Target 3.8: Universal health coverage and affordable medicines
Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
Owners remove an obstacle nothing else removes. Others must also act.
Why shareholder democracy is necessary
About 4.6 billion people were not fully covered by essential services in 2023, and 2.1 billion faced financial hardship from health costs in 2022. Coverage systems are built by governments. The affordable-medicines clause depends on pharmaceutical conduct. The Access to Medicine Index scores companies on pricing, licensing and delivery in low- and middle-income countries. ICCR-coordinated 2024 proposals at six large pharmaceutical companies targeted patent-extension strategies that keep prices high, framing them as human-rights risks. Owners of pharmaceutical firms and, in the US, insurers and hospital operators supply a necessary input on affordability. Financing and coverage design rest with the state, so others must act as well.
How this was scoredNecessary
Necessary. Owners remove an obstacle nothing else removes. Others must also act.
We have not yet written down the two answers behind this rating. Recording them on every item, so a reader can check the reasoning and not only the conclusion, is work in progress.
Every rating is the higher of two answers, one for what companies do and one for what they spend to stop the outcome, because the same vote reaches both. See the full method.
Sources
- Universal health coverage (UHC), World Health Organization, 2025-12-05
- 2024 Shareholder Proposals at Pharma Companies Cite Strategies to Keep Drug Prices High as Potential Human Rights Risks, Interfaith Center on Corporate Responsibility, 2023-12-14
- Pfizer Inc company report, Access to Medicine Index 2024, Access to Medicine Foundation, 2024-11
4 campaigns on record
Proposals asked companies to examine whether stacking secondary and tertiary patents on existing drugs (a strategy investors said AbbVie used to extend Humira's exclusivity to 19 years through 130 patents and 27 price increases) was limiting patient access, to align lobbying with stated access commitments, and, at Moderna and Pfizer, to study transferring vaccine-manufacturing know-how so generic versions could be made.
Result: Sixteen proposals were originally filed; twelve survived company challenges at the SEC and went to a vote. Two proposals at Amgen were withdrawn after the company reached an agreement with the filers; two other proposals, at Pfizer and Moderna, were also withdrawn.
Amgen's agreement with the filers led those two proposals to be withdrawn rather than voted on; the source describing this did not specify what Amgen committed to do, and we found no further documentation of that commitment.
Resolutions asked Moderna and Pfizer to study transferring COVID-19 vaccine technology and manufacturing know-how to lower-income regions and to share technical knowledge with the World Health Organization, and asked Johnson & Johnson to explain how public research funding had affected its pricing and what it meant by distributing vaccine on a 'nonprofit' basis.
With People's Vaccine Alliance
Result: This source does not report the vote outcome for the 2022 annual meetings.
Moderna agreed to sell 500 million vaccine doses to COVAX and 110 million to the African Union and committed not to enforce its patents during the pandemic, which Oxfam called insufficient; Pfizer partnered with South Africa's Biovac for fill-finish production, though Biovac could not produce the active vaccine ingredient itself; Johnson & Johnson's nonprofit-basis distribution remained limited to emergency pandemic use with details Oxfam said were still unclear.
The resolution asked AbbVie's compensation committee to report each year on whether executives were being rewarded, through incentive pay, for pricing strategies that drew public criticism over drug costs.
Result: The proposal won 21 percent shareholder support. AbbVie had asked the SEC to exclude it from the proxy ballot; that challenge failed, and proxy advisor ISS recommended shareholders vote in favor.
We found no documented follow-up report or compensation-policy change that AbbVie made as a result of this specific vote in the sources reviewed.
Shareholders asked each company to publish a report showing how much it had raised prices on its top-selling brand-name drugs from 2010 through 2016, explain the reasoning behind those increases, and assess the legislative, reputational, and financial risk of its pricing strategy.
Result: All ten companies filed petitions with the SEC to exclude the proposals from their proxy ballots (a 'no-action' request), so none of the resolutions ever reached a shareholder vote.
We found no documented change in drug-pricing disclosure practice that resulted from this specific 2016-2017 round of proposals; the resolutions were blocked before a vote could occur.
Interfaith investor coalition pushes shareholder resolutions on drug prices, STAT News
Related subjects on other maps
How this rating was made
Every item on every one of our maps is read against one question: how far does this depend on the people who own companies voting their values? We answer it twice, once for what companies do and once for what they spend to stop the outcome, and take whichever answer is higher, since the same vote reaches both. The score carries its reasoning and its sources so that a reader can check it rather than take it.
- Pivotal. Owners voting their values can deliver most of the outcome.
- Necessary. Owners remove an obstacle nothing else removes, and others must also act.
- Helpful. Owners voting their values help, and others carry most of it.
- Independent. This moves without owners. Other levers carry it.
The advocacy record on this page holds only what a source we opened says happened. Where we searched and found nothing, the page says so rather than leaving a silence. Where a campaign names a filer the source does not name, it says that too. Ratings are ours; the list of subjects is UN Sustainable Development Goals's, and we link to their original.
How we score dependency, in full.