Leading the way on access and global health

Improving access to medicines remains one of the world’s greatest healthcare challenges. At Novartis, we know that building trust with society depends not only on finding new treatments but also on making them available to as many people as possible. Our 2021 materiality assessment identified access as one of our most material topics.

56.2 m

Patients reached

through access approaches

We seek to expand access to our medicines to underserved patient populations in both developed and developing countries, while addressing major global health challenges. We reached 56.2 million patients in 2021 through access approaches, and we have set ambitious targets to reinforce our commitments. Relevant members of the Executive Committee of Novartis have access metrics in their annual performance objectives.

The Access to Medicine Foundation has recognized our efforts in this area, ranking us second in the 2021 Access to Medicine Index among 20 of the world’s largest healthcare companies.

Novartis access principles

We aim to implement an access strategy for all new medicines launched. These strategies include innovative pricing and access models, earlier launches in low- and middle-income countries (LMICs), and approaches to strengthen healthcare systems. Information in this chapter on access and global health is organized according to the three pillars of the Novartis access principles (see infographic below).

Novartis access principles

Novartis access principles (Graphic)

Our targets for access and global health

In 2020, Novartis committed to increase patient reach with our strategic innovative therapies in LMICs by at least 200% by 2025 (vs. 2019). In addition, we aim to increase patient reach of our four global health flagship programs in LMICs by at least 50% over the same period. To reinforce our commitment to these targets, we issued a EUR 1.85 billion sustainability-linked bond1 in 2020. Bondholders are entitled to receive a higher amount of interest if Novartis does not meet its access targets.

We are on track to meet our targets. In 2021, we achieved a 36% increase in patient reach with our strategic innovative therapies compared with the previous year (up 73% from 2019). Patients reached through our global flagship programs declined by 26% from the prior year, when we saw a sharp increase due to our ability to maintain delivery despite wider COVID-19 related supply disruptions. However, the latest figure was still more than double our 2019 baseline (please see the "Access to healthcare performance indicators" table below for more details).

1 For more information on our SLB, including measurement criteria, please see the bond prospectus at www.novartis.com/slbprospectus

Our global health priorities

Our work on global health is aligned with our overall efforts to expand access to our medicines. We follow an integrated approach for the control or elimination of four diseases where there has been market failure and little investment in research and development:

Sickle cell disease (SCD) is a genetic blood disorder that affects more than 6 million people worldwide. While around 80% of the global disease burden is in Africa, SCD also affects approximately 100 000 children and adults in the US. Novartis is exploring new therapeutics and working to improve care for SCD patients in both developed and developing countries.

Chagas disease affects approximately 6 million people, mainly in Latin America. Starting as a parasitic disease, it can lead to chronic cardiac disorders in up to 30% of patients. Novartis is active in drug discovery for new antiparasitic compounds and clinical research on Chagas cardiomyopathy, as well as health system strengthening initiatives.

Malaria is preventable and curable, yet it remains one of the most deadly infectious diseases in the world. Novartis has been at the forefront of the fight against malaria for more than two decades, launching the first fixed-dose artemisinin-based combination therapy (ACT) and working with partners to deliver more than 1 billion antimalarials, the majority without profit.

Leprosy causes physical disability and stigma for approximately 1.5 million people worldwide. Multidrug therapy donated by Novartis has been a cornerstone of global elimination efforts, leading to the treatment of more than 7 million people since 2000. In addition, through the Novartis Institute for Tropical Diseases (NITD), we continue to research and develop a promising portfolio of drug candidates for the treatment of neglected tropical diseases that affect around 1.6 billion people worldwide, including dengue fever, diarrheal disease and visceral leishmaniasis.

For more information on our global health priorities, please see www.novartis.com/esg/global-health

Access to healthcare performance indicators





Overall patients reached (millions)




Patients reached with medicines – total




Patients reached through access approaches1




Sustainability-linked bond (September 23, 2020 – September 23, 2028)




Patients reached with strategic innovative therapies

947 699

695 669

547 664

Patients reached through flagship programs

32 695 224

43 912 152

15 069 483

Novartis Global Health2, 3




Countries with medicines on the ground




FTEs4, 5

1 330

1 334


Patients reached with medicines through Novartis Global Health (millions)6




Health educators trained

2 827


1 536

Healthcare providers trained

10 719

12 648

1 516

Policymakers trained




Points of service provision7

4 365

5 902

13 635

People reached at points of service provision

360 356

486 642

986 701

Awareness events held

412 872

424 878

250 432

People reached at awareness events

9 678 360

8 048 360

10 211 704


Includes patients reached with medicines through Novartis Global Health, as well as patients reached with support programs, emerging market brands and donations


Data reflect the full scope of access approaches managed by the Global Health organization, including the activities formerly managed by Novartis Social Business, as well as the newly formed sub-Saharan Africa (SSA) organization and the Integrated Access Programs & Markets unit.


Novartis Global Health focuses on transforming health in low- and middle-income countries through various approaches, which include the flagship programs (targeting malaria, sickle cell disease, leprosy and Chagas disease) as well as a core portfolio of medicines for non communicable diseases.


Full-time equivalent positions and contractors


Significant number of headcounts integrated from different units as a result of the establishment of the new SSA organization


The patient number is calculated based on treatments delivered and the following elements: daily treatment doses, treatment duration, treatment adherence and potential treatment overlap (NCD patients often take several drugs). The treatment adherence and treatment overlap factors are based on assumptions from developed markets. Includes patients reached through flagship programs (malaria, sickle cell disease, leprosy, Chagas disease), patients reached with donations (leprosy and fasciolisis), and patients reached with other Sandoz medicines


Points of service provision include facilities and health camps where healthcare services are provided.