Public-Private PartnershipsPublic-Private PartnershipsWashington DC: Global Health Council, June 1 2006Washington DC: Global Health Council, June 1 2006

Charles A. GardnerCharles A. GardnerThe Rockefeller FoundationThe Rockefeller Foundation

BVGH: Bioventures for Global Health

GFHR: Global Forum for Health Research

LaunchLaunch MaturityMaturity

IAVI: International AIDS Vaccine Initiative

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010...

MMV: Medicines for Malaria Venture

TB Alliance: Global Alliance for TB Drug Development

IPM: International Partnership for Microbicides

PDVI: Pediatric Dengue Vaccine Initiative

Goal: Product Availability for the PoorGoal: Product Availability for the Poor

GDF: Global TB Drug Facility

MIHR: Ctr for Management of IP in Health R&D

R&DR&D

Local PPPsLocal PPPs

ManufactureManufacture

ProcurementProcurement

PDPsPDPs

Perinatal conditions

Lower respiratory infections

HIV/AIDSHIV/AIDS

Diarrhoeal diseases

Unipolar depressive disorders

Ischaemic heart disease

MalariaMalaria

Cerebrovascular disease

Tuberculosis Tuberculosis

Road traffic accidents

Source: 1990 data from: Global Burden of Disease, Murray and Lopez, 1996, WHO, p. 180, 262; 2001 data from World Health Report 2002 Annex

Prepared by The Boston Consulting Group

Leading Causesof Death

6.2

5.6

11.1

20.9

0.5

0.5

>100

0.7

26.3

1.0

Percent of DALYsin Developing /

Developed Regions

Priorities: Based on Health InequitiesPriorities: Based on Health Inequities

IAVI & IPMIAVI & IPM

MMV & MVIMMV & MVI

TB AllianceTB Alliance& Aeras& Aeras

TB AllianceTB Alliance

FINDFINDSocialSocial

DemandDemand

Scientific MaturityScientific Maturity

IPMIPM

AerasAeras

PDVIPDVI

IAVIIAVI

MVIMVI MMVMMV

Filling the Ecological NichesThey Have Collectively Raised over $1.5 Billion USDThey Have Collectively Raised over $1.5 Billion USD

Priorities: Based on Demand & SciencePriorities: Based on Demand & Science

It wasn’t just about productsIt wasn’t just about products

Product DevelopmentProduct Development

Advocacy and AwarenessAdvocacy and Awareness

““Culture Change”Culture Change”

These were the original goals of The These were the original goals of The Rockefeller Foundation in this fieldRockefeller Foundation in this field

Core BudgetsCore Budgets(1)(1)

ExpertiseExpertise(2)(2)

Model/ProcessModel/Process(2)(2)

Advisory BoardAdvisory Board(3)(3)

& Management& Management(4)(4)

Public SectorPublic Sector

Private SectorPrivate Sector

100% Public100% Public 50-50 Joint Venture 100% Private 50-50 Joint Venture 100% Private

(1) Less than 1% private capital based on MMV and IAVI in 2003(2) BCG subjective rating including development of sound business plans, conduct of pharmaco-economic analyses(3) Approximately a third of Boards have private sector experience based on IAVI (8/19), MMV (4/9), & GAVI (2/18)(4) Approximately 42% of management with private experience: IAVI (1/2); MMV (5/5); IPM (1/4); GATB (1/4); GAVI (1/11)

IP Rights for DiseaseIP Rights for DiseaseEndemic CountriesEndemic Countries(2)(2)

Resources InvestedResources Investedin Projectsin Projects

R&D Work BeingR&D Work BeingCarried OutCarried Out

PDPs: Public and Private ContributionsPDPs: Public and Private Contributions

A business plan; market analysesA business plan; market analyses CEO, CSO, CFO, Board of Directors CEO, CSO, CFO, Board of Directors

(Public and Private Representatives)(Public and Private Representatives) Stakeholders’ MeetingsStakeholders’ Meetings Portfolio Management StrategyPortfolio Management Strategy Access and Advocacy StrategyAccess and Advocacy Strategy

Non-Profit Business ModelsNon-Profit Business Models

Portfolio Management StrategyPortfolio Management Strategy

PDP Portfolio ApproachPDP Portfolio Approachnew to public-sector product developmentnew to public-sector product development

Better than Old Linear ModelBetter than Old Linear Model

Allows Modeling for SuccessAllows Modeling for Success

Insulates Donors from RisksInsulates Donors from Risks

PDPs Expand Development PipelinesPDPs Expand Development Pipelines

19Drugs developed since 1975 to 2000

55Drugs in development from 2000

Industry 21

Industry 14

MMV 22

DNDI 6

GATB 7

TDR 11

IOWH 3

0

10

20

30

40

50

60

70

Number of drugs/projects

PPPs

Industry

21Drugs developed in past

25 years (1975-2000)*

63Drugs registered or in

development since 2000

2000

* Some with TDR collaboration

** Further SME in-house activity yet to be included Data from Mary Moran, LSE, Whitehall Presentation, funded by The Wellcome TrustData from Mary Moran, LSE, Whitehall Presentation, funded by The Wellcome Trust

Products in the

pipelines of PDPs

Level of Complexity

MarginalMarginalIncreaseIncrease

ininAccessAccess

Health ExpendituresHealth Expenditures

6-9 Months6-9 MonthsDOTS RxDOTS Rx

(TB)(TB)

OVERCOME DECLINING MARGINAL RETURNSOVERCOME DECLINING MARGINAL RETURNSON ADDED INVESTMENTS IN ACCESSON ADDED INVESTMENTS IN ACCESS

Vaccines &Vaccines &Shorter RxShorter Rx

AIDS Care &AIDS Care &HIV PreventionHIV Prevention

Iron LungIron Lung(Polio)(Polio)

Priorities: Breakthroughs to increase accessPriorities: Breakthroughs to increase access

Product Development PartnershipsProduct Development Partnerships Northern headquarters, but global focusNorthern headquarters, but global focus A mix of public and private contributionsA mix of public and private contributions Follow non-profit business modelsFollow non-profit business models Portfolio approach; expanding pipelinesPortfolio approach; expanding pipelines““Products, Advocacy and Culture Change”Products, Advocacy and Culture Change” Priorities are based on health inequities,Priorities are based on health inequities, social demand, and maturity of the sciencesocial demand, and maturity of the science

Technological goal would increase Technological goal would increase accessaccess

PushPush PullPull GoalGoal

• Fast-track regulatory approval vouchersFast-track regulatory approval vouchers

• Transferable patent extensionsTransferable patent extensions

• Market analyses & partnering assistanceMarket analyses & partnering assistance

• Global procurement / distribution fundsGlobal procurement / distribution funds

• Advance Market Commitments (AMCs)Advance Market Commitments (AMCs)

• Airfare Solidarity ContributionAirfare Solidarity Contribution

• R&D funding from governmentsR&D funding from governments

• Tax breaks for private sector R&DTax breaks for private sector R&D

• Double-bottom-line venture capitalDouble-bottom-line venture capital

• Liability protection for manufacturersLiability protection for manufacturers

• Patent pooling; open source innovationPatent pooling; open source innovation

• Univ. humanitarian licensing practicesUniv. humanitarian licensing practices

Tilting health product innovation systemsTilting health product innovation systemstoward the poor and vulnerabletoward the poor and vulnerable

• Public-private product development partnerships (PDPs)Public-private product development partnerships (PDPs)

R&DR&D Intellectual Property

Intellectual Property ManufactureManufacture Regulatory

Approvals

RegulatoryApprovals

Procurementand Sales

Procurementand Sales

Distribution ofEssential New

Products

Distribution ofEssential New

Products

• Earmarked consumption tax revenuesEarmarked consumption tax revenues

• Conditional cash transfersConditional cash transfers

• ICT for remote expert adviceICT for remote expert advice

• Software to assist in diagnosis and referralsSoftware to assist in diagnosis and referrals

• Health system management changesHealth system management changes

Tilting innovation in health systemsTilting innovation in health systemstoward the poor and vulnerabletoward the poor and vulnerable

Distribution ofEssential New

Products

Distribution ofEssential New

Products

• Micro-insuranceMicro-insurance

• Pooled procurementPooled procurement

• Social marketingSocial marketing

• Social franchisingSocial franchising

• Conditional cash transfersConditional cash transfers

Resource Generation

Resource Generation

Service Provision

Service Provision

Health Information

Health Information StewardshipStewardship

• Earmarked consumption tax revenuesEarmarked consumption tax revenues

• Conditional cash transfersConditional cash transfers

• ICT for remote expert adviceICT for remote expert advice

• Software to assist in diagnosis and referralsSoftware to assist in diagnosis and referrals

• Health system management changesHealth system management changes

Tilting innovation in health systemsTilting innovation in health systemstoward the poor and vulnerabletoward the poor and vulnerable

Distribution ofEssential New

Products

Distribution ofEssential New

Products

• Micro-insuranceMicro-insurance

• Pooled procurementPooled procurement

• Social marketingSocial marketing

• Social franchisingSocial franchising

• Conditional cash transfersConditional cash transfers

Resource Generation

Resource Generation

Service Provision

Service Provision

Health Information

Health Information StewardshipStewardship