Monday, January 14, 2013

Innovation to fund global health

Millions of lives are saved today in developing countries because of bold, innovative financing arrangements over last 10 years. These financing mechanisms are good examples of private sector partnership with public sector for common good.

These financing initiatives have pooled large public sector funding with private sector resources, thus allowing tax payers funds to have much larger impact than would otherwise be possible. Some of the examples are given below.

In 2000, the Global Alliance for Vaccines and Immunization (GAVI) was set up by major donors to provide support for immunization programs. GAVI has immunized 296 millions children in 74 countries and committed $7.2 billions to immunize an additional 245 million children by 2016. By increasing demand, pooling global requirements, and making additional resources available, GAVI has helped reduce prices of vaccines and brought in more producers in the market place.

In 2002, The Global Fund to fight AIDS, TB, and Malaria was set up. Over last 11 years, it has put 4.2 million HIV patients on treatment, treated over 9.5 million TB cases, and saved millions of lives from Malaria. Predictable large scale financing helped major reduction in prices of health products especially HIV treatment drugs ARV.

In 2006, the International Finance Facility for Immunization (IFFIm) was established by France and UK. The Fund ensures flow of funds from developing countries to support immunization programs in developing countries. The IFFIm is a legally binding commitment of donors for up to 23 years and nine countries proposed donation of $6billion for immunization programs.

In 2006, France in partnership with Brazil, Chile, Norway, and UK has set up UNITAID, an airline levy solidarity initiative. Today it is backed by Gates Foundation and several other countries. Over last six years, it has provided $2.5billion to support medicine and diagnostics procurement for poor people in 94 countries for HIV/AIDS, TB, and Malaria. Its market dynamics initiative has resulted in price reduction of 10% to 40% for medicines and diagnostics.

The Clinton Foundation hosts many initiatives that raise funds for fighting poverty and diseases everywhere. Over the last seven years, President Clinton has organized global forums for world leaders that have raised more than US$73 billion that will go towards saving 400 million lives around the world. Clinton Health Initiative is a major partner of UNITAID to provide treatment for HIV positive children. 7 out of 10 HIV positive children receive treatment under UNITAID funding.

Two other innovations that complement the work of the innovative financing mechanisms. These are patent pools. They are supposed to address the barriers posed by Intellectual Property (IP) system so that drugs can be made available through generic producers to poorer countries in exchange for a small fee to the patent holders. The two patent pools are: Medicines Patent Pool (MPP) and Pool for Open Innovation. MPP was established by UNITAID for HIV/AIDS drugs and is now an independent entity. The Pool for Open Innovation was conceived and created by GlaxoSmithKline(GSK) for neglected tropical diseases and is now led by several pharmaceutical companies, the World Intellectual Property Organization(WIPO), and BIO Ventures for Global Health.
Universal access to health care requires major financing from international donors which is not available from bilateral donors alone, thus requiring innovative financing initiatives with the private sector.

Medicines and diagnostics are a major part of developing country health budgets. Many new medicines are expensive and low income countries cannot afford them.

Financing initiatives that can reduce prices of medicines and diagnostics as well as allow use of technology to reduce delivery costs facilitates sustainable health financing by low income countries.

Large scale predictable financing and facilitation by patent pools promote generic drug production of expensive medicines by local pharmaceutical companies. The local production allows large scale availability of cheaper medicines to meet local demands.

Our efforts must be to support and expand these innovative financing mechanisms and promote innovation for efficient pricing arrangements. At the same time, we must ensure that these financing mechanisms remain lean, efficient, and transparent.

Rahman is an international health specialist with over 25 years experience in the health sector of several countries.

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