IFPMA Report, Panel, Examine Rise Of Industry Global Health Partnerships

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A new report commissioned by international pharmaceutical industry released yesterday offers findings and recommendations based on study of more than 200 global health partnerships aimed at low- and middle-income countries. The report was released at a panel discussion of a range of health experts who highlighted work to date and upcoming needs in the area of global health partnerships.

The event was organised by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). Also at the event, an updated version of IFPMA’s Developing World Health Partnerships Directory was announced. The directory is an online database of 220 health development programs involving the research-based pharmaceutical industry (though not generics).

The new report, or review, was produced by the Business for Social Responsibility (BSR) consulting group. The report, which authors said is independent, is focussed on partnerships involving industry and identified key strengths and gaps as well as future trends.

IFPMA highlighted that the report found that some 90 percent of surveyed companies expect to increase partnership work on noncommunicable diseases, in addition to other therapeutic areas. It also found that 65 percent of industry-led partnerships are in sub-Saharan Africa, industry is branching out more to South and East Asia and Latin America. The report also found 40 percent of companies expect to increase investments in partnerships.

Strengths included coverage of a broad of range of diseases, a focus on health systems infrastructure, and that almost half of partnerships involve government and/or non-governmental organisations. Other strengths were the leveraging of assets – such as other human resources like lawyers or communications specialists – as well as improving financing of late stage R&D, and ensuring quality and stability of treatment.

Gaps identified in the analysis included: a greater focus on NCDs, holistic capacity building at the local level, and “a clear absence of fully aligned multicompany partnerships and coordination of partnerships involving multiple organisations.” It also included an understanding of return on investment, including non-financial aspects, and encouraging a “partnership mindset,” as well as constricted resources and lack of impact measurement.

Therefore, the group identified several “success factors” it thought could help bridge the gaps. These included: taking a health-needs-based approach, engaging in broad-based partnerships, establishing aligned partnerships, using existing country systems and promoting local ownership, and measuring impact. Details on each of the factors were provided.

The report refers to “appropriate” stakeholders but does not thoroughly explain what this means, and did not address issues of coordination among partnerships.

The report cites several common recent examples of industry partnerships, such as a World Intellectual Property Organization partnership with the IP-owning pharmaceutical industry called Re:Search, which encourages use of patented compounds, technologies, know-how and data for R&D for neglected diseases.

Based on feedback from the forum, author Little said there may be a need to work with more stakeholders in and outside of the pharmaceutical industry, and a need to map out who likely stakeholders are. There may also be a need to address partnerships with vulnerable populations, such as women or people in rural areas, as well as look at the distribution and procurement of medicines.

Panel Delves into Issues

The panel was moderated by Sunoor Verma, executive director of the Geneva Health Forum, and speakers included: Kenyan Ambassador Tom Mboya Okeyo; Daniel Lopez Acuña, adviser to the director-general at the World Health Organization (WHO); Johanna Ralston, CEO of the World Heart Federation and founding member of the NCD Alliance; Jon Pearman, head of accelerated vaccine introduction at GAVI; Evan Lee, vice president of global health programs and access at Eli Lilly; and report author Mark Little, director of health care at Business for Social Responsibility (BSR)

In his panel remarks, Kenyan Ambassador Mboya stressed the need for greater coordination among the various partnership efforts, with a focus on the national level, and on impact at the national level. He said what is important to note in the range of partnerships is the “shared goals.”

Mboya gave several examples of how various partnerships had had a significant impact on local populations, sometimes with very little funds. He included examples of industry contributions of vaccines, or of lower-priced versions of expensive drugs.

But he said now coordination of different partnerships needs to take place, at the country level. He said he expects WHO to work to put the focus more at the national level, supporting national objectives.

Efforts at WHO

Mboya called on the WHO Executive Board to create a mechanism for having discussions about partnerships among the big funds (such as Gates Foundation or the Global Fund), industry, non-governmental organisations, religious groups and others. He called the IFPMA event a “milestone.”

The emphasis on coordination was also mentioned to Intellectual Property Watch by a Brazilian health official after the event.

Acuña of the WHO said the UN agency adopted a policy on partnerships in 2010, and is expected to advance work in its programme for next 6 years to be adopted at next May’s annual World Health Assembly.

He said WHO expects to bring a draft policy on engagement with NGOs to member states at the January 2013 Executive Board meeting. Also expected at that date is a report on partnerships hosted by WHO with an analysis of how they fit with WHO’s work. And by May 2013, WHO expects to bring a draft policy on its interaction with the private sector to members.

Acuña highlighted aspects of WHO’s current policy on partnerships, such as that they should have clear value-added, work with the WHO’s objectives as set by its members, reflect different stakeholders, support national development objectives, give public health goals precedence, and have a monitoring mechanism.

Acuña also stressed that engagement with WHO there “will always be a fine balance to strike” to work with different actors, but that it the agency provides objectivity and independence, and must maintain transparency with no vested interests. The organisation provides the possibility of listening to different perspectives and finding common ground, with a focus on shared goals in order to find solutions.

Panel moderator Verma opened with provocative remarks such as that the word “partnerships” has developed a negative connotation. Experts he consulted before the meeting reacted to the word in various ways, he said, such as saying it is synonymous with “sponsorship,” or is a form a “piggyback riding” in which the partner does all the work for you and you get the credit.

But, he said, partnerships are serious business. They can drain resources and need good leadership. In the case of low- and middle-income countries, it can be difficult to find or work with partners, Verma as well as industry representatives on the panel said. Verma said the country may be a failed state, or suffering from corruption or other issues.

In addition, he said, the pharmaceutical industry has endured a “series of scandals,” he said, such as many recalls of drugs in recent years, not to mention the “rub-off” effect of association with problems tied to other areas like the food and beverage industry.

But he said he has not heard a “leadership voice” from the pharmaceutical industry, like a Bill Gates or Steve Jobs. This is coupled with a “lack of articulated vision” from international organisations, which more often than not present project statements, not vision.

Verma said an area of focus could be, for instance, the health status of Africans, who, despite seeing a 200 percent rise in per capita GDP in the last 20 years, have only added 2 years to average life expectancy.

Ralston highlighted NCD issues and provided data and targets. She took issue with the word “industry” in reference to public health, as her organisation receives industry funding. She also rejected the popular reference to noncommunicable diseases as being “lifestyle” diseases, as it does a disservice to those in low- to middle-income countries who may not have had a choice in their diet or other factors. She also said that with NCDs, the focus should reach beyond the health sector to related areas such as agriculture or transportation. Ralston also suggested the health sector look at the environmental movement, to “see how we can make ‘wellness’ be the new ‘green’.”

Pearman of Geneva-based GAVI touted the success of GAVI as a partnership between various entities, citing its “exponential” rise in funding, and the saving of millions of lives through its provision of vaccines, reaching “nearly half of the children on the planet.”

Pearman said a key factor for success of GAVI’s work is the speed of price declines, as the organisation allows companies to raise volume of products and thereby drop prices to reach the same revenue. He said that country readiness to engage in vaccine programmes is the biggest challenge.

William New may be reached at wnew@ip-watch.ch.

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