Abstract
BackgroundIn low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development.MethodsWe developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents.ResultsThe Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action.ConclusionThe application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.
Highlights
In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges
The World Health Organization (WHO) has developed a checklist for governments dealing with corporate access to medicines initiatives [21]—gaps remain in understanding the extent to which this or other proposed structures and processes for stronger governance have been adopted by countries
This paper presented an assessment tool to study how a country governs pharmaceutical industry-led public health programs, which are growing in number—especially in LMICs
Summary
In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development Transnational corporations, including those in the pharmaceutical industry, have gradually been taking on more proactive roles in national-level development, acting as development partners with governments and nongovernmental organizations (NGOs) in many low- and Bünder et al Globalization and Health (2021) 17:123. Pharmaceutical companies have taken on especially strong roles as development partners for LMICs addressing non-communicable diseases (NCDs) [10] The industry has both expertise and strategic interests in supporting LMIC’s NCD response, as medicines for NCDs constitute the core business of many pharmaceutical companies [11]. The World Health Organization (WHO) has developed a checklist for governments dealing with corporate access to medicines initiatives [21]—gaps remain in understanding the extent to which this or other proposed structures and processes for stronger governance have been adopted by countries
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