Refine
Document Type
- Article (3)
- Part of a Book (1)
- Doctoral Thesis (1)
Language
- English (5)
Is part of the Bibliography
- no (5)
Companies increasingly seek to strategically integrate social objectives in commercial activities to address societal challenges, yet little is known about how companies can sustain such a commitment over time. To address this question, we conduct a case-based, abductive study of two pharmaceutical companies widely considered industry leaders in facilitating access to medicine over a 20-year period (2000–2019). We identify product and operation-level integration as distinct types of integration efforts enacted by these companies. Tracing the intraorganizational dynamics associated with these efforts, we theorize that sustained integration is contingent on companies’ ability to respond to and address the challenges specific to product and operation-level integration. The theoretical framework we develop contributes to an emerging debate on the potential of companies to make progress on societal challenges by strategically integrating social objectives, including but not limited to those related to global health.
Insufficient access to medicines is a persistent global problem that affects billions of people in low- and middle-income countries. In this chapter, we use access to medicines as a case to understand how business can become instrumental in making progress on persistent and global problems we associate with sustainable development. We examine the emergence and evolution of access to medicines as a mandate for the pharmaceutical industry to contribute to sustainable development. More specifically, we trace the historical developments of corporate social initiatives in the industry and revisit existing research on access to medicines in management and related fields. We then introduce three distinct analytical perspectives - field emergence and change, firm heterogeneity, organizational processes - to examine access to medicine, expose managerial challenges and offer a research agenda that helps to advance research on access to medicines and, more generally, on corporate efforts to address pressing global problems subsumed under the Sustainable Development Goals.
Society increasingly calls on business, in particular multinational companies, to contribute to solving global challenges such as poverty, hunger, or the recent pandemic. Many companies and industries have responded positively to these expectations and use a broad set of efforts to work toward objectives such as the United Nations Sustainable Development Goals. However, research has frequently pointed out that that there is limited evidence for multinational companies being effective to this end, as they have to overcome many internal and external hurdles in tackling such development challenges. Thus, uncertainty remains with regard to how multinational companies can become instrumental in addressing the persistent and global problems we associate with sustainable development.
This cumulative dissertation explores this question by studying how the multinational pharmaceutical industry has acted upon the challenge of insufficient access to medicines, vaccines, and other health products in low- and middle-income countries. By analyzing how two companies have tried to integrate access objectives into their business, the first empirical paper brings to surface two types of integration efforts that differently enable companies to make progress on the access challenge. It also highlights the strategizing needed for each type of integration to overcome internal and external challenges. The remaining two papers look at the pharmaceutical industry’s contributions to the Kenyan response to non-communicable diseases as a case of the growing scale and scope of involvement of multinational companies on the local level. One paper shows that local development actors perceive this as a challenging and risky phenomenon and lays out why and how they engage with companies as development agents regardless. By studying the Kenyan case, the final piece looks more closely at how governance structures may help to ensure that industry-led public health initiatives contribute to development objectives.
Together, these papers contribute to management research by showcasing different pathways through which companies can become instrumental in making progress on development challenges: an internal pathway of integrating social objectives into the business as well as an external pathway of steering corporate initiatives through local actors and governance structures. Finally, it also informs debates in global health research by adding often neglected firm- and country-level perspectives on the growing role of business in global health.
Background:
In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development.
Methods:
We developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents.
Results:
The Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action.
Conclusion:
The application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.
Kenya, Tanzania, and Uganda founded a Customs Union in 2004 and apply a Common External Tariff (CET) on imports to the region. However, the CET has been increasingly destabilized by countries using unilateral exemptions on a wide range of strongly traded goods. This instability undermines progress in regional integration and creates an uneven playing field for business. The article discusses evidence for the influence of interest groups on the observed instability. This study takes a political economy perspective and tracks lobbying behavior from the domestic to the regional level. It looks at the influence of business membership organizations and other interest groups on CET negotiations. The article applies an exploratory, qualitative approach predominantly drawing on data gathered by the author in 25 interviews with experts in Kenya, Tanzania, and Uganda in January 2016.