WORLD HEALTH ORGANIZATION EXECUTIVE BOARD 105th Session Provisional agenda item 2 EB105/8 14 December 1999
Public-private partnerships for health Report by the Director-General
1. One of the main roles of WHO is to harness and coordinate support from among a variety of players to meet the health development agenda. 2. Innovative new policies and initiatives have been developed for collaboration with the public and private sectors, including foundations, and for alliances between the public and private sectors, in order to implement programmes geared to WHO priorities and to public health in general.
FOUNDATIONS 3. The strong economy in wealthy countries has led to a major surge in the value of endowments, most notably in the United States of America. The health sector and biomedical research have received a significant share of such funding. Increasing numbers of foundations are prepared to look beyond the domestic context to the needs of global health. 4. WHO has always maintained close collaboration with foundations active in the health sector, such as with the Nippon Foundation (leprosy), Rotary International (poliomyelitis), Eli Lilly (mental health), Lions Clubs International (blindness) and the Rockefeller Foundation (vaccines, tropical disease research, and other). Increased analysis of, and contacts with, other foundations in 1999 resulted in commitments from, for example, the David and Lucille Packard Foundation (reproductive health) and the Hewlett Foundation (human reproduction). 5. The major development for WHO has resulted from the establishment of the United Nations Foundation, Inc. in early 1998 and the vast endowment of US$ 17 thousand million made by the Bill and Melinda Gates Foundation. The United Nations Foundation committed US$ 100 million annually over 10 years to organizations of the United Nations system in the fields of children’s health, population and women, and the environment. WHO has received multiyear pledges of some US$ 49 million since September 1998, particularly for tobacco control, e radication of poliomyelitis, immunization, and children’s health, representing roughly one-third of total grants from the Foundation. Consultations with the Gates Foundation are currently under way, and WHO has already received two pledges of over US$ 10 m illion each for the programmes on human reproduction and children’s vaccines. The Global Alliance on Vaccines and Immunization (see paragraph 17) will also benefit from a very substantial donation. 6. Significantly, both these two foundations have made partnerships and collaboration with the private sector a key feature of their grant giving. The United Nations Foundation operates in the
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context of, for example, joint WHO/UNICEF projects, United Nations country team action, and cosponsorship of grants by the p rivate sector; the Gates Foundation, in the context of cosponsorship and joint action on, for example, eradication of poliomyelitis, trachoma control, and cervical cancer.
REACHING OUT TO THE PRIVATE SECTOR 7. WHO is conscious of the potential of collaboration with the private sector at global, regional and country levels. The private sector has strong advantages that enable WHO to reach wider and to have a more significant impact on global public health. 8. Thus far formal or informal partnerships have been established around drug and vaccine donations, donations in kind, pro-bono services, advocacy and communications, and financial support. 9. Substantial in-kind drug donations in support of public health action are being made by Merck, through the United States National Committee for UNICEF, to the Onchocerciasis Control Programme in West Africa; by SmithKline Beecham PLC, for the elimination of lymphatic filariasis; by Glaxo Wellcome PLC, for malaria control; by the Novartis group, for leprosy control; and by Pasteur Mérieux Connaught, to the Global Polio Eradication Initiative. 10. The Global Polio Eradication Initiative is an outstanding example of successful public -private sector collaboration between organizations of the United Nations system, Member States, foundations, nongovernmental organizations and the private sector. Rotary International, in particular, has contributed millions of volunteer work-hours, donations in-kind and advocacy efforts, along with financial support exceeding US$ 325 million, to the eradication of poliomyelitis. The recent commitment of De Beers to eradication of poliomyelitis has so far resulted in not only significant financial support but also advocacy activities ranging from its Chairman’s calls to other business leaders, through active community engagement, to global media coverage. 11. Given the imperative need to ensure that donations from the private sector are suitable, avoid conflicts of interest and provide clear health benefits, WHO revised its Guidelines on interaction with commercial enterprises in July 1999 for implementation on a trial basis. Consultations on these guidelines with governments and the private sector are being pursued.
MOBILIZING NEW ACTORS ON THE INTERNATIONAL HEALTH STAGE 12. Joining forces with a variety of private sector partners from industries that have not traditionally worked with WHO can clearly enable WHO to have a broader and deeper impact on global public health. In 1999 two new alliances were forged in the private sector that offer a new model for successful partnership with industry, outside the pharmaceutical sector. 13. One of these new ventures is WHO’s cooperation agreement with the World Alliance for Community Health, a not-for-profit organization set up by five international mining companies. As part of this cooperation, WHO lends its technical expertise to evaluate and monitor community health projects and thus provides a framework within which the Alliance’s member companies can promote long-term health gains in the local communities in which they operate. 14. In addition, WHO has worked with the Association of Oil and Gas Producers to help establish strategic health management principles and guidelines for the oil and gas industry. These guidelines
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outline steps that international oil and gas companies can follow to ensure systematic, cooperative planning with local authorities for primary health care projects that should lead to a more healthy workforce and promote lasting improvements in the health of their host community in general. 15. Round tables with the pharmaceutical industry are focusing on improving individual and public health through collaboration in the areas of research and development for neglected infectious diseases, better access to essential drugs, and the fight against substandard and counterfeit drugs. Extension of the round-table concept to other sectors active in the health field, such as the food industry, is under review.
ENGAGING IN ALLIANCES 16. WHO has welcomed opportunities to join forces with a range of other organizations of the United Nations system, governments, nongovernmental organizations and the private sector. 17. WHO has most recently taken a lead role in the Global Alliance for Vaccines and Immunization, which aims at saving children’s lives and protecting people’s health through the widespread use of safe vaccines. The Alliance has attracted support from a wide array of public and private partners. 18. Other examples of alliances with public and private partners are the Medicines for Malaria Venture, launched as a partnership with the pharmaceutical industry to discover new tools to combat malaria; the Global Programme to Eliminate Lymphatic Filariasis, which focuses on mobilizing partners from all sectors of society; Vision 2020, which works towards eliminating the major causes of blindness; and the Global Vitamin A Alliance, which works with industry on food fortification and provision of vitamin A capsules to combat deficiency in the developing countries. 19. Plans are under way to launch in June 2000 a global alliance for health promotion, bringing together representatives of the public sector, the private sector, and civil society (the Prince of Wales’s Business Leaders Forum, the International Union for Health Promotion and Education, the World Travel and Tourism Council, and others) in order to foster the concept of “health-promoting companies”.
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WORLD HEALTH ORGANIZATION EXECUTIVE BOARD 105th Session Provisional agenda item 2 EB105/8 Add.1 6 January 2000
Public-private partnerships for health Medicines for Malaria Venture Report by the Director-General
1. The Medicines for Malaria Venture is a new public/private sector partnership that provides a sustainable mechanism for the professional discovery, development and commercialization of affordable new antimalarial drugs. Professionalism in research and development will be achieved by industry engagement in specific projects. Affordability of products will result from assumption by the public sector of the direct costs of research and development and of the risk of failure; the commercializing company only has to recover production costs and limited development costs. Such a partnership is unique and will pave the way for future public/private sector initiatives. 2. The Venture, launched on 3 November 1999, is designed to foster and to finance through public/private partnership the discovery and development of new, cost-effective and affordable antimalarial drugs to regulatory approval at a rate of one new registered product every five years, and to facilitate their commercialization. In addition to WHO and the International Federation of Pharmaceutical Manufacturers Associations, the main sponsors of the Venture are the governments of the Netherlands, Switzerland and the United Kingdom of Great Britain and Northern Ireland, the World Bank, the Rockefeller Foundation, and the Global Forum for Health Research. 3. The Venture will finance projects for the discovery and development of malaria drugs through a “public venture capital fund”, which is expected to amount to US$ 30 million per year over the next four years. This financing will come primarily from the public sector and philanthropy and will be complemented by the provision of resources, expertise, and donations in kind from the Venture’s industrial partners, estimated at many millions of dollars per year. The Venture has received so far contributions and pledges of US$ 10 million for its initial operations in 1999 and 2000. 4. In order to succeed in the long term, the Venture will need to run its affairs primarily as a notfor-profit business, with its own governing board, including an appropriate blend of expertise. This structure was felt to be essential if the Venture is to have the necessary flexibility to operate at the boundary of the public and private sectors. The Venture was therefore established as a foundation under Swiss law and is thus independent of WHO. The post of Chief Executive Officer has been advertised and an appointment is expected in early 2000. 5. WHO intends to work in close collaboration with the Venture. In order to ensure that it has the full benefit of the Organization’s technical and public health guidance, the Director-General took an initial decision to appoint two staff members as representatives to the decision-making body of the
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Venture, namely the Board of Trustees.1 This initial decision, taken in the interest of promoting an enhanced response to the fight against malaria, is submitted to the Board for endorsement.
ACTION BY THE EXECUTIVE BOARD 6. The Board may wish to endorse the initial decision of the Director-General to appoint two representatives to the board of the Medicines for Malaria Venture.
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Project Manager, Roll Back Malaria, and Coordinator, Product Research and Development, Special Programme for Research and Training in Tropical Diseases.
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