The index measures how well the world’s top 20 pharma companies do at getting their drugs and vaccines — and often their scientific expertise — to the world’s poorest countries.
The list was created by Wim Leerveld, a Dutch former pharmaceutical executive, and grew with early support from the Bill & Melinda Gates Foundation and the Dutch and British governments. At first, many drug companies ignored its requests for information.
Now, virtually all cooperate. Some have created global health divisions and even compete to do well on the list.
Positions in the rankings, issued every two years, have remained relatively constant, except for Japanese companies. They began as bottom dwellers and have slowly risen; the Eisai Company is now in 11th place.
The C.E.O. often determines how generous a company is. Richard Sykes, one of Mr. Witty’s predecessors at the former GlaxoSmithKline, was until his retirement in 2002 the industry’s most vocal opponent of easing patent monopolies in poor countries so they could import cheaper drugs.
Indian companies were on the initial 2008 list, but were moved to a separate one later because they generally have much smaller budgets and different missions.
Johnson & Johnson has risen steadily up the list and is now No. 2, followed by Novartis and the “two Mercks” — what were once the American and European divisions of the drug giant, but are now separate companies.
Novo Nordisk, which has ranked as high as No. 2, fell to No. 10. The company focuses entirely on diabetes, and not all its products are available for licensing or “equitable pricing strategies,” the index said in explanatory notes.
The list’s companies collectively have 850 products that treat 51 diseases that burden poor and middle-income countries, said Jayasree K. Iyer, the executive director of the Access to Medicine Foundation, which produces the list.
The drug companies are developing another 420 products, often in partnerships with smaller companies in India or elsewhere.