By Herb Riband
Director, Access Accelerated

As the burden of noncommunicable diseases (NCDs) continues to increase in all countries, the urgency of improving equitable access to quality NCD prevention, treatment and care has become even more pressing. Access Accelerated, through its strategic partnerships and diverse initiatives, has worked since 2017 to expand access to life-saving NCD prevention, treatment and care in low- and middle-income countries (LMICs). To ensure these efforts are translating to meaningful impact, rigorous monitoring, evaluation, and learning (MEL) and transparent reporting have been a central part of our efforts, working with leading organizations including RTI and Boston University, and now Results for Development (R4D).

What Gets Measured, Gets Done

It’s not just about tracking numbers and generating reports; it’s about learning, generating evidence, and understanding what works in order to more effectively mobilize resources and drive the policy changes needed to improve health and well-being for millions. Measurement and reporting provides clarity on what is succeeding, what isn’t, and where adjustments are necessary to achieve our ultimate goal: improving access to quality NCD prevention, treatment, and care for underserved populations.

Critically, these efforts also serve as a tool for collective accountability. Our work involves a wide range of stakeholders— including governments, healthcare workers, civil society, the private sector, and the people whose lives we aim to improve. By measuring and sharing our progress, we demonstrate our joint commitment to fulfilling the promises we make.

Towards a More Harmonized Approach

In March 2023, a Chatham House event on “Improving access to healthcare: Effective partnerships with Industry” was held in partnership with Access Accelerated and Boston University. The event brought together multilateral organizations, policymakers, academics, NGOs and the private sector for a far-reaching discussion focused on access, access measurement and evaluation, the need for harmonization and simplification (citing the growing proliferation of access reporting frameworks and the associated reporting burden), the value of partnerships to improve global health, the unique challenges of NCDs, and the need for effective multi-stakeholder approaches and accountabilities. There was a call for continuing dialogues regarding improved ways to measure access in global health.

Recently, Access Accelerated was pleased to join the Bill & Melinda Gates Foundation and Boston University, which organized workshops in Boston (June) and Berlin (October) aimed at harmonizing access and impact measures. These workshops brought together a diverse group of stakeholders—from private sector companies, industry associations, standard setters, ratings agencies, and investors to multilateral organizations like the World Health Organization and the World Bank—to discuss perspectives on how we measure and report impacts in global health.

Key discussions focused on how the pharmaceutical industry measures its impact on people, reviewing reporting standards and metrics, and addressing data gaps that hinder meaningful reporting. A recurring theme was the proliferation and fragmentation of existing reporting frameworks. Multiple frameworks, varied and overlapping requirements, and different standards create an administrative burden for companies and their global and local partners, potentially detracting from their ability to focus resources on the greater goal: improving health outcomes for people and societies. Many participants expressed a desire to reduce redundancies and develop a more harmonized approach to measuring access and reporting on impacts.

Access Accelerated was pleased to play a key role in these discussions, sharing insights from our own MEL approach that not only focuses on measuring outcomes but also on using these learnings to foster the design and implementation of future access strategies and initiatives.

A Measurement Framework for a Complex Challenge

As we move forward with our renewed partnership with the World Bank to help LMICs improve financing for NCDs, Access Accelerated remains committed to building a robust MEL framework with support from R4D. We recognize the need for continued collaboration with key stakeholders, including the World Bank, R4D, and global and local partners, to ensure our MEL efforts remain effective, efficient, and relevant as we launch the next phase of our work.

Over the years, our measurement framework evolved to better capture both the quantitative and qualitative aspects of our collective impact. While data points and quantitative metrics are critical for understanding the scope of our work, they are not enough. The complexity of multi-stakeholder collaborations requires a robust and thoughtfully designed measurement framework. By evaluating harder-to-measure aspects like systems-level changes and the ripple effects on partners, local stakeholders, and communities, we can provide a more holistic view of how efforts are improving access to quality NCD prevention, treatment, and care in LMICs.

The Path Forward in Measuring Impact

By simplifying and harmonizing reporting frameworks—and ensuring that different measurement systems are interoperable, so that data systems can communicate efficiently—we can free up resources for companies and global/local partners to focus on using the evidence, data, and insights to deliver impactful programs that improve health outcomes for people and societies.