praziquantel Consortium, we developed a potential new schistosomiasis treatment option for pre-school-aged children called arpraziquantel. The pivotal clinical Phase III trial was successfully completed in Côte d’Ivoire and Kenya and the program has now proceeded to the regulatory filing stage. In 2021, we signed a manufacturing agreement with Universal, a contract manufacturer in Kenya, for the large-scale production of the treatment upon its registration. The consortium has also launched an access initiative to prepare for deliveries of the new medicine to young patients in need.
In 2021, we also made progress on investigating a new generation of drugs to prevent and cure schistosomiasis. We identified a new candidate, which entered early drug development. In addition, together with researchers from the Medical College of Wisconsin (USA), we described for the first time the presumed mode of action of praziquantel. We also signed a memorandum of understanding with our partners, the Drugs for Neglected Diseases initiative (DNDi) and the Swiss Tropical and Public Health Institute (Swiss TPH), with the aim of combining our efforts on drug discovery, development and access activities.
More sensitive diagnostics to detect cases in low-endemicity settings are needed for the effective management and surveillance of schistosomiasis and are critical for the elimination of this disease. We continued our collaboration with the Foundation for Innovative New Diagnostics (FIND) and a consortium of partners to develop a sensitive rapid diagnostic test to improve schistosomiasis mapping and case detection. In 2021, our strategic partnership with Janssen Pharmaceuticals evolved into a new consortium of partners to accelerate the development of an artificial intelligence-based diagnostic tool for the diagnosis and surveillance of schistosomiasis and soil-transmitted helminthiasis.
Our research & development programs integrate and invest in scientific, educational and training initiatives as well as activities that enhance capacity in low- and middle-income countries.
More information can be found in the chapter Building health capacity and awareness.
WASH
In 2021, we started a collaborative access to water program in Ghana. It encompasses an implementation research study to analyze water, sanitation and hygiene in 200 healthcare facilities as well as the quality of water in selected districts. Moreover, it aims to improve the healthcare infrastructure to provide safe water services to health centers as well as to train health workers on schistosomiasis case management.
Health education
In 2020, we extended our partnership with the NALA Foundation by an additional three years. This joint health education project – including WASH activities – focuses on southwestern Ethiopia. It aims to promote long-term sustainable behavioral changes via a community-based approach in the drive to eliminate schistosomiasis and other neglected tropical diseases.
Despite the challenges, including the Covid-19 pandemic, security issues and political instability, the reopening of schools enabled NALA to resume regular activities in 2021. These included the implementation of school-, community- and WASH-based interventions. An impact evaluation in two of the target districts showed a meaningful decrease in the prevalence of schistosomiasis since the start of the program in 2017: It decreased from 28% to 11% in Mizan Aman, and from 11% to 8% in the southern Bench zone.
More information can be found in the chapter Building health capacity and awareness.
Advocacy and partnerships
We work with international and local partners to advance the agenda for schistosomiasis control and elimination. For example, the Global Schistosomiasis Alliance (GSA) is a coordinated, multi-sectoral effort to combat the complex disease schistosomiasis. In early 2021, WHO released its new NTD roadmap, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 neglected tropical diseases and disease groups between 2021 and 2030. The GSA contributed to WHO consultations during the roadmap conception phase.
Malaria: Treatment and prevention
Developing new therapeutic solutions
As part of our “As One Against Malaria” program, we are developing a new drug (M5717) for the prevention and treatment of malaria. In 2021, we completed a Phase Ib clinical trial to test the compound’s ability to prevent the disease and published the data. The project is now progressing to Phase II (proof of concept) for both the treatment and prevention of malaria. In addition to our clinical program, our collaborative drug discovery activities are delivering promising candidates that are progressing into the preclinical stage.
Preventing and controlling malaria transmission
Preventive methods such as the use of insect repellents form part of the strategic toolkit to combat malaria. We are testing our insect repellent IR3535® for malaria. It is already used for protection against insect and tick bites that can transmit diseases such as Lyme disease, Zika, dengue fever and chikungunya.
Through laboratory tests conducted in Ghana, we are evaluating the efficacy and acceptance of a new formulation of IR3535® that is expected to provide longer-lasting protection. Positive results would enable IR3535® to serve as a preventive measure for personal use and a large-scale vector control method to support population-based national malaria control programs.
In partnership with local institutions in Africa, we have established PAVON (Pan-African Vivax and Ovale Network), a network of centers of excellence for the epidemiological surveillance and scientific research on malaria.
Sustainable access to medicines in low- and middle-income countries
To prevent and control high-burden non-communicable diseases (NCDs), we invest in access initiatives that address health system gaps in low- and middle-income countries. We adopt a partnership approach to maximize our impact within this complex and challenging environment.
One initiative supports our country teams in low- and middle-income countries to create and accelerate innovative business models that improve medicine access. The “India Fights Back for Head & Neck Cancer” public-private partnership between our company, the Indian Employees’ State Insurance Corporation and India Railways was established in 2021 as part of this initiative. It enables patients to receive faster access to early diagnosis and the right care and treatment.
Our collaborations in Africa to establish robust and sustainable supply chains are also crucial for ensuring safe, effective and continuous healthcare delivery. Our Access Mentorship program, in which expert volunteers from our Global Supply Network Organization share their knowledge with local African distributors, demonstrates our commitment to improving supply chain operations and increasing access to health.
We have also developed an evaluation ecosystem to track the impact of our access programs on patients, healthcare providers and health systems. It enables us to monitor our progress over time and to integrate recommendations from ESG ratings, such as the Access to Medicine Index, into our strategy.
Engaging stakeholders
Partnerships and dialogue are critical to addressing global health challenges and to improving access to health. Our partners include multinational organizations, government agencies and NGOs as well as academic institutions, health industry associations, private companies, and independent global health experts.
In 2021, we continued to engage with our partners and key stakeholders, including WHO, to advance global health discussions and address shared challenges, such as neglected tropical diseases. We collaborate with partners such as WIPO and DNDi as well as with academia in African countries. We engage in consortiums of partners, such as the Pediatric Praziquantel Consortium, alliances, including the Swiss Malaria Group, and advocacy groups, such as Uniting to Combat NTDs and GSA. In addition, we closely interact with foundations that support scientific research and health access, including the Bill & Melinda Gates Foundation and the Access to Medicine Foundation.
We also strengthened our collaborations with the scientific community through publications, patents and taking on active roles at international events. In 2021, we attended meetings of the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) to address the spread of misinformation about NTDs. We also took part in the 12th European Congress on Tropical Medicine and International Health (ECTMIH), which discussed the current state of R&D in NTDs. We also presented our collaborative research and development projects on schistosomiasis at the 10th European and Developing Countries Clinical Trials Partnership (EDCTP) Forum.