innovation in science and technology a critical path to addressing global health inequities
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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 - PowerPoint PPT PresentationTRANSCRIPT
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Innovation in Science and Innovation in Science and TechnologyTechnology A critical path to addressing global A critical path to addressing global health inequitieshealth inequities
May 2008
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• 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
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Leadership
Bill and Melinda GatesCo-chairs
Patty Stonesifer
CEO
Bill Gates Sr.Co-chair
Warren Buffett
Future Trustee
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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
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All lives—no matter where they are lived—have equal value. All lives—no matter where they are lived—have equal value.
Science and technology can save livesScience and technology can save lives
Our focus - reducing inequitiesOur 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
Gates Foundation Values & Principles
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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
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Priority Diseases and Conditions
• 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 Diseases and conditions conditions addressed addressed by the by the Foundation – Foundation – 38% of the 38% of the global health global health burden burden
Injuries – 12%
Communicable diseasesnot addressedby the foundation – 3%
Non-communicableconditions – 47%
Total Global Health BurdenTotal Global Health BurdenDisability-Adjusted Life-Years LostDisability-Adjusted Life-Years Lost
Foundation FocusFoundation Focus
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Accelerate Access & Drive Innovation
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
The world’s greatest health challenges are solvable –
Drive research on new tools to fight disease
› Focus on solutions that are appropriate for use in the areas of greatest need
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Global access is the target – partnerships can drive
solutions
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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
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Success, yes, but more to doIn 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, …)
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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
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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 $1.3 billion to more than 14 entities Other donors: UK, Netherlands, Ireland, Rockefeller Foundation, Wellcome
Trust, World Bank, USAID, Switzerland, Norway, Sweden, Canada, MSF, Germany, EU
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Product Development Partnerships (PDPs)
Source: BMGF, Q1 2006
Disease/Product
Year Founded Capital Raised ($M) est. Q1 2006
% BMGF
FIND Diagnostics 2003 33.2 100%
MMV Malaria Drugs 1999 263 63%
MVI Malaria vaccines 1999 268.4 96%
GATB TB Drugs 2000 175 74%
IOWH Neglected Diseases 2000 147.5 98%
AERAS TB Vaccines 1997 111.2 97%
IAVI HIV Vaccines 1996 436.5 29%
IPM Microbicides 2002 164.3 37%
PDVI Dengue Vaccines 2003 56.8 97%
MVP Meningitis Vaccines 2001 70 100%
CVP-JEP Japanese Encephalitis Vaccine 2003 27 100%
IVI Vaccines for Neglected Diseases 1995 181.2 34%
IDRI Infectious Diseases 1993 18.5 81%
PVS Pneumococcal Vaccines 2004 84 100%
Total 2036.6 66%
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Clarifying Markets – P
rice
AMC
$x billionPost-AMC market
GuaranteedAMC price
Years
0
2
4
6
8
10
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1 2 3 4 5 6 7 8 9 10 11 12 13 14
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.
Defining Existing Markets
TB Vaccines - $0.5-$1B (BVGH)
Creating Markets
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• Innovations in science and technology can create better tools – the Grand Challenges in Global Health
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Origins of GCGH:
Yr. 1900:Yr. 1900: David Hilbert, at the International Congress of Mathematicians, David Hilbert, at the International Congress of Mathematicians, proposed that twentieth-century mathematicians should devote themselves to proposed that twentieth-century mathematicians should devote themselves to solving 23 outstanding problems in mathematics. solving 23 outstanding problems in mathematics.
Yr. 2002:Yr. 2002: Bill Gates was inspired to establish the "grand challenges" in global Bill Gates was inspired to establish the "grand challenges" in global health initiative because he was familiar with the way that Hilbert's problems health initiative because he was familiar with the way that Hilbert's problems galvanized and focused the mathematics community.galvanized and focused the mathematics community.
Yr. 2003:Yr. 2003: Partnership with the Foundation for the National Institute of Health Partnership with the Foundation for the National Institute of Health established; scientific board assembled; issued call for ideasestablished; scientific board assembled; issued call for ideas
Grand Challenges in Global Health is not meant to be an exact replica of 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 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 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 solve these problems, it can help draw attention to and promote more research on these scientific challenges. on these scientific challenges.
Innovations in science and technology can create better tools- the Grand Challenges in
Global Health (GCGH)
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THE 14 GRAND CHALLENGES IN GLOBAL HEALTH SERVE 7 LONG-TERM GOALS
OngoingImprove Childhood VaccinesGC#1: Create Effective Single-Dose Vaccines GC#2: Prepare Vaccines that Do Not Require RefrigerationGC#3: Develop Needle-Free Vaccine Delivery Systems
Create New VaccinesGC#4: Devise Testing Systems for New VaccinesGC#5: Design Antigens for Protective ImmunityGC#6: Learn About Immunological Responses
Control Insects that Transmit Agents of DiseaseGC#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 DiseasesGC#10: Find Drugs and Delivery Systems to Limit Drug Resistance
Cure Latent and Chronic InfectionGC#11: Create Therapies that Can Cure Latent Infection GC#12: Create Immunological Methods to Cure Latent Infection
Measure Health Status Accurately and EconomicallyGC#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)
Engineering Immunity Against HIV (David Baltimore)
Biomarkers of Protective Immunity For TB (Stefan Kauffman)
26 Vaccine Projects Funded Total
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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
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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
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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
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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
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• Many challenges remain – more innovation is needed
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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