November 18, 2025 /3BL/ – A new investor-led report calls on global pharmaceutical companies to reassess the commercial potential of low- and middle-income countries, highlighting the potential untapped opportunities for growth and innovation in underserved markets.
The Business Case for Global Health Equity: The Investor View, published today by sustainability consulting firm, SLR Consulting, and commissioned by the Gates Foundation, explores how improving access to medicines in low- and middle-income countries can drive commercial success for innovation-based pharmaceutical companies while progressing global health equity. The report captures the views of a group of investors representing a cross-section of international investors, including analysts from fundamental, impact and stewardship teams.
“The persistent gap in global health equity is well-known,” said Clare Wood, Analyst at Stewart Investors. “But what’s less explored is the strategic upside for pharma companies that engage early and thoughtfully in these markets. Our aim with this report is to help our portfolio companies and others in the sector recognise the business case for doing so.”
The global pharmaceutical industry’s revenue and profits have predominantly been concentrated on a narrow set of 10 to 15 established high-income countries. However, the report identifies the macro-trends that signal the need for the sector to reassess this strategy:
- Emerging markets growth potential: Low- and middle-income countries are experiencing rapid economic expansion, with S&P Global projecting annual GDP growth of 4% compared to 1.5% in high-income markets over the next ten years. With the middle-class population in emerging markets likely to double over the next decade, healthcare spend is set to expand.
- Improved market conditions: Governments in low- and middle-income countries are actively reforming regulatory frameworks to ease red tape as well as offering incentives to attract private sector investment.
- Operational advantages: Locating R&D and manufacturing in low- and middle-income countries can enhance research effectiveness, reduce costs, and accelerate speed to market.
- Challenges in traditional markets: Set against these trends are the growing pressures on price and margin in high income markets.
“Now is the time for exploring opportunities in non-traditional markets,” said Benjamin Lacaille, co-Portfolio Manager at Nomura Asset Management. “Current global geopolitical factors are accelerating the drive towards diversification and greater resilience in company strategies, which new markets could offer. We want to see companies demonstrating that they are well-positioned to capitalise on this opportunity.”
The report suggests a staged approach that pharma companies can use to evolve their current approaches to doing business in low- and middle-income countries into a self-sustaining commercial presence.
The report also gives practical guidance to fellow investors on the key questions to ask their portfolio companies to kick-start engagement on this important topic.
The full report is available at www.slrconsulting.com/insights/global-health-equity
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For further enquiries, or for further comment from the participating investors, please contact: Cecilia Law, Global Head of External Communications, SLR Consulting: claw@slrconsulting.com
Notes to editors
Investors from Nomura Asset Management, PGGM and Stewart Investors are available for interview on request.
Representatives from the following organisations participated in the discussion series that informed the report:
- BNP Paribas Asset Management
- Columbia Threadneedle Investments
- Legal & General Asset Management
- Lombard Odier Investment Managers
- M&G Investments
- Nomura Asset Management
- PGGM
- Principles for Responsible Investment (PRI)
- Robeco
- Stewart Investors
About SLR
SLR is a leading global sustainability consulting firm, with a team of 4,500+ talented professionals operating from a network of offices in Europe, the Americas, Asia-Pacific and Africa.
SLR is a committed partner in our clients’ sustainability journeys. We help companies turn intent into purposeful, practical action that delivers real-world results. Guided by our philosophy of Rational Sustainability, we focus on what truly drives long-term value. By viewing decisions through the lenses of risk, reward, and resilience, we help clients act with confidence, balancing environmental and social responsibility with commercial and strategic success. Our teams have been advising clients for over 30 years at every point of their project life-cycle; from Board-room strategy to on-the-ground delivery.
Our purpose – Making Sustainability Happen – means delivering outcomes that are grounded in evidence, shaped by experience, and built to last.
Find out more: www.slrconsulting.com
