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

Innovationsome of this risk might be to match private sector venturecapital investments in vaccine R&D for certain diseases withpublic sector funds or to provide grants to venture capitalfirms that fill a certain fraction of their portfolio withinvestments in these areas.These ideas merit further investigation, although it is notclear from initial consultations with venture fund managersthat subsidies of this kind would substantially change therisk/reward calculations of potential investors. Moreover,venture capitalists were skeptical of the idea of a venturefund that blended AIDS/TB/malaria vaccine projects withother biotech activities 15 . This is because venture investorswould prefer that all projects in a fund be evaluated relativeto the same objectives (i.e., financial returns or contributionto a social goal), rather than by different and potentiallyincompatible criteria.If successful, venture capital subsidy or matching schemeswould have the potential to bring private sector capital aswell as private sector project evaluation and managementexpertise to early-stage vaccine R&D.ConclusionsGlobal health has moved to centre stage in recent years, ashealth care is increasingly recognized as a critical part ofefforts to reduce poverty and improve the quality of life ofbillions of people, and as a powerful way to harness scienceand technology to the pursuit of social goals.There has been substantial innovation in global healthfinancing recently, especially in creating new sources,intermediaries and financial modalities for the purchase ofexisting drugs and vaccines and the delivery of healthservices. Although there has been less change in the fundingof health R&D, the establishment of PDPs and the launch ofa vaccine AMC are important developments.Despite these advances, there are still significant gaps anddeficiencies in vaccine R&D financing, including insufficientvolume, focus, flexibility and predictability. In this paper webegin to develop a framework for characterizing andassessing the strengths and limitations of financingmechanisms for vaccine R&D and propose some newfinancing approaches that might address the deficiencies thatwe have identified. ❏Robert Hecht is the Head of Policy Research and Advocacy atthe International AIDS Vaccine Initiative. In that capacity, heoversees a programme of analysis and outreach that aims toaccelerate the scientific search for an AIDS vaccine and ensurerapid access to a vaccine which can help to end the globalpandemic. He joined IAVI in 2004 after a 20-year tenure at theWorld Bank, where his last position was as Director and SectorManager of the Bank’s Central Unit for Health, Nutrition andPopulation, with oversight for global strategies, knowledge,technical services and partnerships. His other positions at theBank included Chief of Operations for the World Bank’s HumanDevelopment Network, Principal Economist in the Latin Americaregion, and member of the core team and a principal author of the1993 World Development Report, Investing in Health. From 1987to 1996, Dr Hecht was responsible for a number of World Banksponsored studies and projects in health in Africa and LatinAmerica, most notably in Zimbabwe and Argentina.He also served as an Associate Director of the Joint UnitedNations Programme on HIV/AIDS (UNAIDS) from 1998 to 2001,where he managed technical units based in South Africa, Côted'Ivoire and Thailand, as well as in Geneva.Dr Hecht is the author of more than 30 articles and otherpublications. He received his undergraduate degree from Yale andhis doctorate from Cambridge University.Paul A Wilson has recently joined the International AIDSVaccine Initiative (IAVI) as Director of Policy Research. He comesto IAVI from Columbia University, where he is an assistantprofessor in the Mailman School of Public Health. At Columbia DrWilson worked on a range of topics in AIDS policy, includingstrategies for meeting the Millennium Development Goal on AIDS,evaluation of programmes for orphans, and financing of AIDSvaccine development. He is the lead author of the UN MillenniumProject’s report Combating AIDS in the Developing World.Dr Wilson spent much of his career as a scientist. Beforemoving to Columbia to work on global health policy, he was anAssistant Professor of Cell Biology at the Cornell Medical College.Dr Wilson holds a PhD in Zoology from the University of Californiaat Berkeley, an MSc degree in Economics from the London Schoolof Economics and an undergraduate degree in Physics fromPrinceton University.092 ✜ Global Forum Update on Research for Health Volume 4