Asked what it would take for big pharma to change its defensive, recalcitrant approach to markets in poorer countries, an experienced industry figure once said to me that pharma CEOs are like schoolboys. It just takes just one to break away, he explained, and the others - fearful of being left out - will come sprinting after.
The comment, made in 2005, now seems prophetic. Look no further than Andrew Witty, CEO of GSK, for the plucky, farsighted schoolboy charging off beyond the manicured playing fields - site of the same old games for decades - into the unchartered, tricky but ultimately gainful jungle of expanding access to medicines in poorer countries.
Last year, soon after becoming CEO, Witty spearheaded the creation of a patent pool – a creative approach, whatever the actual impact* – and committed to steep cuts in the prices of medicines in the poorest countries. When Witty made these announcements at Harvard in 2009, a friend who works at GSK told me, afterwards, how he couldn't wait to get home to tell his girlfriend what his company was doing. Such examples of employee satisfaction, though dwarfed by the direct human impacts, illustrate how relatively radical the moves are.
Keeping Score
Many other CEOs are now at least jogging after Mr Witty. But, of course, not everyone is going to be happy about the industry’s new frontier**. New initiatives won't always be easy to implement. And they won't always work. After the initial heady sprint there needs to be, to avoid a retreat when the going gets tough, a score card. An independent voice of encouragement.
Enter Wim Leereveld, founder of the Access to Medicine Index
When I first met Leereveld several years back - before the launch of the first 2008 index - he was still struggling to get support. The index, which would compare big pharma on pricing in developing countries, R&D into neglected diseases and other facets of access to medicine***, bestrode the ever-difficult middle ground. NGOs and pharma companies, at either pole, brayed with concern. Pfizer, when Leereveld visited the company in New York, virtually threw him out of the building.
2010 Index
Resolute in his vision of a transparent carrot-and-stick rating system Leereveld persisted and got enough support to launch the first index. The media coverage was good and - the index now a fait accomplit - the industry started to come on board. For the first index, about half the companies approached provided information. For the second (recently released and now backed by the Bill and Melinda Gates Foundation) more than 95% cooperated, including Pfizer, which rose from 17th to 11th in the rankings.
In the 2010 index, GSK still leads the charge. But with a helicopter above the jungle keeping score, egging the others on, Mr Witty will have competition for good.
Watch Andrew Witty's CNBC interview here, where he talks about the index.
Read Bill Gates' thoughts on the index here.
I should declare an interest as an ambassador for the index.
* A limited number of diseases are included. Among those excluded is HIV.
** Rich countries question whether they are subsidising drugs. Some NGOs see the moves as paltry. Shareholders wonder if middle income markets will be big enough to support prices cuts.
*** The index now measures 106 indicators.