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Taxes - Analysis of tax rate (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Reconciliation of accounting profit multiplied by applicable tax rates [abstract]      
Applicable tax rate $ 98 $ 39 $ 82
Effect of disallowed expenditures (20) (23) (26)
Effect of equity-based compensation (5) (1) (2)
Effect of income taxed at reduced rates 4 2 2
Effect of tax credits and allowances 9 7 13
Effect of adjustments to contingent consideration and other liabilities 17 11 11
Effect of option payments (6) (12) (17)
Tax effect from change in tax rate 10 (342) (14)
Effect of changes in uncertain tax positions (8) 10 (33)
Effect of other items (10) (2) (4)
Tax effect of prior year items (15) 13 (61)
Total income tax income/(expense) $ 104 $ (324) $ 73
Reconciliation of average effective tax rate and applicable tax rate [abstract]      
Applicable tax rate 15.40% 11.70% 27.30%
Effect of disallowed expenditures (3.10%) (6.90%) (8.70%)
Effect of equity-based compensation (0.80%) (0.30%) (0.70%)
Effect of income taxed at reduced rates 0.60% 0.60% 0.70%
Effect of tax credits and allowances 1.40% 2.10% 4.30%
Effect of adjustments to contingent consideration and other liabilities 2.70% 3.30% 3.70%
Effect of option payments (0.90%) (3.60%) (5.70%)
Effect of tax rate changes 1.60% (103.00%) (4.70%)
Effect of changes in uncertain tax positions (1.30%) 3.00% (11.00%)
Effect of other items (1.60%) (0.60%) (1.20%)
Effect of prior year items 2.40% (3.90%) 20.30%
Effective tax rate 16.40% (97.60%) 24.30%
Adjustments for current tax of prior periods $ 15 $ 13 $ (61)
Switzerland [member]      
Reconciliation of accounting profit multiplied by applicable tax rates [abstract]      
Effect of tax rate change on current and deferred tax assets and liabilities from US tax reform   304  
United States [member]      
Reconciliation of accounting profit multiplied by applicable tax rates [abstract]      
Effect of tax rate change on current and deferred tax assets and liabilities from US tax reform   $ 31