Editor’s note: This column is co-authored with Jon Pender, the vice-president for government affairs, IP & access at GlaxoSmithKline.
United Nations negotiations don’t have a great reputation. Too often they’re perceived as little more than a forum for special advisers to ruthlessly horse-trade their government’s pet policies.
But while the process of UN negotiations can be challenging, we cannot underestimate the power of hard-won consensus.
Last week, for example, the UN published its annual statistics on child mortality around the world, revealing that the number of children dying every year has almost halved – down from 12 million in 1990 to 6.6 million in 2012. This historic progress can be partly attributed to the energy and focus generated by the Millennium Development Goals (MDGs). These goals, signed into being in 2000, provided a road map for how all countries could collaborate on the future of development. That agreement, however, expires in 2015.
As global leaders congregate in New York this week to take stock of this progress in the MDGs and to try to shape the ambition for the next 15 years, they should recognise the unprecedented opportunity that they face: Ending preventable child deaths, a goal that is now within our grasp.
But this will only be achieved by bold and decisive action from the international development community and national governments to move beyond business as usual in the global fight against poverty. This includes addressing one of the gaps in the MDGs: harnessing the power of the private sector.
Business can be a key driver of development – stimulating inclusive growth and creating decent jobs; enhancing access to essential services; developing innovations to address human and sustainable development challenges; as well as paying appropriate taxes. Improved infrastructure, a more skilled workforce and a more prosperous society also benefit business in the long-term, creating a virtuous circle.
With the private sector at the table this time round, there is the appetite to explore potentially transformative new business models, with businesses aligning their corporate objectives with the development of products, services and value chain practices that contribute to poverty reduction and human well-being.
While the broad concept of businesses addressing social problems is not new, the setting of explicit social impact targets tied to core business is. If properly interrogated, this could be game-changing.
Creating unusual partnerships is the key to unlocking these new business models. The strategic partnership between Save the Children and GlaxoSmithKline pushes both organisations outside of our comfort zones and prompts innovative behaviours in a bid to help to save one million children’s lives.
For instance, with Save the Children sitting on GSK’s new pediatric research and development board, we expect to see the reformulation of the antiseptic chlorhexidine in a GSK mouthwash so it can be used to clean the umbilical cord stump of newborns to prevent serious infection, a major cause of newborn death in poor countries.
Perhaps even more challenging to our existing organisational cultures and practices, there is a determination to use our combined voices to improve health care access for the poorest, through joint advocacy on the expansion of essential care.
That an NGO and a pharmaceutical company can agree to support universal health coverage within the agreement that succeeds the MDGs – the Post 2015 framework – might seem strange to some people.
But without directly addressing the potentially contentious issues, the full promise of these partnerships will not be reached. Through dialogue we are now clear that our actions should promote investment in public health services as these are cost-effective and more likely to serve the poor.
Governments and donors may be keen to invest resources in the private sector; but this should only be contemplated where good evidence shows that it will benefit the poorest, either directly or by freeing up public resources.
We agree that the for-profit private sector has an important role in health service delivery. The development and production of medicines, vaccines, diagnostics and equipment, especially when tailored to the needs of developing countries, is something for which the world relies on the private sector.
Increasingly there is interest and enthusiasm for using private sector innovations to help improve health service delivery. We recognise that a great deal of healthcare is currently provided by the private sector, whether it is the high-quality services which are usually only available to the better-off or the unofficial services that are used by the poor when public services are inadequate or non-existent.
It is a massive challenge to ensure that this capacity is of sufficient quality, well-regulated by governments and integrated into state health systems so that they can be available, equitably, to those that need healthcare most. Private sector efforts should complement, not compete with, public efforts.
Through these tough conversations about the practical role of different partners in the delivery of the post-2015 framework, we can achieve more than we could by acting alone or in silos.
Talk of public-private partnerships within the framework is not a proxy for unfettered access to new markets for untried or untested new products. The contrasting skills, expertise and purposes of partners are critical in getting the right checks and balance in place.
So when Save the Children and GSK aim to harness the latter’s R&D to produce a new low-cost nutrition product, we do so with a focus on the intended beneficiaries. We must constantly check who will profit, how the materials will be sourced, what the impact will be on the local market, and where the regulatory mechanisms or enforcement capacities that protect consumers against exploitation should sit.
While we don’t claim to have all the answers, we are trying move beyond simple commitments to a debate that tries to identify then incentivise the behaviors and practices - corporate, NGO, and governmental - which will have the greatest impact over the next 15 years.
While high level principles are crucial, this practical, rubber hits the road discussion has the potential for making one element of the complex UN negotiations tangible.
Jon Pender, who co-authored this column, is vice president for IP & access, global health, in GSK’s Government Affairs Department. He is responsible for ensuring that GSK’s approach to sustainably improving access to medicines in the developing world reaches as many people in need as possible, whilst protecting the fundamental business model which underpins the research-based pharmaceutical industry.
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