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Innovation in Science and Technology A critical path to addressing global health inequities

Innovation in Science and Technology A critical path to addressing global health inequities. May 2008. Global health inequity – the problem Global access is the target – partnerships can drive solutions

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Innovation in Science and Technology A critical path to addressing global health inequities

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  1. Innovation in Science and TechnologyA critical path to addressing global health inequities May 2008

  2. Global health inequity – the problem • Global access is the target – partnerships can drive solutions • Innovations in science and technology can create better tools – the Grand Challenges in Global Health • Many challenges remain – more innovation is needed

  3. Leadership Bill and Melinda Gates Co-chairs Bill Gates Sr. Co-chair Patty Stonesifer CEO Warren Buffett Future Trustee

  4. Bill and Melinda Gates Foundation (as of Feb. 2008) • >$ 37.3B in assets • Additional Warren Buffett gift in 2006 • Have awarded $16.5B in grants • Grantees in 50 states, 100 countries • Foundation staff >550 More information at www.gatesfoundation.org

  5. Gates Foundation Values & Principles • All lives—no matter where they are lived—have equal value. • Science and technology can save lives • Our focus - reducing inequities Where does the inequity lie? With the 2/3 of the world’s 6 billion people that live in the developing world. The greatest need is among the 1 in 6 that live on less than $1 per day

  6. The Problem • 2/3 of the world’s 6 billion people live in the developing world. More than 1 in 6 live on less than $1 per day • Millions die unnecessarily each year from diseases that are currently treatable or preventable • AIDS, TB and malaria alone kill 6 million people annually • Vaccine-preventable diseases kill more than 2 million children annually • Access to existing, effective health interventions is severely limited for most of those in need • Systems for delivery of vaccines don’t regularly reach all of those in need • Vaccines available for many years in wealthy countries, but are not used widely in the developing world The Result: a global health problem that undermines economic development, social and political stability

  7. Injuries – 12% Non-communicableconditions – 47% Communicable diseasesnot addressedby the foundation – 3% Priority Diseases and Conditions Foundation Focus Total Global Health BurdenDisability-Adjusted Life-Years Lost • Infectious Diseases • Acute Diarrheal Illness • Acute Lower Respiratory Infections • HIV/AIDS • Malaria • Tuberculosis • Vaccine-Preventable Diseases • Other Infectious Diseases • Nutrition • Micronutrient deficiencies • Nutrition for children under the age of 2 • Maternal, Neonatal, Child, and Reproductive Health Diseases and conditions addressed by the Foundation – 38% of the global health burden

  8. Accelerate Access & Drive Innovation The world’s greatest health challenges are solvable – • Accelerate access to existing health interventions • Financial commitments have to match the scale of the crisis • Existing health interventions (vaccines, pre-natal care, HIV prevention) must be delivered to those who need them • Drive research on new tools to fight disease • Focus on solutions that are appropriate for use in the areas of greatest need

  9. Global access is the target – partnerships can drive solutions

  10. GAVI Alliance: Bringing more vaccines to more people • Estimated 2.6 million deaths prevented since 2000 – WHO, 2007 • Immunizations in 2006 averted estimated 600,000 future deaths – WHO, 2007 • Coverage has improved • 2005 coverage with hepatitis B vaccine in GAVI-eligible countries: 45% (20% in 2000) –WHO/UNICEF, Aug 2006 • 28 million more children have been protected against diphtheria, tetanus, and pertussis – immunization rates increased 63 percent in 1999 to 77 percent in 2006 • 138 million more children received new and under-used vaccines ( hepatitis B, Hib, yellow fever).  Hepatitis B vaccine provided in 15 developing countries in 1999, 61 developing countries in 2006 • 1.2 billion auto-disable syringes delivered – GAVI Alliance Secretariat

  11. Success, yes, but more to do In 2005: • An estimated 28 million children in developing countries were not immunized • 2.5 million children died of vaccine-preventable diseases. Still needed: • WHO and UNICEF estimate that an additional US$10-15 billion will be needed for immunization programmes over the next decade. • More funding needed to introduce vaccines currently in the development pipeline. • More and better vaccines are needed (HIV, TB, malaria, …)

  12. Global Health Opportunities for the Private Sector • Creating platform technologies • Reducing costs and risks through partnerships • Capturing market opportunities • Bringing innovation to health care delivery

  13. Reducing Development Costs and Risks: Product Development Partnerships • The Problem: Despite urgent and significant need for new tools, private and public product development players neglect diseases of the poor because the risks and uncertainties well exceed expected return on investment • A solution: Dedicated, not-for-profit, virtual R&D organizations that accelerate the development and introduction of new products through a portfolio of product partnerships, engaging with industry and academia • The foundation contribution: Over $1.3 billion to more than 14 entities • Other donors: UK, Netherlands, Ireland, Rockefeller Foundation, Wellcome Trust, World Bank, USAID, Switzerland, Norway, Sweden, Canada, MSF, Germany, EU

  14. Product Development Partnerships (PDPs) Source: BMGF, Q1 2006

  15. Clarifying Markets – Defining Existing Markets TB Vaccines - $0.5-$1B (BVGH) Creating Markets The Advanced Market Commitments would guarantee, in advance, a reasonable price for the vaccine. The donor subsidy would add to the small country co-pay and would ensure firms could make a return on investment – if they develop and supply the product. 12 10 GuaranteedAMC price 8 Price 6 AMC $x billion Post-AMC market 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Years

  16. Innovations in science and technology can create better tools – the Grand Challenges in Global Health

  17. Innovations in science and technology can create better tools- the Grand Challenges in Global Health(GCGH) Origins of GCGH: Yr. 1900: David Hilbert, at the International Congress of Mathematicians, proposed that twentieth-century mathematicians should devote themselves to solving 23 outstanding problems in mathematics. Yr. 2002: Bill Gates was inspired to establish the "grand challenges" in global health initiative because he was familiar with the way that Hilbert's problems galvanized and focused the mathematics community. Yr. 2003: Partnership with the Foundation for the National Institute of Health established; scientific board assembled; issued call for ideas Grand Challenges in Global Health is not meant to be an exact replica of Hilbert’s approach. The Foundation’s hope is that by identifying a small number of critical problems in global health, and then funding research to solve these problems, it can help draw attention to and promote more research on these scientific challenges.

  18. THE 14 GRAND CHALLENGES IN GLOBAL HEALTH SERVE 7 LONG-TERM GOALS Ongoing Improve Childhood Vaccines GC#1: Create Effective Single-Dose Vaccines  GC#2: Prepare Vaccines that Do Not Require RefrigerationGC#3: Develop Needle-Free Vaccine Delivery Systems Create New Vaccines GC#4: Devise Testing Systems for New VaccinesGC#5: Design Antigens for Protective ImmunityGC#6: Learn About Immunological Responses  Control Insects that Transmit Agents of Disease GC#7: Develop Genetic Strategy to Control Insects GC#8: Develop Chemical Strategy to Control Insects Improve Nutrition to Promote Health GC#9: Create a Nutrient-Rich Staple Plant Species Improve Drug Treatment of Infectious Diseases GC#10: Find Drugs and Delivery Systems to Limit Drug Resistance Cure Latent and Chronic Infection GC#11: Create Therapies that Can Cure Latent Infection GC#12: Create Immunological Methods to Cure Latent Infection Measure Health Status Accurately and Economically GC#13: Develop Technologies to Assess Population HealthGC#14: Develop Versatile Diagnostic Tools  Example Vaccine Projects Needle-Free Vaccination Via Nanoparticle Aerosols (David Edwards) Development of Novel Mouse Models for HIV and HCV Infection using hES cells(Hongkui Deng) Targeting Dendritic Cells with Modified Antibodies (Ralph Steinman) Genetically Attenuated Sporozoite Vaccine (Stefan Kappe) Biomarkers of Protective Immunity For TB (Stefan Kauffman) Engineering Immunity Against HIV (David Baltimore) 26 Vaccine Projects Funded Total

  19. Approaches to Meeting the Grand Challenges • Stimulate revolutionary innovations and bring cutting edge approaches to solving the critical health challenges of the poorest of the world • Create clear paths to maturing innovations into available products/solutions • Ensure that the innovations are appropriate for the settings and problems that need to be reached and can be made accessible (Global Access Strategy) • Engage all those who may have solutions (“Best possible” teams) • Global participation • Diversity of sectors (academia, industry, non-profit, government) • Range of disciplines

  20. THE NEED • To achieve breakthroughs in global health, we must encourage risk-taking on creative, unorthodox ideas • THE INITIATIVE • US$100 million fast-track grants initiative of the Gates Foundation • Will support hundreds of early-stage research projects on creative concepts for new global health solutions • Initial grants of $100,000; opportunities for future funding

  21. KEY GOAL: To support paradigm-changing ideas • Involve scientists around the world, including those who don’t typically work in global health • This includes innovators in the developing world, from complementary disciplines, and in the private sector, as well as young investigators • FAST-TRACK GRANTS New fast-track grantmaking to make it easy for scientists to apply: • Relatively short funding proposals, preliminary data not necessarily required • Fast proposal review (approximately three months) • Multiple calls for proposals, each funding round will address a few specific topics or themes

  22. GETTING INVOLVED • Sign up at www.gcgh.org for email updates about Explorations funding opportunities • First call for grant proposals was posted in early 2008 • Spread the word to colleagues, and encourage them to sign up on gcgh.org

  23. Many challenges remain – more innovation is needed

  24. The Vision "There is no bigger test for humanity than the crisis of global health. Solving it will require the full commitment of our hearts and minds. We need both. Without compassion, we won’t do anything. Without science, we can’t do anything. So far, we have not applied all we have of either." Bill Gates, World Health Assembly, May 2005 www.gatesfoundation.org

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