Building innovative PPPs to fight poverty-related diseases

Children are checked for trachoma, a neglected tropical disease in Togo. Poverty-related and neglected diseases account for 13.7 million deaths around the world. Photo by: Els Mathieu / Community Eye Health / CC BY-NC

Innovative forms of across sectors partnerships add value and accelerate innovation in the fight against poverty-related and neglected tropical diseases, and at the same time contribute to the European Union’s research and development policy goals.

That was the conclusion of a high-level panel discussion held this week at the European Parliament in Brussels on the value of cross-sectoral partnerships to develop and deliver high-impact, cost-effective global health technologies.

At the event, hosted by Deutsche Stiftung Weltbevoelkerung and PATH, speakers discusses the challenges of developing innovative and effective responses targeted at poverty-related and neglected diseases and conditions in low- and middle-income countries. Each year in these countries, malaria, tuberculosis, and AIDS account for nearly four million deaths, while 31 other neglected or poverty-related diseases account for some 13.7 million deaths. Despite their devastating impact, between 1975 and 2000 out of a total of 1,393 medicines developed in this period, only 16 were directed at diseases most affecting populations in these nations.

We caught up with DSW Executive Director Renate Baehr, who explained how public-private partnerships can provide a range of opportunities and skills to advance innovative work on global health research and development.

Here are a few excerpts from our conversation with Baehr:

What added value can public-private partnerships bring for innovating in the area of global health?

Each sector brings its specific skills, knowledge and expertise. From the private sector comes a depth in industrial and research expertise, long-established experience in product research and development, as well as distribution and supply chain efficiencies. The public sector — governments, multilateral organizations and public research institutions — can provide funding and policy support, and provide a long-term, stable and supportive regulatory and political environment. Together, they can combine these experiences and skills to accelerate the development of much-needed health products that meet the needs of people in low- and middle-income countries — people suffering from diseases that may not ordinarily receive the same amount of attention without these initiatives.

What kind of innovative forms of partnership can be created to accelerate innovation in the fight against poverty related diseases?

One example of new forms of partnerships that has had success in recent years are Product Development Partnerships. These partnerships are non-profit organizations that have emerged in the last 15 years to specifically address the failure by private industry to devote sufficient resources for public health research into poverty-related and neglected tropical diseases.

While it is important that these will be responsible for the development of future products, already now there are some innovations that are having a lasting impact. For example, a new tool has been developed to reduce maternal deaths from post-partum hemorrhage — an anti-shock suit made of neoprene developed by PATH that applies pressure to the lower part of a woman’s body, forcing blood to her vital organs and allowing some extra time to keep the mother alive until she can get treatment. These are the kind of innovations being developed right now that can save lives.

What can such developments bring to partnerships with industry and to donor projects?

PDPs combine public investment with private sector expertise to bring forward much-needed health products that would not ordinarily be developed, because of low market incentives and high risk R&D. PDPs have been responsible for over 40 percent of the new global health products registered between 2000 and 2010.

Additionally, they have been instrumental in supporting local capacity building in low- and middle-income countries, supporting investment in health infrastructure, and improving local knowledge, clinical practices and scientific expertise in sub-Saharan Africa.

What can be done in terms of raising investments to accelerate innovation, as well as the introduction and integration of global health technologies?

Within the EU, for example, we would encourage policymakers to ensure that there is sufficient funding to support the international commitments of the institutions and member states in the area of global health research and development funding. In concrete terms, this could mean support for EDCTP2 and increased funding support from the European Research Council for basic research into poverty-related and neglected diseases.

What is important to remember, however, is that while all these funds and projects are important, at the end of the day donors will have to stand by their financial commitments if they are to have any chance of success. This means standing by their official development assistance commitments in the area of global public health and to the 0.7 percent target.

Can more innovative financial structures, such as the Global Health Investment Fund, be created in order to mobilize new sources of capital to tackle social challenges?

Yes, to an extent. Push and pull mechanisms — such as prices, state guarantees and advance market commitments — can help to mitigate risks and enhance the attractiveness of small product markets.

Again, I would reiterate the point that new funds and funding mechanisms are only as good as the funding they receive allows them to be. Countries have ODA commitments that, if they meet them, can go a long way to driving forward innovation in global health sectors like sexual and reproductive health, and poverty related and neglected diseases.

Through the new research and innovation programs for 2014-2020, the EU will be a key driver of innovation, leading the fight to eradicate poverty-related diseases. But what role can public-private partnerships play in achieving the EU’s research and innovation policy objectives?

PPPs such as those mentioned above — and more generally, investment in global health research and development — has an impact not only on those suffering from diseases in the world’s poorest countries, but also within the EU. Public investment in these kinds of partnerships is highly cost-effective development assistance, developing products that could save millions of lives while reducing healthcare costs and the enormous economic and social costs of poverty-related and neglected diseases.

It also provides incentives in Europe — investment in R&D in this area supports the creation of highly skilled jobs in European research centres and a high return on investment. Investment in R&D for global health will boost EU competiveness and support research excellence — key objectives of EU R&D policy.

The EU has an aspiration to be a leader in global health R&D — PDPs are one tool that can help it achieve this goal.

What can be done concretely to bridge the gap between academic research and action by nonprofits, governments, and firms?

What is important in this area is that we continue to encourage governments, policymakers, non-profit organizations and the scientific community that PPPs are effective — both in terms of cost and in their impact on the lives of people in some of the world’s poorest countries.

Partnerships like PDPs, and the work done by organizations such as PATH, IPM, and IAVI demonstrate clearly that the “gap” between laboratory research and the work of the private sector in developing new global health innovations can be closed — and these advances can make a real difference to people’s health.

IPM, for example, has been working on the development of a dual-purpose vaginal ring that would be able to protect users against HIV and at the same time provide reliable contraception. This and other projects, such as the ongoing innovations in female condoms, are concrete examples of these partnerships making a real difference to the lives of people living in low- and middle-income countries.

We would welcome the continued and increased policy and financial support for innovative initiatives whose sole aim is to treat and eradicate these diseases as, overall, only 10 percent of the world’s health research resources are applied to diseases that affect the poorest 90 percent of the world’s population.

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