<b>Strengthening Health Systems for NCD Care in LMICs: Examining Pharmaceutical Industry Multisectoral Partnerships Beyond the Provision of Medicines</b>

Abstract

Noncommunicable diseases (NCDs) pose a major global health challenge, with 77% of NCDs-related deaths occurring in low- and middle-income countries (LMICs). Weak health systems and system barriers worsen inequities in NCDs management, hindering progress toward the Sustainable Development Goals (SDGs). In response, international organizations like the WHO and UN have called for multisectoral collaborations, including private sector engagement.The pharmaceutical industry is increasingly acknowledged for its potential to contribute to addressing these system challenges and strengthen health systems. In the current state, there is evidence suggesting that the pharmaceutical industry recognizes the value of strategic multisectoral partnerships and has initiated efforts in this area. However, significant practice gaps remain, including limited insights into the industry’s conceptual understanding of health equity, health system strengthening, and multisectoral partnerships, as well as its motivations and current approaches to partnership design. Existing research also provides little business-specific evidence or recommendations for future industry partnerships.This research aims to address these gaps by examining and informing the pharmaceutical industry’s approach to serving as a health system partner in LMICs. Through real-world examples of industry-led strategic multisectoral partnerships as well as insights from industry executives and health systems, the research seeks to answer three key questions: (1) What is the context for pharmaceutical industry partnerships with health systems to improve NCD care in LMICs? (2) How does the industry currently design these partnerships? (3) How can the industry improve its partnership approaches to enhance equitable NCD care?This research was guided by a conceptual framework based on the Bergen Model of Collaborative Functioning (BMCF), enriched with constructs from R = MC², Collective Impact, and the Social Ecological Model. The framework examined partnership context, inputs, throughput, and outputs, providing a comprehensive lens for understanding and improving pharmaceutical industry collaboration with LMIC health systems.An exploratory, multi-method, industry-level case study design was employed, focusing on four sub-units. Health system perspectives were included as an external unit to provide a more comprehensive and diverse view of the industry’s partnership efforts.Data collection included document analysis and semi-structured interviews with pharmaceutical executives and health system representatives. Findings were derived through integration across industry sub-units and triangulation with health system perspectives.By revealing evidence from real-world practice and proposing a mutual value-loop model for future partnership design, this research provides an initial step toward guiding the pharmaceutical industry to invest in and position itself as a health system partner. In doing so, it highlights how long-term business interests can be aligned with global health objectives in addressing system-level challenges and improving equitable NCD care in LMICs. Ultimately, such efforts contribute to the broader goal of “ensuring healthy lives and promoting well-being for all”, as outlined in SDG 3.</p