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Corporate accountability in global health governance? A case study of the Access to Medicine Index

A new briefing paper critically analyses the AtMI to evaluate voluntary corporate performance indexes as an accountability mechanism in health.

Across virtually all markets, a relatively small number of trans-national corporations (TNCs) now wield tremendous oligopolistic power. Using this power, these TNCs have also been able to accrue and deploy tremendous social and political influence, making them one of the most powerful groups of actors worldwide. Many voices are now calling for TNCs to be effectively regulated and held accountable.  

One approach to strengthening corporate accountability has been the use of corporate ‘league tables’ or ‘rankings’. This involves assessing the policies and practices of TNCs and producing a quantified measure of their performance that is then used to rank them. It is believed that TNCs will improve their policies and practices to achieve higher rankings, thus improving their reputations and making them more desirable to work for, invest in, or do business with. One example of this approach is the Access to Medicine Index (AtMI) which ranks the 20 biggest pharmaceutical TNCs according to how well they contribute to improved access to medicines and other products in low- and middle-income countries (L&MICs).  

This briefing paper presents a description and critique of AtMI, including its history, governance, funding, implementation, and impact. Much of it consists of a description and assessment of the AtMI methods, including the 31 indicators used to assess TNC performance. The paper describes how TNCs are given a score between zero and five for each indicator and how these scores are then combined to produce a composite score that is used to produce a ranking of overall performance. 

The report discusses the limitations of AtMI including: i) problems with the completeness and reliability of the data that are used; ii) a lack of transparency about how data are converted into scores for each indicator; iii) the low standards against which companies are assessed; and iv) the narrow scope of corporate conduct that is assessed. It also notes the lack of evidence of the Index actually improving access to medicines and other products in L&MICs, and points to how the Index may weaken efforts to regulate pharmaceutical companies and thus paradoxically work against the public interest. 

Read the full briefing paper HERE

Learn more about the related Independent Expert Group on Corporate Accountability HERE