The access to medicine index: How ranking pharmaceutical companies encourages polycentric health governance

Abstract

The field of access to medicines is becoming a complex governance system. Along with formal international organizations, non-state actors have created various new institutional arrangements, such as funds, initiatives, programs, and partnerships. This study focuses on the role and power of non-governmental organizations (NGOs) who have introduced a new dynamism regarding the problem of access to medicines, by analyzing the “Access to Medicine Index” (hereinafter, AtM Index) case.This study examines how the AtM Index interacts with other initiatives led by various actors. In particular, we focus on several recent initiatives concerning the AtM Index, by actors including the World Health Organization (WHO), the World Intellectual Property Organization (WIPO), and other partnerships. This study examines the linkages between these initiatives and the AtM Index, and explores whether interconnections among multiple initiatives lead to the overall effectiveness of global health governance. We argue that the field of access to medicines is now evolving into a “polycentric” governance system; however, there may be some limitations to such a system.