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In this guest post, Claire Wingfield—product development policy officer at PATH—writes about a series of dialogues PATH and other partners convened to discuss public-private partnerships for global health product development. PATH recently released a report outlining the key themes and recommendations identified during the three policy dialogues. Last year PATH hosted a series of dialogues in Washington, DC, London, and Brussels to highlight the role that public-private partnerships play in driving the development and introduction of new and innovative global health technologies. The aim of these discussions was to examine how the private, public, philanthropic, and nonprofit sectors are working together to address the health needs of low- and middle-income countries, and how these partnerships can evolve to sustain progress made during the past decade and better leverage limited resources in the future. Participants at the Brussels dialogue (from left to right): Gianpietro van de Goor, European Commission; Cecile Vernant, DSW Head of EU advocacy; Ole Olesen, EDCTP; MEP Maria da Graça Carvahlo; François Bompart, Sanofi; Claire Wingfield, PATH; Maite Suarez, IAVI. Photo credit: DSW Representatives from the US and European governments, nongovernmental organizations, philanthropies, and the private sector shared lessons learned, challenges, and why they see multi-sector partnerships as the most efficient means for accelerating research and development (R&D) targeting poverty-related and neglected diseases and conditions. At the event in DC—co-hosted by PATH and the Clinton Global Health Initiative in March—participants discussed ways to incentivize private-sector contributions to global health R&D, and leverage public-sector investment. The second dialogue took place in London in June and focused on the successes and challenges of public-private partnerships, and the important (and often unique) role that nonprofit product development organizations like PATH play in bridging the gap between partners and managing a complex portfolio. The third and final meeting, co-convened by PATH and Deutsch Stiftung Weltbevoelkerung (DSW)—a German NGO leading R&D advocacy efforts targeting the European Union—was held in Brussels in October, and participants reinforced the need for European governments to strengthen their investments in global health R&D. The key themes of the dialogues were: Innovative partnerships accelerate product development by bringing together the public and private sectors. Multi-sector partnerships can play an important role to address complex global health challenges. The business of health technology development changes quickly, and innovative, flexible models of collaboration for partnership are essential to ensure success. A comprehensive planning model that accounts for regulatory pathways, procurement, and distribution while products are still in development is necessary to speed product uptake. An important first step to a successful public-private partnership is ensuring the goals and strengths of each partner align. At the start of a project, partners must begin planning for both the product’s development and introduction. The markets of low- and middle-income countries represent tremendous growth opportunities and long-term sustainability for the private sector. By tapping into the burgeoning manufacturing capacity and knowledge economies of these and other low- and middle-income countries, public-private partnerships could better contain costs and support the efforts of government donors and funders that are prioritizing broader international development and economic growth over specific health outcomes. Product development for global health works best, fastest, and most efficiently when undertaken as part of a portfolio model in which partners coordinate R&D activities across a range of products at different stages of development. Because the perceived financial risks are often too high relative to the potential economic returns, and the scientific challenges are daunting for many of these diseases and conditions, it is impossible to rely solely on one organization or sector to meet the health needs of low- and middle-income countries. Therefore governments, academic institutions, nonprofit organizations, and private companies in high-, middle-, and low-income countries have—and must continue to) come together to share risk, leverage expertise, and maximize impact. These partnerships are an efficient and sustainable model for conducting global health R&D, and their impact can increase with flexible funding and business models, collaborations with nontraditional partners, and in close collaboration with governments and professionals in low- and middle-income countries.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Japan’s National Institute of Biomedical Innovation (NIBIO), GHTC member Aeras, and Create Vaccine Company have entered an agreement to collaborate on preclinical and clinical development of new tuberculosis vaccines. The partnership will advance vaccine candidates with the NIBIO technology through preclinical studies, with the goal of eventually testing candidates at clinical trial stages. According to SciDev, the UK Department for International Development (DFID)’s budget for research and development has fallen under the current government. DFID’s research budget in 2011-2012 was £11 million—or about US$18 million—below the £237 million that was available in 2009-2010, prior to the coalition government coming to power. In response to a US congressman, Roger Glass—director of the Fogarty International Center at the National Institutes of Health (NIH)—made the case for global health research supported by NIH. Glass writes: “In almost every branch of medicine, research overseas has allowed us to advance our discoveries faster, cheaper, and more efficiently than we ever could have at home. We are leaders in global health because we have been able to reach out and engage others to do studies that are locally relevant but can have clear implications for us at home. Global health research truly is the new frontier of science.” amfAR, The Foundation for AIDS Research has launched a new initiative—called Countdown to a Cure—aimed at funding a “broadly applicable cure for HIV by 2020.” The initiative plans to invest $100 million in cure research over the next six years.

In this guest post, Kari Stoever, vice president of External Affairs at Aeras, writes about how mine workers are disproportionately affected by tuberculosis (TB) and why there’s an urgent need for new tools against this deadly disease. Deep underground, in cramped quarters, with silica dust floating through the air, the hacking cough of a miner with TB is a familiar sound. Mine workers in sub-Saharan Africahave the highest rates of TB in the world, with wide spread consequences in communities throughout the region. It is estimated that mining is responsible for as much as 760,000 new cases of TB each year, making it the single biggest driver of the TB epidemic after HIV. Not only does TB contribute to the dangers of mine work, but it also decreases economic viability. Each year, the mining industry loses around $570 million in productivity costs, and miners lose $320 million per year in lost wages, due to TB. Photo credit: David Rockhkind/Aeras Fifteen South African nations, known as the Southern African Development Community (SADC), have pledged to confront the TB epidemic in the mines through investing in treatment and control programs. While these efforts are to be commended, the ultimate solution is to invest in new vaccines to prevent TB. Recently published study results in the New England Journal of Medicine found that when South African miners were given universal isoniazid preventive therapy—intended to prevent the progression of latent TB to active disease—there was no lasting effect on TB incidence among mineworkers. Because rates of TB are so high in this community, significantly reducing the spread of TB will only be possible with transformative new technologies to effectively halt transmission. What needs to happen for the mining industry to support research and development (R&D) for new TB vaccines? Governments must unlock resources for TB R&D. Health experts must educate policymakers about the need for new tools—such as vaccines, drugs, and diagnostics. Mining industry decision-makers must partner with research organizations to advance TB R&D to protect their workforce and to improve productivity and reduce operating costs. Supporting R&D for new tools to diagnose, treat, and prevent tuberculosis will be an integral part of making southern African mines safer. This week, Aeras is at Investing in African Mining Indaba, the world’s largest mining investment event, to discuss potential ways to partner with governments and mining industry officials to address the TB threat. View the slideshow and check out the info graphic to learn more about the deadly combination of tuberculosis and mining, and join us in spreading the word and advocating for new TB vaccines to protect mineworkers.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. In this year’s State of the Union, President Obama mentioned “federally-funded research” and recognized that “there are entire industries based on vaccines that stay ahead of drug-resistant bacteria.” While a modest statement, the President’s recognition of these important US contributions to global health is significant. Last week during the World Health Organization Executive Board meeting, Member States met to discuss moving forward on eight demonstration projects that would look at new ways to spur research and development (R&D) for diseases that affect populations in low- and middle-income countries. However, some advocates were disappointed that the topic of alternative funding mechanisms for global health R&D was not substantively debated. The US Agency for International Development (USAID) announced this week that the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 Tenofovir gel trial was the winner of the agency’s Science and Technology Pioneers Prize. The prize recognizes “excellence in the use of science and technology to solve development challenges.” This is the first year USAID has awarded the prize. The Swiss Federal Department of Home Affairs and the Federal Department of Foreign Affairs, and the Bill & Melinda Gates Foundation have signed a Memorandum of Understanding to improve access to health interventions through the strengthening of regulatory systems. The partnership could improve and accelerate access to health interventions and therapeutic products in resource-constraint countries.