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Health Policy, Access & Public Health
Universal Health Coverage Policy Statement
Universal Health Coverage Policy Statement
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Context

At Johnson & Johnson, we believe that good health is at the heart of human progress—it enables children to thrive, women to succeed, families and communities to prosper, and countries to rise from poverty and achieve economic security. That is why we have a promise to relentlessly drive better health for all.

Unfortunately, for far too many people around the world, good health is not within reach. According to the 2017 Global Monitoring Report from the World Health Organization (WHO) and the World Bank, half of the world’s population lacks access to essential health services, and 100 million people are pushed into extreme poverty because of the cost of various forms of care.

Universal Health Coverage (UHC) is a global priority, championed by the WHO and promoted by governments worldwide. As part of the Sustainable Development Goals, all UN Member States have committed to try to achieve UHC by 2030. Doing so would build not only healthier communities but also stronger economies.

Johnson & Johnson’s Position on UHC

UHC is aligned with Our Credo commitments to patients, caregivers, and communities. Regardless of where they live, everyone should have access to quality and affordable essential healthcare services. No person should have to forgo treatment or be forced into poverty because of the cost of care.

We understand that there are four components that should be included in any effort to work toward achieving UHC:

  • Workforce & Infrastructure: A robust heath system with well-trained and well-equipped health workers is foundational to achieving UHC. In particular, we believe a holistic approach ensures that (1) young people are knowledgeable and supported to enter health-related careers; (2) health workers are provided with opportunities to improve their education and strengthen their skills; and (3) health systems are equipped with the supplies and tools they need to deliver quality care.
  • Access & Affordability: Patients and communities must have access to essential care, including drugs, vaccines, surgical care and other medical technologies needed to prevent and treat diseases and address public health needs. Quality, authentic medicines must be procured and in stock at the local and primary care level. This holds true for many essential medicines that currently are available as generics, as well as newer, more innovative medicines. Ensuring access to innovative products not only helps individual patients, but can also free up health system resources.
  • Sustainable Financing: While UHC is an important, unifying goal, there is no one-size-fits-all approach to how UHC is delivered through government, non-profit or private-sector channels. Rather, tailored strategies must be developed in each country that align to local needs, resources, market conditions and societal values. Ensuring UHC does not mean that provision of care must be free or that a single-payer system is the best or only solution, but it does require sustainable financing for both providers and those needing care. Financing considerations should consider the full complexity of the healthcare system, rather than addressing specific issues in isolation. We support investments in value-based care that ensure patients and health systems are spending their money on effective solutions.
  • Partnerships: While governments typically play a leading role in building health systems and financing and/or delivering care, the inherent complexity of healthcare means no one sector can effectively deliver on the promise of UHC. Moving toward UHC requires a diverse group of stakeholders to participate in the effective design, implementation and delivery of care for all. The public, private and non-profit sectors have both a shared responsibility and accountability toward this goal. Appropriate, transparent measurement systems and dashboards to track country-level progress of key bellwether outcomes for health system capacity are crucial to ensuring this accountability.

Johnson & Johnson’s Activities to Support UHC

We are firmly committed to doing our part to ensure the promise of UHC becomes a reality for patients, families and communities around the world. Doing so requires a mix of global and country-specific programs as well as policy-shaping work. Around the world, we have more than 550 health-related programs and we strive through these to align with government priorities, advocating with both local and central government for quality healthcare workers, especially for women and children. Examples of our work include:

  • Workforce & Infrastructure: We have a legacy of working to support the people who are at the front lines of delivering care, supporting programs for more than 410,000 providers from 2010 to 2015 and more than 84,000 healthcare workers in 2016 alone. We provide a variety of education and training to health professionals, including programs targeting young health workers, and inform and support the adoption of improved clinical guidelines.
For example, for more than a decade we have worked with the Government of China and other partners to implement and scale up a program aimed at saving and improving newborn lives by targeting birth asphyxia, a newborn’s inability to breathe at birth. This initiative, implemented in more than 90% of labor and delivery health facilities, has trained more than 250,000 healthcare workers, and saved more than 150,000 babies’ lives, demonstrating the impact of building health worker skills. More recently, through the Born on Time partnership with World Vision, Plan International, Save the Children, and the Government of Canada, we have focused on health system capacity as one piece of a comprehensive approach to preventing pre-term birth in Mali, Bangladesh and Ethiopia.

We also advocate to ensure that others, including governments and donors, invest in the health workforce and are members of the Frontline Health Workers Coalition (FHWC). In 2018, we led and hosted the inaugural event, Health Heroes +SocialGood with the UN Foundation and FHWC during the Sixth Annual World Health Worker Week.

In 2002, we launched the Campaign for Nursing to help address the looming crisis that projected a shortage of 500,000 nurses in the United States by 2020. Over time, we have provided more than $20 million in nursing scholarships, built digital content, and launched television advertising to raise the profile of nurses. Working with partners, we are proud that the nursing workforce has now grown by 1 million and is projected to continue growing in the years ahead.1 Going forward, we are embarking on new work with a focus on fostering and recognizing the critical role nurses play in innovation for better patient care.

  • Access & Affordability: At Johnson & Johnson, we have a responsibility to make our medicines, vaccines, devices and diagnostics accessible and affordable to people in traditional reimbursed healthcare markets, emerging economies and developing countries. These commitments are reflected in our #2 ranking on the 2016 Access to Medicines Index, which summarizes our various Access programs. For instance, we have reached patients around the world with 2nd- and 3rd-line HIV medicines through a variety of access strategies, including patent/licensing agreements, specific collaborations with generics manufacturers, donation programs and more. As of Q1 2018, we have reached more than 50,000 patients with our multidrug-resistant tuberculosis (MDR-TB) therapy SIRTURO® (bedaquiline), and each year we are committed to donating 200 million doses of our soil-transmitted helminth drug VERMOX® (mebendazole) for children around the world.
Addressing high-burden diseases with innovative solutions that dramatically improve health outcomes can free up healthcare system capacity to support UHC. For instance, we are currently working on a dramatically simplified treatment regimen that would include SIRTURO®. Delivering this would ultimately reduce strain on health systems to treat the leading cause of antimicrobial resistance (AMR) deaths worldwide.

Beyond our product-specific access initiatives, we also utilize mHealth programs like mMitra in India and MomConnect in South Africa to encourage key populations – e.g., expectant mothers – to access care in existing health systems. For instance, Johnson & Johnson-supported mobile messaging programs have reached six million mothers and families with vital health and parenting information in 10 countries since 2010.

  • Sustainable Financing: Countries around the world have committed to and made gains toward achieving UHC, yet questions persist about the sustainability of such efforts. We have championed a variety of programs to support sustainable approaches for both patients and governments/providers.
While the Philippines’ national health insurance program has made substantial progress in expanding its coverage, the range of benefits covered and the reimbursement level is limited. We have worked with the Bank of Philippines Islands to create a new personal loan program for healthcare costs that offers middle-class consumers a very low-interest loan for emergency health expenses, or for treatment of pre-existing conditions that are excluded from government health insurance coverage.

In China we supported an industry initiative managed by the Pharmaceutical Research and Manufacturers of America (PhRMA) that aimed to promote the development of private health insurance. As a follow-on project, we initiated a research initiative with the China Development Research Foundation to continue providing guidance to the Government of China on the development of complementary private health insurance to ensure sustainable UHC in the country.

Improving hospital payment models to reward value and not volume is critical for healthcare system financial sustainability. As a member of the Instituto Coalizão Saúde (Health Coalition Institute) in Brazil, we actively participated in the production of the private-sector-proposed Agenda for the Transformation of the Healthcare System in Brazil. We also chaired the Value-Based Payment Models working group of the Health Coalition Institute to produce the first Technical Note with concrete proposals for hospital payment reforms in Brazil.

In Colombia, we partnered with PROESA, the Centre for Studies in Social Protection and Health Economics at ICESI University, to produce an in-depth analysis of the healthcare system and identify main health policy areas and proposals that could improve system efficiency and financial sustainability. We are also proud members of Asi Vamos en Salud, and contribute to critical financial sustainability discussions of the Colombia Healthcare System.

  • Partnerships: Partnerships are critical to leverage strengths across sectors in support of UHC. In addition to those mentioned above in areas like health workforce strengthening (e.g., Born on Time), we have many partnerships in advocacy and product development that support UHC.
On the advocacy front, we have been a proud and active participant of many initiatives focused on ensuring access to medicines and UHC. We routinely participate in inter-agency/public-private working groups such as the IFPMA Essential Medicines List task force, and support the UHC 2030 coalition. We lead a Communications Advocacy Group (CAG) during UN General Assembly week and international congresses, such as the International Confederation of Midwives and Women Deliver. The CAG coordinates communications across more than 25 international organizations to lift high-priority health and development issues and encourage others to act on challenges, e.g., youth leadership, maternal health and the global surgery shortage. We are also a key member of the Every Woman Every Child advocacy team. At the 2017 UHC Forum in Tokyo, we were proud to partner with the G4 Alliance and the Harvard Medical School Program in Global Surgery and Social Change to host a side-event with the Governments of Zambia and Zimbabwe and the WHO, with a focus on how expanding access to surgical care can catalyze UHC.

Leveraging our size and skills, we have also placed an emphasis on innovative R&D partnerships that aim to move beyond treating diseases to intercepting them or preventing them in the first place. In January 2015, as the Ebola virus outbreak continued to devastate communities in West Africa, we mounted an unprecedented response by launching a series of partnerships with respected research institutions, donors and others across the globe to help accelerate clinical testing of an Ebola prime-boost vaccine regimen. By the end of 2015, Phase 1, 2 and 3 clinical studies of the vaccine regimen were active across three continents, including countries like Sierra Leone.2

For More Information

Guided by Our Credo, we are firmly committed to doing our part to ensure the promise of UHC becomes a reality for patients, families and caregivers around the world. More information about our programs and commitments can be found in the Health for Humanity Report and Health for Humanity 2020 Goals, as well as in our commitment to the U.N. Sustainable Development Goals.

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Last updated: May 2018

  • 1 Increase in the number of registered nurse workforce between 2001-2015, according to the study accessible at: https://www.aaacn.org/sites/default/files/documents/StateoftheRegisteredNurseWorkforce.pdf

    2 Janssen’s investigational Ebola vaccine regimen was developed in a collaborative research program with the National Institutes of Health (NIH) and received direct funding and preclinical services from the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, under Contract Numbers HHSN272200800056C, and HHSN272201000006I and HHSN272201200003I, respectively. The MVA-BN-Filo material used in Phase 1 studies was produced under NIAID/Fisher BioServices contract #FBS-004-009 and NIH contract HHSN272200800044C.

    BARDA previously awarded Janssen a total of US$44.6 million in 2015 and 2016 under contract HHSO100201500008C to help optimize manufacturing systems and capacity for the vaccine regimen, including heat-stability studies to verify that the regimen was optimized for use in African countries, and final product manufacturing and quality control activities. The U.S. Department of Defense (DoD) is also supporting the vaccine clinical program, with the United States Military HIV Research Program (MHRP) at the Walter Reed Army Institute of Research (WRAIR), with the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF) conducting one of the Phase 2 studies.

    The Innovative Medicines Initiative (IMI), which is supported by the European Commission, provided funding of more than €100M through the IMI Ebola+ Programme to support a number of consortia that are conducting multiple clinical trials and other vaccine development activities. Janssen’s partners in these consortia include the London School of Hygiene and Tropical Medicine, the Institut national de la santé et de la recherche médicale (Inserm), Inserm Transfert, University of Oxford, Le Centre Muraz, Bavarian Nordic A/S, Vibalogics, Grameen Foundation and World Vision of Ireland. The consortia funded by the Innovative Medicines Initiative 2 (IMI2) Joint Undertaking are EBOVAC1 (grant nr. 115854), EBOVAC2 (grant nr. 115861), EBOMAN (grant nr. 115850) and EBODAC (grant nr. 115847). This Joint Undertaking receives support from the EU’s Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations (EFPIA).
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