An interview with Wim Leereveld, Founder of the Access to Medicine Foundation and Chair of the Supervisory Board, Index Initiative

Over a decade ago, when Wim Leereveld first had the idea to start the Access to Medicine Index, he did not have an example benchmark to draw upon or a blueprint case study to show him how or why this idea could work. What he did have was a vision and an in-depth knowledge into the dynamics of the pharmaceutical industry, where he had spent over 15 years of his career. “After some time,” Wim muses, “I knew these companies better than they knew themselves.” This experience made him realise two key things. First of all, what pharmaceutical companies cared the most about was other pharmaceutical companies. “These companies were very competitive,” Wim states. “Every day they would discuss what they were going to do next based on what their competitors did. They always wanted to beat their competitor. Yes, they were interested in what NGOs and governments thought about them, but what they most cared about was each other.” Secondly, pharmaceutical companies were more than willing to do more to make their products more accessible, but lacked the knowledge. As Wim reflects, “companies are very willing to do more, but they simply don’t know how!”

Like many of these companies, Wim was also looking to do more. Following his successful career in the field, Wim had the ambition to develop a deeper personal and professional focus on corporate social responsibility. In 2002, Oxfam, VSO and Save the Children gave him inspiration on how to do that. They released a report entitled Beyond Philanthropy: The pharmaceutical industry, in corporate social responsibility and the developing world. This report, a copy of which can still be found in Wim’s office today, described how the pharmaceutical industry had a key role to play in supporting health for all in the developing world. Wim realised that while companies had the power to drive change, NGOs and other stakeholders had the expertise on what change was needed. He began to reach out to NGOs such as Doctors Without Borders and Oxfam, asking them what they considered to be the biggest problems. They all told him that the prices of medicines were too high and that the pharmaceutical industry could be doing more to improve people’s access to medicine.

It was at this point Wim suggested something that had never been done before. Pharmaceutical companies should be compared to one another, to show which ones were performing the best and which ones were lagging behind on issues relevant to improving access to medicine. A benchmark seemed to offer exactly that. By ranking companies and comparing them against each other, the competitive spirit that drove the industry would be channelled towards making a positive impact. Wim believed that “through asking all stakeholders what they think pharmaceutical companies should do to reach the people that are left behind, we can build consensus between all stakeholders – investors, NGOs, governments, and also companies – on what can be expected of the pharmaceutical industry.” There was, however, one big problem with Wim’s proposal: no one wanted it.

“Companies felt it went too far, and NGOs felt it didn’t go far enough,” Wim said. His idea was both radical and unpopular, two things which would place the first iteration of the Access to Medicine Index under intense scrutiny from companies, civil society and investors alike. To ensure its credibility and, therefore, impact, Wim took five years to go from idea to implementation– working with a team of researchers, consulting with stakeholders, and engaging as many companies as possible to develop the methodology and make sure it was right. According to Wim, “if you don’t do it thoroughly, the industry will not respect it.” The first Index was finally realised in 2008, with the ranking featured as a front-page article in the Financial Times (FT). This hyper visibility meant the criticism came in fast and from all sides. Wim recalled that “some companies were shocked at the results, and a major firm sent in an angry letter to the FT as soon as the publication was released. NGOs were also disappointed – how can any pharmaceutical company ‘be the best’ when they were all terrible?”

In addition to Andrew Jack, the reporter who wrote the story, there were two key people who saw the Index published in the FT and believed in its potential. The first was Bill Gates, who gave an interview in Time Magazine the same year the ranking was published where he described the Access to Medicine Index as a perfect example of ‘creative capitalism’ and a way to reward companies for the good they were doing. He suggested that the ‘report-card’ idea be expanded beyond the pharmaceutical industry. The Bill and Melinda Gates Foundation went on to become core funders of the Access to Medicine Index and later started the Access to Nutrition Index. The second key person to see the FT article who held a similar view was Gerbrand Haverkamp, Executive Director of Index Initiative. At the time, Gerbrand was working at the Dutch Ministry of Agriculture. He was inspired by Wim’s story and wanted to try a similar initiative within the seeds industry, a small but crucial industry in the food system. Wim told Gerbrand that if he could get the idea funded, then Wim would help him set it up. Gerbrand did, and the Access to Seeds Index was born.

The successes of these benchmarks pushed the envelope of what was possible. If the pharmaceutical industry and the seeds industry could be benchmarked, why wouldn’t this work for other industries as well? The world faces a number of urgent and critical challenges addressed by the SDGs where companies can have an impact, ranging from climate change to gender inequality to limited access to clean water. In thinking about his experience and the potential impact of SDG-aligned benchmarks, Wim recounts “when you work inside a company, your view might be narrow. You always think you are the best. They can’t go outside and look at themselves objectively. That is what we do, no one else is doing that. Companies need help to discover how they can contribute to achieving the SDGs. Companies need to know where they are now and how they can improve. That is what a benchmark does.”

More than a decade later, with the Access to Medicine Index moving towards its 6th ranking, the initiative is now recognised as a major game changer. Wim notes that benchmarks are no longer viewed with the same level of suspicion. He recalls attending a meeting in Tokyo earlier this year for the Seafood Stewardship Index that is currently in development. “When I started in 2008, we had to convince companies that an index is something important that they should be involved in. In Tokyo, all the big seafood companies in Japan were there. They saw that an index could help them to do better.”

 

This interview was included in the final publication we published in September 2018, prior to our launch. You can read the entire publication below, to find out what we have learned, what insights people gave us and how we experienced our consultation phase.