Two billion people have no access to the medicines they need. Many in the developing world can't afford drugs to fight diseases like malaria or HIV/AIDS.

It's a common perception that pharmaceutical companies are to blame. Now there's a tool that reveals how much - or little - they're actually doing about the problem: the Access to Medicine Index - developed by Dutchman Wim Leereveld.

RNW audio report

"Companies are interested in what you think, or what I think. Or what governments think. But they're mostly interested in what their peers think […] They compete every day."

Wim Leereveld is satisfied. His second Access to Medicine Index - the first one appeared in 2008 - is now a familiar concept in the pharmaceutical industry itself. The index provides the companies and the general public with an easy overview of what drugmakers are doing to make their medicines more available in the developing world. For years, the industry has been under fire for failing to put its drugs and drug patents on the market at prices the developing world can afford.

Competition
Because the drug companies are anxious to put forward a sustainable, social face, they see the index as an opportunity for good publicity. Of course, companies also risk losing face if they drop further down the list. Leereveld - a former consultant for the pharmaceutical industry - stresses the positive side: the stimulating effect of competition.

"If suddenly their competitors are much further […] - and that's what we show now in this index - then you see that some companies take a leading role in making their medicines more available."

Pricing
The 2010 AMI has just been published online. Compared to 2008, it's clear that several US drugmakers - such as Pfizer and Merck - are quickly closing the gap on their European counterparts in terms of making medicines more available in the developing world. Still at the top though, scoring an overall 3.7 on a scale of 0 to 5, is British drug giant GlaxoSmithKline.

The index breaks down the concept of medicine accessibility into several categories: the role of management, lobbying and marketing, research, patenting policy, and several others. But above all, of course, pricing.

"I think it's very important that we have such an index. To know exactly what each big pharmaceutical company is doing," says Dr Robert Sibbag, vice president of the French pharmaceutical firm Sanofi-Aventis. His company has come fifth on the index twice in a row.

Impressed
Dr Sibbag says the AMI is an important stimulus to keep improving performance - if only to keep in step with the competition. And he says he's impressed by Wim Leereveld's methodology.

"It is made in a very professional way. With a lot of parameters. A lot of interactive meetings with different companies. A lot of very precise questions. It's facts, not just perceptions or feelings that this company is doing that. It is very concrete. This is very positive."

Wim Leereveld says the companies were taken aback when he first approached them. But now they've embraced his idea. Merck, for instance, posts a link to the index on its own Corporate Social Responsibility report. And he says that despite the cut-throat, profit-driven business pharmaceutical companies operate in, shareholders are not their only consideration.

"The people in these companies, the CEOs, have a heart. That sounds naïve, but they all want to be working for a company they can be proud of. So their social behaviour is a real factor. And the world is changing, you see that in other sectors too. The world wants companies to not only accumulate money, but also to take part in building our planet."