Public-Private Partnerships Washington DC: Global Health Council, June 1 2006

1. Public-Private Partnerships Washington DC: Global Health Council, June 1 2006 Charles A. Gardner The Rockefeller Foundation

2. Goal: Product Availability for the Poor IAVI: International AIDS Vaccine Initiative MMV: Medicines for Malaria Venture PDPs TB Alliance: Global Alliance for TB Drug Development IPM: International Partnership for Microbicides PDVI: Pediatric Dengue Vaccine Initiative R&D Local PPPs Manufacture Procurement GFHR: Global Forum for Health Research MIHR: Ctr for Management of IP in Health R&D BVGH: Bioventures for Global Health GDF: Global TB Drug Facility Launch Maturity 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010...

3. Priorities: Based on Health Inequities Leading Causes of Death Percent of DALYs in Developing / Developed Regions Perinatal conditions Lower respiratory infections HIV/AIDS Diarrhoeal diseases Unipolar depressive disorders Ischaemic heart disease Malaria Cerebrovascular disease Tuberculosis Road traffic accidents 6.2 5.6 11.1 20.9 0.5 0.5 >100 0.7 26.3 1.0 IAVI & IPM MMV & MVI TB Alliance & Aeras Source: 1990 data from: Global Burden of Disease, Murray and Lopez, 1996, WHO, p. 180, 262; 2001 data from World Health Report 2002 Annex Prepared by The Boston Consulting Group

4. Priorities: Based on Demand & Science IAVI TB Alliance Aeras MVI MMV Social Demand FIND IPM PDVI Scientific Maturity Filling the Ecological Niches They Have Collectively Raised over $1.5 Billion USD

5. Product Development Advocacy and Awareness “Culture Change” It wasn’t just about products These were the original goals of The Rockefeller Foundation in this field

6. PDPs: Public and Private Contributions Core Budgets(1) IP Rights for Disease Endemic Countries(2) Expertise(2) Model/Process(2) Advisory Board(3) & Management(4) Public Sector Private Sector Resources Invested in Projects R&D Work Being Carried Out 100% Public 50-50 Joint Venture 100% Private (1) Less than 1% private capital based on MMV and IAVI in 2003 (2) BCG subjective rating including development of sound business plans, conduct of pharmaco-economic analyses (3) Approximately a third of Boards have private sector experience based on IAVI (8/19), MMV (4/9), & GAVI (2/18) (4) Approximately 42% of management with private experience: IAVI (1/2); MMV (5/5); IPM (1/4); GATB (1/4); GAVI (1/11)

7. Non-Profit Business Models • A business plan; market analyses • CEO, CSO, CFO, Board of Directors (Public and Private Representatives) • Stakeholders’ Meetings • Portfolio Management Strategy • Access and Advocacy Strategy • Portfolio Management Strategy

8. PDP Portfolio Approachnew to public-sector product development • Better than Old Linear Model • Allows Modeling for Success • Insulates Donors from Risks

9. PDPs Expand Development Pipelines 2000 Products in the pipelines of PDPs * Some with TDR collaboration** Further SME in-house activity yet to be included Data from Mary Moran, LSE, Whitehall Presentation, funded by The Wellcome Trust

11. Priorities: Breakthroughs to increase access OVERCOME DECLINING MARGINAL RETURNS ON ADDED INVESTMENTS IN ACCESS AIDS Care & HIV Prevention 6-9 Months DOTS Rx (TB) Vaccines & Shorter Rx Marginal Increase in Access Iron Lung (Polio) Level of Complexity Health Expenditures

12. Northern headquarters, but global focus A mix of public and private contributions Follow non-profit business models Portfolio approach; expanding pipelines “Products, Advocacy and Culture Change” Priorities are based on health inequities, social demand, and maturity of the science Technological goal would increase access Product Development Partnerships

13. Tilting health product innovation systems toward the poor and vulnerable Push Pull Goal R&D Intellectual Property Manufacture Regulatory Approvals Procurement and Sales Distribution of Essential New Products • R&D funding from governments • Tax breaks for private sector R&D • Double-bottom-line venture capital • Liability protection for manufacturers • Patent pooling; open source innovation • Univ. humanitarian licensing practices • Fast-track regulatory approval vouchers • Transferable patent extensions • Market analyses & partnering assistance • Global procurement / distribution funds • Advance Market Commitments (AMCs) • Airfare Solidarity Contribution • Public-private product development partnerships (PDPs)

14. Tilting innovation in health systems toward the poor and vulnerable Resource Generation Service Provision Health Information Stewardship Distribution of Essential New Products • Micro-insurance • Pooled procurement • Social marketing • Social franchising • Conditional cash transfers • Earmarked consumption tax revenues • Conditional cash transfers • ICT for remote expert advice • Software to assist in diagnosis and referrals • Health system management changes

15. Tilting innovation in health systems toward the poor and vulnerable Distribution of Essential New Products Resource Generation Service Provision Health Information Stewardship • Micro-insurance • Pooled procurement • Social marketing • Social franchising • Conditional cash transfers • Earmarked consumption tax revenues • Conditional cash transfers • ICT for remote expert advice • Software to assist in diagnosis and referrals • Health system management changes