Key Points

  • Half the world’s population still lacks access to essential healthcare services and medicines.
  • The BSR Access to Healthcare Leadership Ladder framework is an important step forward in establishing standards for industry-led access programs.
  • The tool can assess the current level of maturity across different dimensions, help companies look at their practices through a value chain lens, realize the extent to which access is currently integrated across their organization, and identify gaps and opportunities for progress.

The right to health is a fundamental part of human rights and of our understanding of a life with dignity. While progress has been made in the past two decades, half the world’s population still lacks access to essential healthcare services. This continues to be one of the biggest global challenges and one that demands system-wide change.

For the past 12 years, BSR and the Healthcare Working Group have explored new methods to bring about change, via guiding principles, research papers, and multistakeholder dialogue. Today, the assessment is clear:

  1. The healthcare industry has unique competencies they can harness for continued progress. By working alongside peers, governments, NGOs, and other organizations, companies can continue to help overcome barriers that prevent underserved populations from receiving quality healthcare and contribute to expanding universal and equitable access to all.
  2. With regards to companies in the healthcare sector, access should be understood as a core business issue and opportunity. While long addressed through donations and one-off initiatives or programs, it is has become clear that real progress can only be achieved by integrating “access thinking” throughout a company: including from R&D to logistics, from the board room to the patient, from idea to impact.
  3. There are still some largely untapped avenues for progress, and even the most mature business and corporations have opportunities to move the sector forward.

“The BSR Access to Healthcare Leadership Ladder framework is an important step forward in establishing standards for industry-led access programs. We encourage all stakeholders, within and outside the industry, to get involved and agree on such standards, in order to establish a common understanding of the industry’s role and achievements in improving global access.”

—Profs. Veronika Wirtz and Peter Rockers, Boston University School of Public Health

As a step in their collective action for driving progress, BSR and the HCWG have developed the Access to Healthcare Leadership Ladder, a maturity diagnostic and ambition-setting tool to guide and drive progress on access to healthcare. Based on BSR research and dialogues with external experts (including academics, industry associations, investors, relevant foundations, and NGOs) and HCWG members, the Ladder aims to achieve HCWG members’ shared vision of access to healthcare.

The tool helps companies to drive impact by assessing the current level of maturity and opportunities for progress across different dimensions that constitute access to healthcare, helping companies look at their practices through a value chain lens, realizing the extent to which access is currently integrated across their organization, and identifying gaps and opportunities for further improvement.

The Ladder has been designed to cover a broad spectrum of access issues for healthcare companies, irrespective of the medicine they develop or the market in which they distribute their products. Furthermore, the tool is relevant to any company and should provide insights to even the most mature companies.

In the Ladder, access maturity is evaluated across the company value chain through nine dimensions: six dimensions covering the “four As” (Availability, Affordability, Accessibility, and Acceptability) plus three dimensions covering business practices and measurement.


Healthcare leadership ladder graphic

For each of the dimensions, the Ladder defines four maturity levels:

  • Working at a base level, i.e., defining the minimum practice, beyond regulatory requirements
  • Achieving good access practices, i.e., an overview of good practice
  • Pioneering innovative solutions, i.e., examples of current, innovative practices
  • Driving impact, i.e., next steps to achieving the HCWG vision of access

We trust the Ladder will be a useful tool to spark the higher ambitions and resources needed for underserved patients across the world to receive quality healthcare.

The Ladder now enters a pilot phase that companies are welcome to join. For any questions or comments, please contact the Healthcare Working Group.

Download a presentation of the Leadership Ladder