Global health: Today at World Vaccine Congress Washington, Kim Bush delivered a special keynote address highlighting the importance of combining scientific innovation and great partnerships in order to achieve innovative high impact global health.
Mr Kim Bush described the Bill and Melinda Gates Foundation’s commitment to global health, which he emphasized is a truly dynamic area of healthcare. He highlighted the importance of science and innovation in improving the health of the world’s poorest. Three major objectives for his discussion included: 1) the current landscape of global health, including indicators of progress, 2) the Gates Foundation’s strategy on building partnerships between various stakeholders, and why partnerships are needed, and 3) emerging constructs that will help raise the level of industry engagement and participation in global health.
The importance and effectiveness of vaccines in improving global health is demonstrated by a few quick statistics: With the help of childhood vaccinations, the global mortality rate for children under five years old has declined by half over the past 50 years. Even so, as many as 1,500 people still die of infectious diseases every hour in the developing world, and over half of these are children under 5. Among the most important factors in reducing childhood mortality are vaccines, drugs for malaria, bednets, and the work of UNICEF to improve childhood survival and wellbeing worldwide.
The Gates Foundation works in two general realms of global health which are infectious diseases and family health. Vaccines are the highest priority within the foundation, and have been among the best instruments for improving global health, reducing both morbidity and mortality, and expanding the possibilities for length and quality of life for the global poor.
Need for a New Business Model
He went on to say that the "traditional" business models for vaccines and drugs are not suited well for global health vaccines. Developing countries bear 90% of the disease burden, while only 10% of all R&D is allocated for their diseases. While there have been approximately 1,500 medicines licensed since 1975, less than 20 were for diseases that primarily impact developing countries.
In general, emerging markets tend to be focused on infectious diseases. The majority of investments in the global R&D market are not for infectious diseases, however. Even though there have been some recent examples of solid commitment by industry leaders toward global health, only 3% of the biotech industry participates in global health, and part of what the Gates Foundation is doing is trying to change the risk in investments so that more of industry will get involved. Some hopeful signals of progress include new technologies, increased cooperation, sharing of drug libraries, and innovative financing schemes. The Gates Foundation is promoting a number of public-private partnerships, and Mr Bush described several ways that the Foundation is trying to "leverage the power of diverse partnerships to find solutions to some of healthcare very toughest challenges."
The Gates Foundation is involved with supporting The GAVI Alliance. GAVI has immunized 288 million children since 2000, potentially saving over 5.5 million lives, and currently serving the needs of 73 countries. At the same time, 1.7 million children still die every year from vaccine preventable diseases. By 2025, GAVI will immunize 90% of children against diseases like measles, pneumococcal pneumonia, and rotavirus. Progress can be measured by significant reductions in deaths due to diphtheria, measles, and tetanus.
In January, 2012, a broad coalition of partners, including the Gates Foundation, met in London and committed to targeting ten of the most common neglected tropical diseases (NTDs). These diseases affect one billion people in the developing world. The agreement for these diseases is unprecedented, with 1.4 billion treatments committed every year through 2020, and innovative licensing through the Drugs for Neglected Diseases Initiative (DNDi). It includes $785 billion in new financial commitments.
PDPs promote high levels of partnerships with industry in order to solve problems. The Gates Foundation is involved in 15 PDPs. One partnership addressed the need for a meningitis vaccine for Africa, MenAfriVac. The Meningitis Vaccine Program was put in place through a PDP and a grant from the Gates Foundation. The vaccine has been administered to 20 million people, and cases have dropped from over 10,000 per year to 8 per year.
Polio cases reported last year were fewer than 1,000. This is largely due to OPV development, a large donor base, and dedicated delivery teams. India celebrated their one year of being completely polio-free. Through the Global Polio Eradication Initiative (GPEI), 2.5 billion children have been immunized. Afghanistan, Pakistan, Nigeria are the only remaining countries with circulating wild-type polio. Summary of GPEI: 23 years of operation. 4 spearheading partners. 200 countries involved. 20 million volunteers.
The Decade of Vaccines is a call to action in global health, to potentially save the lives of 6.4 million children globally. It supports accelerated introduction of licensed vaccines, and rapid introduction of new vaccines, and will potentially avert over a hundred billion dollars in costs due to disease. Summary: time-limited, Consultative, WHA endorsed.
One new partnership the Foundation has funded is Liquidia Technologies. They invested $10 million dollars and received a commitment for Liquidia to develop target products. It was founded in 2004 in North Carolina, and has a novel particle fabrication technology called PRINT.
Mr. Bush says that global health has a long way to go toward engaging the resources and goodwill of the private sector. He highlighted the benefits to industry, such as helping finance and de-risk product development through strategic collaborations, and to help industry find new markets. Additionally, the Gates Foundation is working on mobilizing more global health funding, advocating for resources from other donors. Right now, the US, UK governments and the Gates Foundation account for 58% of all global health R&D funding. Mr Bush encouraged interested industry partners to be proactive in reaching out to the Foundations, noting the opportunities to submit both solicited and unsolicited funding requests.
Interesting start to the Congress. We'll be blogging about new revelations as the day progresses so stay tune!
Check back here in a couple of days for the presentation. Excellent presentation Kim!