Combining health and social protection measures to reach the ultra ...

Research resources
18
16
14
No. of PPPs
12
10
8
6
4
2
0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
the developing world, such as malaria and tuberculosis;
✜ are seriously disabling or life threatening, for which
treatment options are inadequate or do not exist such as
leishmaniasis and Chagas’ disease;
✜ could be cured or prevented with the currently available
science and technology, but for which research and
development has ground to a standstill;
✜ do not constitute a valuable enough market to stimulate
adequate research and development of new medicines;
✜ governments have failed to redress market failure.
To redress the imbalance in availability of medicines to
developing countries, PPPs are used as a means to gather
resources and funding to be applied to solving this problem,
as by the 1990s, both the private and public sectors
acknowledged that “a pure market mechanism generally does
not work” 12 where medicines are involved and new
approaches needed to be developed.
Millions of people globally die or become disabled from
diseases for which there are inadequate or no medicines and
the free market had no incentive to develop such medicines.
From 1975 to 2004 only 1.3% of the 1556 new chemical
entities marketed were registered for tropical diseases and
tuberculosis despite the fact that these diseases account for
12% of the global disease burden 17 . Partnerships and more
specifically, PPPs were created to fill this void.
Barriers to access to products and
treatments for diseases of the poor
The barriers to access to products and treatment for diseases
of the poor that these partnerships have been created to
address can be classified under the following six groupings.
1. Lack of affordable, effective safe diagnostics, medicines, or
vaccines.
2. The cost of the products, medicines, and vaccines (to both
the National Health Service and to individuals).
Year
Figure 1: Number of Public-Private Partnerships created between 1986 and 2003
Source: Extracted from data found on the website for Initiative on Public-Private
Partnerships for Health, www.ippph.org. Accessed week of February 1-8, 2006
3. Lack of a reliable supply of products, medicines, or
vaccines.
4. Weak/fractured health systems.
5. Cultural perceptions and beliefs.
6. Political will.
The majority of PPPs were formed in the past seven years
as illustrated in Figure 1, corresponding to interest and energy
from private foundations, particularly the Rockefeller
Foundation and the Bill & Melinda Gates Foundation.
Kinds of partnerships
In general, public-private partnerships can be broadly
categorized into the following areas: (1) product distribution
or disease control programmes; (2) product development;
and (3) policy, advocacy, or health systems issues 18 .
1. Disease control programmes/product distribution.
Certain PPPs are designed to improve access to
treatment in developing countries by improving
distribution of medicines or medical products to prevent
or treat specific diseases. The disease control
programmes are mainly through drug donations; there
are now four major drug donations for annual mass
treatment: Ivermectin, MSD, for onchocerciasis (Merck &
Co. Inc.); azythromicin for Trachoma (Pfizer);
Albendazole and Ivermectin for lymphatic filariasis (Glaxo
Smith-Kline, Merck & Co. Inc.), mebendazole for soil
transmitted helminthes in children (Johnson and
Johnson) and two for individual treatment; leprosy
(Novartis) and sleeping sickness (Aventis, Bristol-Myers
Squibb).
2. Product development. The majority of partnerships focus
on the development of medicines, vaccines, or products for
use in the treatment or prevention of neglected diseases 19
such as the Medicines for Malaria Venture (MMV), The
International AIDS Vaccine Initiative (IAVI) and the Global
Alliance for Vaccines and Immunization (GAVI Alliance).
Global Forum Update on Research for Health Volume 4 ✜ 133