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Fall Pharmaceutical Access in
Least Developed Countries:
on-the-ground barriers and
industry successes”.
D. Wayne Taylor, Ph.D., F.CIM
Executive Director
10
Table of contents
Executive Summary ........................................................................................................................... 4
Findings of this Report……………………………………….………………………………………..7
Biases and Gaps in the Literature…………………………………………………………13
Perceived Problem, Bureaucratic Solution, and Unintended Consequences…...15
The Real ‘On-the-Ground’ Problems and Solutions……………………………………17
Conclusion…………………………………………………………………………………….20
An Annotated Catalogue of Public-Private Partnerships that Provide Access to
Pharmaceuticals in Least Developed Countries……………………………………………….22
Major Global Initiatives in which Pharmaceuticals Played a Major Role……................143
List of Access to Pharmaceuticals Interventions…………………………………….............157
List of the 50 least developed countries………………………………………………………..177
The Cameron Institute……………………………………………………………………………..182
2
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Disclaimer:
This report provides a comprehensive overview of existing knowledge
that existed in the public domain respective of access to medicines to the least
developed countries as of the time of writing. The analysis and conclusions
contained herein do not necessarily reflect the views of The Cameron Institute,
its Board, or its funders. Any errors or omissions are the sole responsibility of the
author and this project's research staff. Comments and suggestions are welcome.
Please cite this paper as:
"D. Wayne Taylor, Pharmaceutical Access in Least Developed Countries:
on-the-ground barriers and industry successes”.
3
Pharmaceutical Access
in Least Developed Countries:
on-the-ground barriers and
industry successes
F10
Executive
Summary
The research-based
pharmaceutical industry, in
various public-private
partnerships (PPPs), has
been improving access to
medicines in the least
developed countries of the
world since the 1950’s.
1
Summary data
140
Number
of
PublicPrivate
Partnerships
Industry success
120
100
80
60
40
Over the past two decades,
the most significant gains
have been made by the
industry and its partners in
improving both access to
medicines and health
outcomes in the poorest of
the world’s nations.
2
0
1950 1960 1970 1980 1990 2000 2010 2020
Year
On-the-ground barriers
The greatest barriers to
access and improved
health are not drug prices or
patents but “on the ground”
barriers such as market
failure, corruption, nonexistent health human
resources and infrastructure,
and the lack of both local
and international political
will.
20
Doha Declaration and licensing
3
To date there have been 150 public-private
partnerships to improve access to medicines
in the least developed countries; 90% have
been industry-led; and one-half of those
were created since the Doha Declaration of
2003 thus making compulsory licensing
unnecessary.
4
Continued on page 5
Summary data as of 2010 for
research-based pharmaceutical
industry contributions to least
developed countries
USD 8,450,000,000 of product and
investment
950,000,000 patients treated
(Continued)
A basic right in law is to retain possession of
one’s own ideas and discoveries. Sustainable
development is the way of the future for both
North and South and, for there to be
sustainable healthcare enterprise and optimal
health outcomes in the least developed
countries, there must also be the necessary
infrastructure, health human resources,
political stability, and professional
administrative legal structures.
Even though existing medicines for HIV/AIDS
has reduced mortality rates in developed
countries by 70%, adherence and compliance
are two major obstacles, amongst many, to
the successful deployment of these drugs in
developing countries.
9,500,000,000 doses/treatments
administered
350,000 doctors, nurses and other
health personnel trained
Research-based pharmaceutical companies
contribute USD 8.5 billion and 9.5 billion
doses/treatments to benefit 1 billion lives.
Summary data re types of
interventions by research-based
pharmaceutical companies in the
least developed countries
Access to medicines (pricing)
31
Access to medicines (donations)
45
Access to medicines (voluntary licensing) 3
Research and development
15
Capacity building
66
Education
28
WHO’s list of essential medicines is comprised
of over 95% off-patent products – the
remainder being primarily second-line antiAIDS medicines. Patents pose no barrier to
essential medicines being affordable and
accessible throughout the world. If it wasn’t
for patent protection none of those medicines
would have been available in the first place,
producing revenue from developed countries
that now allows 100 medicines and vaccines
to be in development to tackle malaria, multidrug resistant tuberculosis, dengue fever, and
all the other scourges of the developing world.
The real barriers to access are money, power,
politics, and ideologies. Decades of market
failure and corruption have denied least
developed countries the rule of law, efficient
infrastructure and roads by which to distribute
and administer medicines, access to potable
water, and trained health personnel.
This report demonstrates beyond a reasonable
doubt that, contrary to the opinion of many,
intellectual property protection (IPP), in the
form of patents or other devices, does not
impede access to medicines in the least
developed countries of the world; in fact, IPP
fosters access.
5
Voluntary Licences (VLs) up to April 2010
Pharmaceutical company
No. Of VLs
issued
Abbott
7
Boehringer Ingelheim
3
Bristol Myers Squibb
20
Gilead
5
GlaxoSmithKline (GSK)
7
Merck
13
Roche
4
Tibotec
2
ViiV
( a joint venture of GSK and
Pfizer)
30
Total VLs
91
Up to 2007
31
2007-2010
60
Voluntary Licences
Licensing of products and/or processes must be
voluntary and mutually beneficial if it is to be
sustained. Voluntary licensing is a win-win for
pharmaceutical companies and the least
developed countries. By voluntarily licensing
medicines to be manufactured by third parties
in developing countries, research-based
pharmaceutical manufacturers do not have to
incur distribution costs, while they retain their
proprietary rights and help improve health
outcomes among the most needy of the
world’s inhabitants. In exchange, the lowerpriced pills are required to be sold in distinctly
different shapes, sizes, and/or colours,
dramatically lowering the possibility that they
will be exported back into developed countries
through black market channels to compete
against full-price medicines. A collateral
benefit to the developing country in which the
production occurs is the addition of high-value
employment, tax revenue, and wealth creation
opportunities.
The Cameron Institute – www.cameroninstitute.org
263 John Street South
Hamilton, Ontario
Canada
L8N 2C9
6
[Type text]
Findings of this Report
There is a public health crisis in the least developed countries. It is a crisis made by humans
and solvable only by humans. There is urgency for governments, businesses, NGOs and
academia to collaborate in dealing with this most urgent of problems. However, actions
taken today need to solve the problem and not exacerbate it or create another set of
problems.
The World Health Organization’s (WHO) Draft Global Plan and Strategy for Action focused its
energies on “the growing burden of diseases and conditions that disproportionately affect
developing countries, and particularly women and children”. Various discussions and papers
have clarified that this burden of disease is largely attributable to communicable diseases
within the developing world.
The Cameron Institute is committed to improving patient care and outcomes, not just in
Canada, but everywhere in the world. Based upon the findings of much earlier works1, as well
as the findings of this report, The Cameron Institute endorses public-private partnerships (PPPs).
As a policy research institute, The Cameron Institute does not support any attack on
intellectual property (IP) – the cornerstone of affordable innovation and discovery so
necessary for the solutions to world public health problems.
Innovation is the hallmark of the pharmaceutical industry. Without innovation there would be
no immunizations, medicines or biologics to save lives, improve quality of lives, and to save
much needed healthcare dollars. Every dollar invested in new medicines relieves the
healthcare system of seven dollars of expenditure elsewhere. New drugs increase life
expectancy and life-time income by about 1.0% per year while also decreasing years of life
lost. 2
Innovation through research and development sits astride a three-legged stool – each leg of
which is integral to successful innovation: (i) sufficient capital and skilled researchers to create
the critical mass needed to pursue the quest of discovery; (ii) an efficient means by which
discovery can be developed into an efficacious and effective product for use; and, (iii) strong
protection of intellectual property to motivate and reward the development of these
innovations, and provide the capital for new and improved developments.
However, innovation-based industry is also high-risk industry. What makes the pharmaceutical
industry particularly vulnerable to patent infringement is that it is the most research-dependent
industry in the world with individual firms reliant upon research for their very survival (see figure
D. Wayne Taylor, Business and Government Relations: Partners for the 1990’s, Toronto, Gage, 1991.
Frank R. Lichtenberg, “Are the benefits of newer drugs worth their cost?” Health Affairs, 20(5):241-251,
2001.
1
2
below) 3. Whether products are by prescription or over-the-counter, for human use or
veterinary use, pharmaceuticals are developed, produced and sold to either prevent or cure
illness, or to provide a better quality of life for those with illnesses for which there is no
prevention or cure as of yet.
The Biopharmaceutical Industry is the Most Research-Intense
Source: Harvard Business Review, November 2008, 84.
Over a 12 year period, 700,000 substances will be tested before 1,000 compounds can be
isolated for advanced testing; from those 1,000 compounds only one will become an
efficacious, effective, commercial drug available on the market for patients. With each new
drug also comes the incremental depletion of long-established chemical possibilities which in
turn raises the bar for further chemical discovery. It takes, today, over USD1.3 billion to bring a
prescription drug to market, 90% of which never break-even to recoup all research and
development costs thus requiring successful firms to rely upon a “portfolio” of products to
realize their revenue needs (see figure below).
Although we are perched on the brink of a new age of discovery – that of biotechnology
where large molecule entities, rather than the traditional small molecule entities, will cure
disease and improve outcomes – the art and science of discovery and innovation need to be
nurtured and protected all the more for that reason.
A basic right in law is to retain possession of one’s own ideas and discoveries. Sustainable
development is the way of the future for both North and South. For there to be sustainable
3
Edwin Mansfield, “Intellectual Property Protection, Foreign Direct Investment and Technology Transfer”.
International Finance Corporation Discussion Paper No. 19, 1994.
8
healthcare enterprise and optimal health outcomes in the least developed countries, there
must also be the necessary infrastructure, health human resources, political stability, and
professional administrative legal structures. Even though existing medicines for HIV/AIDS have
reduced mortality rates in developed countries by 70%, adherence and compliance are two
major obstacles, amongst many, to the successful deployment of these drugs in developing
countries.
New Pharmaceutical Product Development of 10-15 Years Versus Patent Life of 20 Years
~ 5,000 – 10,000
Preclinical
Clinical Trials
250
FDA Review Scale-Up to Mfg.
Post-Marketing
Surveillance
5
COMPOUNDS
3 – 6 YEARS
PHASE
1
PHASE
2
PHASE
3
NUMBER OF VOLUNTEERS
20–100
100–500
6 – 7 YEARS
1,000–5,000
NDA SUBMITTED
ONE FDAAPPROVED
DRUG
IND SUBMITTED
PRE-DISCOVERY
Drug Discovery
0.5 – 2
YEARS
INDEFINITE
Source: Congressional Budget Office, 2006.
Canada and the research-based pharmaceutical industry have been leaders and have
played an active role in improving access to needed medicine around the world which in turn
greatly improves health outcomes worldwide. In the last decade alone, Canadian researchbased pharmaceutical firms have discovered four generations of medicines to treat HIV/AIDS,
the first treatment for Alzheimer Disease, and many cholesterol-lowering drugs that help
prevent heart attacks. Canadian firms and their global affiliates have worked in partnership
with more than 25 international aid programmes to build clinics, train health professionals,
improve health – especially amongst women and children – and donate medicines and
vaccines throughout the developing world.
Today, Canada is focusing more and more of its energies on bilateral aid for countries that
have demonstrated that they can use it effectively, and the results are positive. Therefore, the
same approach needs to be taken when improving access to medicines in order to make
sure that the drugs get to where they need to be, rather than detoured into black markets. By
targeting their scare resources Canada, along with its partner companies, agencies and likeminded countries, has reduced the percentage of the world’s population living in extreme
poverty from 33% to 19%; has increased enrollment in primary education 10%; and, has
9
reduced infant mortality by 20% in 11 West African countries, largely due to immunizations
supplied by research-based pharmaceutical companies. Over the past decade there has
been a twelve-fold increase in those receiving treatment for HIV/AIDS.
Generic drugs have an important and acknowledged role to play in reducing healthcare
costs after patents have expired on drugs. There is a clear time and place for generics to
enter the market. WHO’s list of essential medicines is comprised of over 95% off-patent
products – the remainder being primarily second-line anti-AIDS medicines. IP poses no barrier
to essential medicines being affordable and accessible throughout the world. In fact, if it
wasn’t for the protection of IP none of those medicines would have been available in the first
place. Intellectual property protection (IPP) allows 100 medicines and vaccines to be in
development to treat diseases of the developing world. Even Uganda’s President, Yoweri
Museveni, who presided over the world’s largest reduction in HIV/AIDS prevalence, has
declared that the whole essential medicines argument against patents is a red herring
perpetrated by vested interests.
IP is not a barrier to access. The real barriers to access are money, power, politics, and
ideologies. The research-based pharmaceutical industry invests huge sums required for
innovation and discovery as a direct result of the protection of IP and because of that they
are able, and more than willing, to partner with governments and non-government
organizations (NGOs) to make medicines affordable and available to all. The protection of
intellectual property has enabled the pharmaceutical industry to develop more than 90% of
all the medicines available worldwide today. As stated above, today it takes 10-12 years and
USD1.3 billion to develop a new, innovative medicine for patients. Without innovation and
related safeguards in place there will be no new vaccines or medicines to tackle malaria,
multi-drug resistant tuberculosis, dengue fever, and all the other scourges of the developing
world.
This report demonstrates beyond a reasonable doubt that, contrary to the opinion of many,
intellectual property protection (IPP), in the form of patents or other devices, does not impede
access to medicines in the least developed countries of the world; in fact, IPP fosters access.
Without the protection of IP no new medicines would be discovered and access would
become a moot point. Since 2000, global research-based pharmaceutical companies have
provided health interventions worth USD4.4 billion, enough to help up to 540 million people.
Medicines have been shipped at preferential or no-profit prices. Many companies have
fostered partnerships in developing countries. Some companies have even gone so far as to
sponsor their own “give away” programmes. According to the Organization for Economic Cooperation and Development (OECD), pharmaceutical companies “punch way above their
weight” in the field of international development assistance contributing over 10% of all
monies donated (OECD 2008).
Research and development (R&D) plus technology transfer have been improving in the
developing world thanks to the work of many firms and partners and the enforcement of IP
10
rules and regulations 4. Research institutes have been established in Africa to focus on
HIV/AIDS. Capacity-building to manage breast cancer in Ethiopia is underway. Sustained “at
cost” pricing has been established for antiretrovirals for a decade. Neglected diseases such
as lymphatic filariasis are being targeted. One partnership has seen 14 million individuals
cured of leprosy. Current pipeline projects include 17 medicines and 2 vaccines for
tuberculosis and 18 medicines and 2 vaccines for malaria. One research-based
pharmaceutical company has invested USD20 million of capital and USD5 million operating
funds per year in a research institute based in India employing more than 80 research scientists
dedicated to finding a therapy to combat multi-drug resistant tuberculosis. Another firm has
established a public-private partnership in search of the same therapy and promises to
collaborate with others to accelerate the discovery phase. In Singapore, a public-private
partnership employing over 100 scientists is focusing on developing treatments for dengue,
malaria and tuberculosis which, once developed, will be offered at no profit to poor patients
in developing countries. According to a 2009 Tufts University report, the pharmaceutical
industry was the third highest funder of R&D related to neglected diseases that
disproportionately afflict the least developed countries after the U.S. National Institutes of
Health and the Bill & Melinda Gates Foundation.5
With respect to technology transfer, the licensing of products and/or processes has always
been a recognized means by which firms can do business internationally. However licensing
of products and/or processes must be voluntary and mutually beneficial if it is to be sustained.
Voluntary licensing is a win-win for pharmaceutical companies and the least developed
countries. By voluntarily licensing medicines to be manufactured by third parties in developing
countries, research-based pharmaceutical manufacturers do not have to incur distribution
costs, while they retain their proprietary rights and help improve health outcomes among the
most needy of the world’s inhabitants. In exchange, the lower-priced pills are required to be
sold in distinctly different shapes, sizes, and/or colours, dramatically lowering the possibility that
they will be exported back into developed countries through black market channels to
compete against full-price medicines. Collateral benefits to the developing country in which
the production occurs is the addition of high-value employment, tax revenue, and wealth
creation opportunities.
This report identified there being 91 voluntary licences for brand-name medicines, two-thirds of
which have been initiated within the past three years (see figure below).
4
Mark Dutz, Antara Dutta, and Jonathan Orszag, Intellectual Property and Innovation: New Evidence
on the Relationship between Patent Protection, Technology Transfer and Innovation in Developing
Countries, Compass Lexecon, October 2009.
5 Tufts Centre for the Study of Drug Development, Neglected Diseases in the Developing World:
Progress, Current Challenges, and Promising Approaches, Boston MA: Tufts University, October 16, 2009.
11
Voluntary Licences (VLs) as of April 2010
Pharmaceutical company
No. Of VLs issued
Abbott
7
Boehringer Ingelheim
3
Bristol Myers Squibb
20
Gilead
5
GlaxoSmithKline (GSK)
7
Merck
13
Roche
4
Tibotec
2
ViiV
( a joint venture of GSK and Pfizer)
30
Total VLs
91
Up to 2007
31
2007-2010
60
On the other hand, compulsory licensing has proven to be ineffective and in some cases
duplicitous and criminal6. Compulsory licensing exists to deal with public health crises;
products produced under compulsory licence are not to be diverted from their intended
beneficiaries in a specific country. Any work done to achieve health for all must be done in
good faith and legally, and the short track record with compulsory licensing shows that this is
not always the reality. In fact, all so-called “compulsory licences” other than the CanadaRwanda example have been simply political fiats unrestrained by law.7
Kristina M. Lybecker and Elizabeth Fowler, “Compulsory Licensing in Canada and Thailand: Comparing
Regimes to Ensure Legitimate use of WTO Rules,” Journal of Law, Medicine and Ethics, Summer 2009,
222.239 (Lybecker is a Research Associate of The Cameron Institute and Fowler is a former staff
associate of the Institute).
7 Richard A. Epstein and A. Scott Kieff, Questioning the Frequency and Wisdom of Compulsory Licensing
for Pharmaceutical Patents, John M. Olin Law and Economics Working Paper No. 527, Chicago:
University of Chicago, 2010, 5.
6
12
Pharmaceuticals, like most legal products, are sold globally using differential pricing – basically
charging what each respective market can bear. This maximizes both the income for the firm
and, in the case of the pharmaceutical industry, patient access to medicines around the
world. Differential pricing is a win-win-win for risk-taking innovators, fiscally challenged payers,
and patients in need of treatment. As Danzon and Furukawa concluded (2004), drug price
differentials among countries roughly reflect income differences as do food prices and prices
for consumer electronics. 8
Biases and Gaps in the Literature
A recent review of the literature respective of access to medicines in least developed
countries 9 identified a number of biases (or recurrent themes) and gaps that have probably
tilted the debate in an erroneous direction either by design or coincidence. The review
covered over 50 articles, published between 1992 and 2009, and other materials on barriers to
access to medicines.
A key finding of the literature review was “the paucity of illuminating research so far
conducted on this topic”. What literature there is, is not robust or scientific. Most of the
‘access to medicines’ literature focused on only the cost of drugs. Half of the literature
reviewed reflected anti-IP views, with a number of papers by a few well-known, biased, third
parties claiming that these factors have damaged healthcare in the least developed
countries. Almost all of these articles accepted a priori that IPP automatically translates into
higher prices, which they interpreted as resulting in poor access to treatment with little or no
evidence to support their claim.
As will be explored below, the cost of treatment is only one variable in an extremely complex
situation – maybe even the least important variable in the mix. Access to medicines is
hindered in the majority of the least developed countries as a result of a wide range
of issues, some of which are documented in the literature reviewed, including
inadequate government administration, bare-bones healthcare systems, inadequate
distribution capacity, and counterproductive regulation and taxation. While it is becoming
much more widely understood that these other variables are far more important barriers to
access than the cost of medicines (both innovative and generic), the literature does not yet
reflect this and there was not one single article that investigated these variables scientifically.
Regardless of the uneven distribution of thought in the literature some of the factual findings
are worth noting.
Patricia M. Danzon and Michael F. Furukawa, “International Prices and Availability of
Pharmaceuticalsin 2005,” Health Affairs 27(22), 2008.
9 Phillip Stevens, Eman Al Saaed, David Taylor, Access to Medicines in Less Developed Countries: An
Annotated Bibliography, London UK: International Policy Network and The School of Pharmacy,
University of London, October 2009.
8
13
"
"
"
"
"
"
"
one-third of the world’s population does not have access to “essential medicines”
(even though almost all of these are off-patent and genericized)
o in the poorest of countries, such as many of those in sub-Saharan Africa, this
figure rises to 50%
o the WHO’s “essential medicines list” is woefully outdated and overly bureaucratic
to amend, to the extent that there are no lipid-lowering drugs on the list even
though 80% of deaths resulting from the world’s number one killer, cardiovascular
disease, occur in developing countries
one-third of all medicines supplied in the least developed countries are counterfeit
and/or sub-standard (the majority of which are manufactured in China, India and
Thailand)
more than 20% of medicines supplied to government-run facilities in the least
developed countries are stolen and resold by staff thus explaining, in part, the chronic
stock shortages in public health system dispensaries
supply chain mark-ups from manufacturers’ supply prices to those found in
private pharmacies and other retailers are typically 300-500% for generics and 10001500% leading brand name medicines
patients are often ill advised and inadequately supported in medicine purchasing and
use; there is a chronic shortage medical human resources
where essential medicines are still on-patent, innovative manufacturers very rarely
choose to enforce their intellectual property rights
there was no scientific evidence that trade-related intellectual property agreements
were causatively associated with worse health outcomes in least developed countries
Many articles reviewed concluded that the least developed countries should issue compulsory
licences as a means of driving down prices (an issue discussed at length later). Only one such
licence has ever been issued with little effect on health outcomes. Again, there was no
evidence presented, either theoretical or empirical, to support such a recommendation.
Some articles still adhere to price controls as a means of lowering costs in the least developed
countries ignoring the empirical reality that price controls only reduce supply, the exact
opposite outcome that is desired, and fuel black markets that, in this case, would traffic in
counterfeit, sub-standard products.
According to this 2009 review, in a nutshell, the literature is not balanced, is largely overt
political advocacy, and is dominated by a few ideologically-biased third parties that ignore
the facts and cling to hypotheses that are out-dated and have no grounding in evidence.
Unlike the authors that dominate the literature, The Cameron Institute is interested in the facts
and present them later on in this report in an attempt to “balance” the argument.10
Interesting enough a review of the broader literature on intellectual property and developing
countries was accurate in every respect except the section regarding access to medicines in which the
authors uncritically accepted what was published as being factual when in fact it was not; see
10
14
Perceived Problem, Bureaucratic Solution, and Unintended Consequences
Twenty-five years ago, during its Uruguay Round, the World Trade Organization (WTO)
negotiated its Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). In
essence, TRIPS attempted to globally harmonize rights-based protection of intellectual
property and the enforcement thereof. This included patents.
However, some countries found TRIPS to be too rigid because it stipulated that a compulsory
licence could only be issued to service the domestic market so “flexibilities” were written into the
agreement. This was of particular concern to developing countries that had neither the
manufacturing capabilities nor the infrastructure to take advantage of the compulsory licensing
provisions. Paragraph 6 of the November 2001 WTO Doha Declaration on TRIPS and Public Health
addressed this perceived problem inherent in Article 31(f) of the TRIPS Agreement.11
Moreover, key transitional time periods in the TRIPS Agreement required worldwide protection for
pharmaceutical products beginning in 2005 which challenged the practice of middle income
countries reverse engineering medicines and then producing them for export.
Consequently, it was agreed under Paragraph 6 that the Council for TRIPS would find an
expeditious solution and report to the General Council by 2002. However, it was not until August
2003, shortly before the Cancun Ministerial Conference, that a consensus was reached. This was
known as the Paragraph 6 Implementation Agreement. It granted rights to developing countries to
waive the provisions under Article 31(f) and also allowed member countries to issue compulsory
licences to export generic versions of patented pharmaceutical products to meet the needs of
importing countries with insufficient or no pharmaceutical manufacturing capacity, subject to
certain conditions. This Agreement created a waiver to Article 31 of TRIPS which was supposed to
be temporary pending an amendment which was achieved on December 6, 2005. The new
amendment approved changes to the TRIPS Agreement and made the waiver permanent.
The Amendment comprises three parts; the first allows developing countries without a significant
pharmaceutical capacity or sector, in the event of a public health crisis, to access alternative
supplies of medicines. The annex of this amendment then goes on to spell out the specific
circumstances in which a compulsory licence can be used and provides safeguards against
parallel importing. Lastly the appendix deals with the criteria for accessing lack of manufacturing
capacity in the importing country.
Emmanuel Hassan, Ohid Yaqub and Stephanie Diepeveen, Intellectual Property and Developing
Countries: A Review of the Literature, Cambridge UK: RAND Europe, 2010.
11 At the time of writing the Doha Declaration had still not been ratified by a majority of the member
states of the WTO.
15
The Implementation Agreement makes compulsory licences easy to obtain for least developed
countries by defining an eligible importing Member as “any least developed Member without any
supplementary proof required from that Member”.
The Paragraph 6 Implementation Agreement also introduces remuneration requirements which are
not only difficult to calculate but are also paradoxically required even when the product is not
produced for a country where medicine is not patented.
Based on the “Chairman’s statement”, which accompanied the amending Agreement, middle
income countries needing to import generics because of incapacity of their pharmaceutical
sector must actually prove and defend such claims of need. Safety is, once again, a concern
given that Good Manufacturing Practices and identified best practices are not always practised
ideally in these circumstances.
In effect, this “flexibility” in TRIPS allowed governments to issue a “compulsory licence” to a
company, other than the innovator of the drug in question, to produce a patented drug, or
use the patented process, under licence, provided that the legitimate interests of the patent
holder were safeguarded. Numerous cases arose where compulsory licences were allegedly
issued in middle income countries with total disregard for patent holders’ rights. Often drugs –
still under patent - produced under these “compulsory licences” were not used for the public
health of the producer’s domestic market but sold for a profit around the world. Most of these
cases have been settled in favour of the innovator company. Compulsory licensing, when
enacted illegally, is nothing short of piracy. 12
At its spring meetings, the World Trade Organization took stock of its trade liberalization
initiatives which included Paragraph 6 of the Doha Declaration re compulsory licensing of
pharmaceuticals. A month prior to that a small group of mostly middle income, socialist
countries, including Brazil, China, Cuba, Ecuador, Egypt, India, Indonesia and Venezuela,
claimed that Paragraph 6 was not working effectively. Others at that meeting, including
Argentina, Canada, the European Union, Switzerland, and the United States, claimed that
Paragraph 6 was not working because it was not needed.
The findings of this report clearly show that Paragraph 6 is not needed to deliver much needed
medicines to the least developed countries. Where possible, those drugs are being delivered
Only one legal compulsory licence has ever been invoked, for a brief time by Rwanda to treat 21,000
AIDS patients. Canada, the exporting country, said that the shipments to Rwanda took longer than
expected because the company seeking a compulsory licence needed time to find an interested
importing country, as well as on account of Rwanda’s procurement tendering procedures. Regrettably
nothing has changed “on the ground” in Rwanda to improve access to medicines.
12
16
through numerous public-private partnerships. Where they are not being delivered has little to
do with price or patents but with on-the-ground barriers.
The Real ‘On-the-Ground’ Problems and Solutions
In the post-TRIPS world, enforcement of existing rules is almost non-existent world-wide. The
Cameron Institute could find no evidence for supporting the application of flexibilities as
provided for in Paragraph 6 of the DOHA Declaration under TRIPS. Where flexibilities have
been invoked to date, desired results have not been achieved and wrongdoings have been
identified. Compulsory licensing is being abused and should be discontinued for the welfare
of all. Compulsory licensing was established as a humanitarian act and not as a vehicle to
encourage privateering. In a TRIPS-compliant world, the patent owner of a product already in
mass production will likely be the lowest cost producer since the cost of producing an
incremental quantity of the product will be lower than the all-in costs for a start-up operation
producing a limited amount of the product. As a result, compulsory licensing has done
nothing to promote public health in least developed countries and has only reduced the
incentive for investing in the innovation of new drugs (as illustrated in the figure below).
The Patent Infringement-Innovation Loss Dynamic
Intellectual Property Protection
#
Patents
#
Patent Infringement through Compulsory Licensing or other means
#
Economic Consequences
#
Social Consequences
(Loss of profits and reduced
(Concerns about drug safety and
investment in innovation)
unexpected, deleterious health outcomes)
Instead of compulsory licences, various research-based pharmaceutical companies around
the world have voluntarily entered into partnerships that permit their partners use of their
compound libraries in R&D collaborations. However, the free and unrestricted opening of
compound libraries owned by private entities undercuts the positive and constructive
voluntary collaborations underway and the protection of IP. Furthermore, safety is always a
17
paramount concern in both the pharmaceutical R&D and manufacturing worlds. Unfettered
access to compound libraries could potentially raise the safety risk significantly.
Since September 11, 2001 we live in a different world. Any and all bilateral, multilateral or
global initiatives must take into account the possibility of bioterrorism. Never before has the
threat of bioterrorism been more real. Only because of the vigilance of the United States and
its allies has a serious bioterrorist attack not occurred. Yet the potential for such an atrocity is
high if chemical and biological compounds used in the manufacture of pharmaceuticals are
not closely protected through a system of secure intellectual property rights and government
enforcement of same. Intellectual property protection never played a greater role in global
security than now. Opening compound libraries beyond voluntary arrangements such as exist
today could very conceivably feed the capacity needs of bioterrorists.
Innovative and complementary incentive schemes for R&D have also contributed to the
success of many public-private partnerships. For example, advanced market commitments
(AMCs), which provide a defined market through contractual agreement by governments,
international agencies and/or NGOs to procure specified quantities of product, already exist
in certain circumstances. Advanced market commitments have merit as both incentive and
reward for innovation, as well as means to expedite the successful delivery of needed
medicines to those most in need around the world.
The real challenges facing access to medicines in the least developed countries are not ones
of IP but ones of market failure, corruption, and lack of political will. These have been
documented in the literature going back more than 20 years. 13 Most of the least developed
countries do not have an efficient infrastructure by which to distribute and administer
medicines. A real impediment to improving patient care and health outcomes in the least
developed countries is the lack of roadways, potable water, basic education, transport and
communications. Without infrastructure and capacity (both material and human) “drive-by”
aid does little good.14
One-third of the world’s population lacks a safe water supply. The United Nations calculated
that 25,000 people die unnecessarily from water-borne diseases every day, and that by 2025
two-thirds of the world’s population will live in countries with serious water shortage.
It is not uncommon to have time-sensitive medical supplies off-loaded onto a dock only to sit
there with no means of being transported to their destination. Developing countries must
invest in rapidly evolving their own internal health delivery infrastructure to efficiently deliver
For example see: P. Farmer, AIDS and Accusations: Haiti and the Geography of Blame, Berkeley CA:
University of California Press, 1990; World Health Organization. The Rational Use of Drugs: Report of a
conference of experts, Nairobi, 25-29 November 1985.
14 General Rick Hillier, A Soldier First: Bullets, Bureaucrats and the Politics of War, Toronto: HarperCollins
Publishers Ltd., 2009:293.
13
18
pharmaceuticals to those most in need. Healthcare must become a priority in these countries
if better health is to be achieved. For example, local tariffs (as high as 24% in some cases) and
taxes on healthcare products should be removed. These tariffs and taxes are two of the real
barriers to access to innovative medicines in developing countries 15. Canada, the United
States, the United Kingdom and other nations, as always, must be willing to stand by and help
those countries who are seen to be helping themselves.
There is a serious shortage of healthcare professionals and those that do exist, exist mainly in
the cities. Frontline, indigenous healthcare personnel are needed to assist in the very basic
provision of immunizations, healthy baby and mother checks, and health promotion
throughout the countryside of developing countries. Yet health human resources are in
disarray and decline in most of the least developed countries. Even though Africa suffers 25%
of the global burden of disease the continent only has 3% of the world’s supply of health
workers. Africa needs 800,000 doctors and nurses. The healthcare infrastructure has totally
collapsed in sub-Saharan Africa. The stigma of HIV/AIDS, the low status of women, and the
absence of potable water make the effective use of medicines problematic. According to
the International Development Research Centre (IDRC) of CIDA (the Canadian International
Development Agency) the disparity between the financial commitments that are needed
even for a minimal package of essential healthcare interventions and current levels of
development assistance calls into serious question the likelihood of achieving health-related
goals.
Above all is the lack of political will to create stable, ethical, and law-abiding government
administrations that will ensure products arrive where they are destined without delay,
diversion, theft or unnecessary tariffs. When drugs are shipped to countries in need they often
sit in warehouses until “fees” have been paid and sometimes the shipments are stolen, sold on
the black market, or even re-exported for profit.
Regrettably, global bodies continue to ignore the reality of delivering drugs in developing
countries and, in particular, the least developed countries; they attack IP and ignore the onthe-ground realities16. In many countries adequate roads, transport facilities and equipment
simply do not exist when and where needed. Tolls, fees, charges, and taxes all slow the
delivery process. Theft of product and diversion into black markets is common. Lack of
security, law enforcement, regulation and legitimate government presence all contribute to a
very difficult delivery reality in much of the South that has gone totally unnoticed by world
assemblies and their agencies.
International Centre for Trade and Sustainable Development, “WTO, WHO and WIPO Vow Cooperation on Access to Medicines, but Challenges Remain,” Intellectual Property Programme, Vol. 14,
No. 27, 21 July 2010.
16 For example see: Alec Irwin and Eva Ombaka, Background Paper of the Task Force on Major Diseases
and Access to Medicines, Subgroup on Essential Medicines, United Nations Development Programme’s
Millennium Project, April 18, 2003
15
19
Foreign aid for healthcare in African countries more than doubled from USD8 billion in 1995 to
USD19 billion in 2006. Yet for every aid dollar sent to African governments for healthcare those
same African governments divert USD1.14 of their own resources to other areas.17
At the African Union Summit in July 2010, it was reported by WHO that only six member
countries had met their 2001 pledge to invest 15% of their national output in healthcare.
Developing countries need to develop their own strategic plans to deal with major public
health problems and invest in the determinants of health such as poverty, potable water,
pollution, peace and the education of women.
Much work needs to be done in formulating new economic models, trade frameworks and
financing schemes by which the private sector can partner with governments and NGOs to
not only deliver drugs to those in need but to create the sort of infrastructure, to develop the
needed personnel, and to evolve the legal and administrative institutions required to improve
patient care and health outcomes on a sustainable basis over the longer term. Only then will
there be health for all in this world.
Conclusion
Based upon the evidence contained in this report, The Cameron Institute believes that both
industrialized and developing countries must adopt, adhere to, comply with and respect
existing IP laws, rules and regulations. Developing countries, with the assistance of developed
countries, must create a parallel oversight capacity, where there is none today, to manage IP
in their countries. A universal IP regime will be integral to any concerted effort to promote
global health and healthcare through public-private partnerships or any other proven means –
simply put, there is no effective substitute for patents. 18 Any attempts to undermine IPP will
only pit the North against the South – and that would be just wrong. Statism and paternalism
will only stifle the improvement of the health of those living in the least developed countries of
the world; the evidence in this report strongly supports North-South, public-private partnerships
as the preferred means by which to deliver health to all.
Access to medicines and innovation are not and cannot be mutually exclusive; without
access, innovation is meaningless; without innovation, there is nothing to access. The
symmetry amongst innovation, free markets, protection of intellectual property, and
democratic societies is no mistake. Patents and other forms of intellectual property protection
are just simple, albeit very powerful, devices by which innovation is optimally incented in free
societies. It is no accident that the lion’s share of the world’s innovativeness comes from
democratic stalwarts like the United States, Canada and the United Kingdom. And the key to
this success has been private property – in this case, patents and other protective devices.
Alec Van Gelder, “How to Worsen Africa’s Health Crisis”, WSJ Europe, August 29, 2010.
Richard A. Epstein and A. Scott Kieff, Questioning the Frequency and Wisdom of Compulsory
Licensing for Pharmaceutical Patents, 14.
17
18
20
Public-private partnerships have been very successful in increasing access to needed
medicines by the least developed countries of the world. The real barriers to access are not
patents but on the ground. Based upon the evidence presented in this report it is concluded
that Paragraph 6 of TRIPS is not required in today’s world.
21
An Annotated Catalogue
of Public-Private Partnerships
that Provide Access to Pharmaceuticals
in Least Developed Countries
22
INITIATIVES TO IMPROVE HIV/AIDS ANTIRETROVIRAL (ARV) ACCESS
1. AAI - Accelerating Access Initiative
Disease area(s): HIV/AIDS
Company (ies): Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead,
GlaxoSmithKline, Merck & Co. Inc., Pfizer, Roche, Tibotec
Partner(s): UNAIDS, UNFPA, UNICEF, WHO, World Bank
Since 2000
Programme type(s): Access - Pricing
Developing country(ies): Developing countries
Established in 2000, the Accelerating Access Initiative (AAI) involves nine research-based
pharmaceutical companies: Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead
Sciences, GlaxoSmithKline, Pfizer, Tibotec, Roche, and Merck & Co., Inc, and five United
Nations partners: UNAIDS, the World Health Organization, World Bank, UNICEF, and the United
Nations Population Fund (UNFPA).
Data on patients receiving treatment with ARV medicines provided by the AAI companies:
"
The total number of patients receiving treatment from the AAI companies in 2008
increased by 77 percent from the previous year, with over 403, 000 people treated with
ARVs supplied by the AAI companies during that time.
"
In Africa alone, over 446,000 patients are being treated with medicines supplied by the
AAI companies. This increase of more than 116 percent from the previous year results in
a 45-fold increase in the number of people being treated with ARVs supplied by the AAI
companies in Africa since the establishment of the AAI in May 2000.
"
As of 30 September 2008, some 773,803 patients in developing countries were
estimated to be taking one or more medicines supplied at preferential prices by an AAI
company.
AAI companies also recognize that expanded access to medications requires a collaborative
approach with governments, NGOs, multilateral organizations, and other public and private
bodies. Many AAI companies are involved in initiatives to strengthen healthcare systems,
streamline product registrations, and conduct clinical studies in developing countries. AAI
companies also continue to invest significantly in research and development of new
medications - including paediatric formulations - and diagnostics, to help combat the global
HIV/AIDS pandemic.
23
2. Abbott Programme for Expanding Access to Treatment
Disease area(s): HIV/AIDS
Company(ies): Abbott
Partner(s): Various partners
Since 2001
Programme type(s): Access - Pricing
Developing country(ies): Africa, Least developed countries, low & lowermiddle income countries
In 2002, Abbott made a commitment to sell its HIV medicines at USD 500 per patient per year
in Africa and least developed countries (Least developed countries), as defined by the United
Nations. In 2006, Abbott announced that the heat-stable lopinavir/ritonavir tablet would also
cost USD 500 per patient per year in Africa and the least developed countries.
In April 2007, Abbott announced a reduction in the mid-tier price to USD 1,000 per patient per
year for middle income countries also.
24
3. Viramune® Donation Programme
Disease area(s): HIV/AIDS
Company(ies): Boehringer Ingelheim
Partner(s): Governments in most recipient countries
Since 2000
Programme type(s): Access - Donation & Pricing
Developing country(ies): 59 developing countries
As part of its policy to extend access to Viramune®, Boehringer Ingelheim offers its
antiretroviral product Viramune® (nevirapine) for single-dose use in the prevention of motherto-child transmission (PMTCT) for free through the Viramune® Donation Programme. So far,
around 1.7 million mother/child doses have been made available to 169 programmes in 59
countries.
For chronic treatment, Boehringer Ingelheim charges a substantially reduced price for all
countries as low income, all least developed countries and for all countries in sub-Saharan
Africa - a total of 78 countries. In addition, all middle income countries qualify for a lowered
price (63 countries).
Since 2000, Boehringer Ingelheim has given free access to single-dose Viramune®
(nevirapine), to be used alone or in combination with other drugs, to prevent mother-to-child
transmission of HIV during birth. The company is currently donating the product to 59 countries
in Africa, Asia, Latin America and Eastern Europe. In total more than 885, 000 mother and child
doses were supplied free of charge so far.
25
4. Bristol-Myers Squibb Global Access Programme
Disease area(s): HIV/AIDS
Company(ies): Bristol-Myers Squibb (BMS)
Partner(s): Various partners, including Health Ministries
Since 2001
Programme type(s): Access - Pricing
Developing country(ies): Africa & least developed countries
In 2001, BMS announced that it would provide all of its HIV medicines at no-profit prices in subSaharan Africa, because of the extreme burden of disease there, combined with the region's
limited ability to pay for HIV medicines.
In July 2005, the company announced a further reduction in the price of paediatric
formulations from no-profit to significantly below cost in an attempt to reduce all barriers
hampering accelerated, broad access to treatment for the millions of children in sub-Saharan
Africa who need these medicines most.
BMS has also implemented a differential pricing policy globally, to enable collaboration with
and support for government activities in regions with high incidence and low ability to pay for
HIV medicines.
26
5. Gilead Access Programme
Disease area(s): HIV/AIDS
Company(ies): Gilead
Partner(s): Various partners
Since 2003
Programme type(s): Access - Pricing
Developing country(ies): least-developed countries
Gilead has developed a tiered pricing system for its HIV medicines, including Viread®
(tenofovir disoproxil fumarate) and Truvada® (emtricitabine and tenofovir disoproxil fumarate),
based on a country's economic status and HIV prevalence. It offers substantial price
reductions through its Access Programme in 130 countries, representing two-thirds of the
countries in the world, and the regions hardest hit by the AIDS epidemic.
Highlights
•
More than 700,000 patients receiving HIV treatment
•
130 countries in the Access Programme
•
Majority of patients on Gilead therapies live in developing countries
•
Partnerships with 14 Indian and South African generic manufacturers
•
Price of generic Viread® is USD 7.25/month
The company has established an innovative access model that has significantly increased the
number of developing world patients receiving the company’s HIV treatments – from just 100
people in 2003 to more than 700,000 in 2010. Today, the majority of people who benefit from
Gilead’s HIV therapies live in developing countries.
27
6. GlaxoSmithKline Access to ARVs
Disease area(s): HIV/AIDS
Company(ies): GlaxoSmithKline (GSK)
Partner(s): Various partners
Since 1997
Programme type(s): Access - Pricing
Developing country(ies): 37 developing countries
GlaxoSmithKline has offered sustainable preferential pricing for certain antiretrovirals (ARVs)
since 1997. All its ARVs are now available at no-profit prices to public sector customers and
not-for-profit organizations in all least developed countries and all of sub-Saharan Africa - 64
countries in total. In addition, all private employers in sub-Saharan Africa who provide care
and treatment to their uninsured staff can purchase its ARVs at no-profit prices. All CCM
(country coordinated mechanism) projects fully funded by the Global Fund to fight AIDS, TB
and malaria, and projects funded by the US President's Emergency Plan for AIDS Relief
(PEPFAR), are also eligible.
GSK's prices are sustainable - it does not make a profit on them, but it does cover its costs. This
means that it can sustain supply of these high-quality products for as long as they are needed.
In February 2008, GSK introduced significant new price reductions averaging 21% across the
range of its ARVs. The most significant reduction, of almost 40%, was on Ziagen® oral solution
(abacavir), which is recommended by the World Health Organization (WHO) for use in first-line
and second-line regimens within resource-limited settings, particularly for children. Combivir®
was reduced by 17% to USD 0.54 per day.
During 2008, GSK supplied ARVs at no-profit prices to 37 countries, compared to 31 in 2007.
GSK shipped 11.4 million tablets of no-profit Combivir® and 58.6 million tablets of no-profit
Epivir® to the developing world in 2008 compared with 13 million and 72 million tablets
respectively in 2007. In 2008, GSK licensees supplied more than 279 million tablets of their
versions of Epivir® and Combivir® to Africa.
The cost to the Indian economy is estimated to exceed USD 840m every year due to treatment
costs, reduced working time and lost productivity. The Nashik facility will potentially save the
Indian health system an estimated Rs. 1.38 billion (USD 30 million) in treatment costs and
improve lives of 550 million people in India who live at risk of developing this debilitating
condition.
28
7. Access to ARVs
Disease area(s): HIV/AIDS
Company(ies): Merck & Co. Inc.
Partner(s): Various governments and NGOs
Since 2001
Programme type(s): Access - Pricing
Developing country(ies): Developing countries
Since 2001, Merck & Co., Inc. has had a differential pricing policy whereby it provides its
antiretroviral medicines (ARVs) at no-profit prices in least developed countries and those
hardest hit by the AIDS pandemic.
Merck's ARV pricing policy applies to all of the company's ARVs: Crixivan™, Stocrin™, Atripla™
and Isentress™. For each product, Merck offers its lowest price - a price at which Merck does
not profit - to the world's least developed countries and those countries hardest hit by the
HIV/AIDS pandemic, as measured by adult HIV prevalence.
For the most economically-developed countries, Merck applies competitive, market-based
principles in pricing its ARV products.
As of July 2008, more than 777,000 patients in 125 countries and territories were being treated
with regimens containing at least one of Merck's ARVs. Four out of five (81%) - or an estimated
631,000 patients - obtained these ARVs in the more-than-80 countries where they are sold at a
price at which Merck does not profit.
An additional 7% received Merck ARVs in countries where they are offered at significantly
discounted prices. Nine out of ten patients using Merck ARVs live in developing countries in
Africa, Asia, Latin America and the Caribbean where the pandemic is having its most
devastating impact. Of those being treated with Merck ARVs, there are an estimated 96,600
children using paediatric formulations, representing 13% of all patients on Merck ARVs.
29
8. Access to ARVs
Disease area(s): HIV/AIDS
Company(ies): Roche
Partner(s): Various partners
Since 2002
Programme type(s): Access - Pricing
Developing country(ies): All low and lower-middle income countries
Roche supplies its HIV protease inhibitors, Invirase® and Viracept® (including paediatric
powder), at no profit prices for people living in least developed countries (as defined by the
United Nations and appended at the end of this report) and in sub-Saharan Africa. These
prices are the lowest at which these medicines can be provided in a sustained, long-term
manner, and have been shown to be similar or less than that of generic versions of the
medicine.
In addition, Roche established significantly reduced pricing for Invirase® and Viracept® for low
and lower middle income countries (as defined by the World Bank), where there is need for
access to HIV/AIDS treatments, and where local governments are able to play a greater role
and make a more significant contribution towards the provision of public healthcare. The
reduced prices apply to 88% of all people living with HIV/AIDS worldwide.
The Cambodia Treatment Access Programme (CTAP)
Launched in September 2003, the Cambodia Treatment Access Programme (CTAP) is a
public-private partnership between the Cambodian Ministry of Health, the National Centre in
HIV Epidemiology and Clinical Research at the University of New South Wales, Australia, and
Roche. Cambodia is thought to have the highest rate of adult HIV infection in Asia. CTAP aims
to increase access to essential treatments for HIV/AIDS and provide training for local
healthcare professionals.
As part of CTAP, a new outpatient treatment centre for patients with HIV/AIDS has been
opened in Cambodia’s capital, Phnom Penh. The centre provides counseling, clinical care
and HIV therapy, and supports HIV training and research.
By 2006, CTAP had enrolled more than 1,200 people for free treatment thanks to Roche’s
support. In September 2006, Roche funded a training event for 400 healthcare professionals
from all over Cambodia to expand their knowledge and share experiences of treating
HIV/AIDS.
30
9. Single Tablet per Day
Disease area(s): HIV/AIDS
Company(ies): Bristol-Myers Squibb, Gilead, Merck & Co. Inc.
Partner(s): Ministries of Health
Since 2003
Programme type(s): Access - Pricing
Developing country(ies): Developing countries
In August 2006, Gilead and Merck announced an agreement for the distribution of Atripla® in
106 developing countries around the world where convenient treatment options are critical to
patient compliance and adherence to therapy. Gilead is manufacturing Atripla® using
efavirenz supplied by Merck, and Merck is distributing Atripla® in these markets.
In all of the developing countries, Atripla® is being sold at significantly discounted prices. As of
April 1, 2008, 55 countries - including most in sub-Saharan Africa - had either granted
regulatory approval for Atripla® or allowed the product to be imported. Tens of thousands of
patients are already benefitting from this first-of-its-kind fixed dose combination ARV.
31
10. Technology Transfer & ARV Licensing in Developing Countries
Disease area(s): HIV/AIDS
Company(ies): Boehringer
Ingelheim,
Bristol-Myers
GlaxoSmithKline, Merck & Co. Inc., Roche
Partner(s): Various generic pharmaceutical manufacturers
Squibb,
Gilead,
Since 2001
Programme type(s): Access - Licensing
Developing country(ies): Kenya, India, South Africa
Since 2001, Bristol-Myers Squibb has had a policy of not enforcing its patents for HIV products in
sub-Saharan Africa and has immunity from suit agreements for stavudine and didanosine with
five African generic companies.
In February 2006, it concluded technology transfer agreements with generic companies
Aspen PharmaCare (South Africa) and Emcure Pharmaceuticals (India), for its newest
antiretroviral, atazanavir (sold as Reyataz® in the US).
Bristol-Myers Squibb has transferred intellectual property and technical know-how related to
the manufacturing, testing, packaging, storage and handling of the active pharmaceutical
ingredient and finished dosage form.
Gilead has partnered with Aspen Pharmacare, South Africa to manufacture and distribute
branded and generic versions of Viread® and Truvada® in Africa. In 2006, Gilead also entered
into non-exclusive licensing agreements with 10 Indian generic companies, allowing them to
distribute generic versions of tenofovir in 95 developing countries, including Thailand. Matrix,
India, has received tentative FDA approval for its generic tenofovir and tenofovir-lamivudine
fixed-dose combination, and Aurobindo has received tentative FDA approval for its generic
tenofovir.
GSK's licensees supplied 279 million tablets of their versions of Epivir® and Combivir® to Africa
in 2008. This represents more than 50% growth over 2007 and 130% more than in 2006. This trend
is welcome as it gives customers in sub-Saharan Africa greater choice and contributes to
better security of supply.
Agreements have been signed with 10 companies in Bangladesh, Ethiopia, Kenya, South
Africa, Tanzania and Zimbabwe. Expressions of interest have been received from 40 more
companies in 17 eligible countries and assessment visits have been conducted with 38 of
these potential partners.
32
11. AmpliCare Programme
Disease area(s): HIV/AIDS
Company(ies): Roche
Partner(s): William J. Clinton Presidential Foundation
Since 2002
Programme type(s): Capacity Building - Support & Training
Developing country(ies): Sub-Saharan Africa, South America and the least
developed countries
The AmpliCare programme began in 2002 and supplies HIV viral load tests at the lowest
possible price to sub-Saharan Africa, South America and the least developed countries as
defined by the UN. AmpliCare also offers an education programme to keep local doctors and
nurses fully informed about the latest advances in HIV/AIDS care.
In 2008, in sub-Saharan Africa, 450,000 infants were tested for HIV and an estimated 560,000
patients had their HIV/AIDS treatment monitored.
12. CARE [The Cohort to evaluate Access to antiretroviral treatment and Education]
Disease area(s): HIV/AIDS
Company(ies): Roche
Partner(s): PharmAccess Foundation
Since 2001
Programme type(s): Capacity Building - Support & Training
Developing country(ies): Africa and Asia
Since 2001, the CARE programme has provided a forum for healthcare professionals across
Africa, and more recently Asia, to meet and discuss their experiences of managing HIV/AIDS,
with the aim of helping to improve the care and treatment offered in their own countries.
Since the start of the CARE programme in 2001, the HIV/AIDS management exchange
meetings have brought together more than 600 healthcare workers – including doctors,
nurses, counselors, pharmacists and laboratory managers – from over 29 countries in Africa
and Asia.
33
INITIATIVES FOR MOTHER AND CHILD PROGRAMMES
1. Abbott Fund Programme for Supporting Children Affected by AIDS
Disease area(s): HIV/AIDS
Company(ies): Abbott
Partner(s): Baylor College of Medicine in USA, Catholic Medical Mission Board
CMMB, Elizabeth Glaser Paediatric AIDS Foundation EGPAF, Academic Model
for Prevention and Treatment of HIV/AIDS , Partners In Health, Family Heath
International.
Since 2000
Programme type(s): Capacity Building - Support & Training
Developing country(ies): 10 developing countries on 3 continents
The Abbott Fund is partnering with several organizations to expand access to healthcare for
mothers and children affected by HIV/AIDS in developing countries. Since 2001, more than 1
million children and adults have received services in Burkina Faso, India, Kenya, Malawi,
Romania, Tanzania and Uganda.
Baylor and the Abbott Fund also partnered to establish the Baylor Children's Clinical Centres of
Excellence Network to train health professionals who together treat 30,000 children - the
largest number of children with HIV in any treatment programme worldwide.
The Abbott Fund is working with the Catholic Medical Mission Board (CMMB) to help prevent
mother-to-child HIV transmission in 100 health facilities in Kenya. Through the partnership,
testing, care and treatment will be provided to pregnant women and exposed infants.
The Abbott Fund-Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) partnership in Tanzania
and Uganda is working to accelerate enrollment of HIV-infected children into care and
treatment programmes, and to train and support healthcare workers.
The Abbott Fund and Family Health International (FHI) are partnering in Tanzania and Malawi
to reduce mother-to-child HIV transmission and expand access to HIV care and treatment for
children.
The Abbott Fund works with AMPATH (also known as the Indiana University-Moi University,
Kenya Partnership) in Kenya to prevent HIV infections through testing, counseling (primarily
home-based), education and treatment.
34
2. Bristol-Myers Squibb’s Secure The Future® Children´s Clinics & Paediatric AIDS Corps
Disease area(s): HIV/AIDS
Company(ies): Bristol-Myers Squibb
Partner(s): Baylor College of Medicine in USA
Since 1999
Programme type(s): Capacity Building - Support & Training
Developing country(ies): Botswana, Burkina Faso, Kenya, Lesotho, Malawi,
Swaziland, Tanzania, Uganda.
This centre now has more than 1,500 children under treatment. Additional children’s clinical
centres have now been opened in Lesotho, Swaziland and Uganda. These centres add
capacity to fight HIV/AIDS by providing modern facilities for testing, treating and
monitoring children and their families, as well as training local healthcare professionals.
To increase the number of trained paediatric specialists, Secure The Future® and Baylor
College of Medicine created the Paediatric AIDS Corps, which will send 50 doctors a year
over five years to Africa to treat some 100,000 children and train local healthcare
professionals. The first class of 50 doctors arrived in Africa in August 2006. Additional Secure The
Future® projects provide education, psychosocial care and support for orphans and
vulnerable children, training, food security and income-generating projects for caregivers; and
work to reduce stigma and encourage testing.
Since 1999, Bristol-Myers Squibb and the Bristol-Myers Squibb Foundation have committed USD
150 million to develop and replicate innovative and sustainable solutions for vulnerable
populations, including women and children, infected and affected by HIV/AIDS in subSaharan Africa.
35
3. Elizabeth Glaser Paediatric AIDS Foundation
Disease area(s): HIV/AIDS
Company(ies): Abbott, Boehringer Ingelheim, Johnson & Johnson (J&J)
Partner(s): EGPAF
Since 1988
Programme type(s): Access - Donation, Capacity Building - Training, Education
Developing country(ies): 17 developing countries
The Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) was set up in 1988 to prevent
paediatric HIV infection and to eradicate paediatric AIDS through research, advocacy,
prevention and treatment programmes.
It works in two broad programme areas: HIV/AIDS Research and Training Programmes, and
International Family AIDS Initiatives. The Abbott Fund, Boehringer Ingelheim and Johnson &
Johnson are major supporters of EGPAF and its work.
EGPAF
collaborates
with
host
governments,
international
healthcare
facilities,
non-
governmental organizations and community-based organizations to plan, implement and/or
expand programmes. It also provides technical assistance and support for community
mobilization and training of healthcare workers, HIV counseling and testing, mother-to-child
prevention regimes and infant feeding education.
As of September 2008, EGPAF had reached more than 6.3 million women with access to
“preventing mother to child transmission” (PMTCT) services and almost 6.2 million have been
counseled. Among these, more than 5.3 million individuals have been tested, 510,000
identified as HIV-positive, and ARV prophylaxis has been provided to over 480,000 women and
over 280,000 infants.
J&J has partnered with the EGPAF since 2003 and now has expanded to 770 sites in six
countries. As of June 2007, the EGPAF-J&J PMTCT Partnership has directly contributed to
reaching more than 860,000 women with counseling, providing nearly 760,000 women with HIV
testing, and administering ARV prophylaxis to over 39,000 HIV-positive mothers.
Total money spent in 2008 was close to USD 103 million, which represent 87% of total revenue.
Administrative cost was just 10% of total revenue (USD 120 million dollars), which shows the high
commitment and high efficiency with which the programme is being conducted.
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4. Life Skills Community Support for Children Affected by HIV/AIDS
Disease area(s): HIV/AIDS
Company(ies): Johnson & Johnson
Partner(s): Life Skills Development Foundation
Since 2005
Programme type(s): Capacity Building - Training, Education
Developing country(ies): Thailand
There are some 150,000 AIDS orphans in the Upper Northern region of Thailand. From
economic struggle and emotional hardship to social stigma and isolation, they face many
problems. The Life Skills Development Foundation, a NGO that provides life skills education and
training for children, youth, women and families, works in many districts to reach children
affected by HIV/AIDS. With the help of Johnson & Johnson, the foundation provides assistance
to these children and their caregivers through HIV/AIDS education, psychological and
financial support, and community education.
Out of total expenses of USD 22 million, only 10% was administration costs and the rest went
into implementing the various aspects of the programme.
37
5. Abbott Rapid HIV Test Donation Programme
Disease area(s): HIV/AIDS PMTCT
Company(ies): Abbott
Partner(s): Various partners
Since 2002
Programme type(s): Access - Donation
Developing country(ies): 39 countries - including all of Africa
Each year, approximately 370,000 babies around the world become infected with HIV during
their mothers' pregnancy, during birth or through breastfeeding. Enabling pregnant women to
know their HIV status before they give birth is the first step in preventing mother-to-child
transmission (PMTCT) of HIV.
To facilitate access to rapid HIV testing, Abbott has made a commitment to donate a rapid
(15 minute) HIV test to PMTCT programmes in 69 countries, including all of Africa and the least
developed countries, as defined by the United Nations. Abbott also has extended its PMTCT
donations to include testing of spouses and children of pregnant women who are found to be
HIV positive through the programme.
To date, Abbott has donated more than 11 million rapid HIV tests in 39 countries: Angola,
Benin, Botswana, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic,
Chad, Côte d'Ivoire, Djibouti, Democratic Republic of Congo, Ethiopia, Gabon, Ghana,
Guinea Bissau, Guinea, Haiti, Kenya, Laos, Lesotho, Liberia, Madagascar, Malawi, Mali,
Mozambique, Namibia, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Africa,
Swaziland, Tanzania, Togo, Uganda, Zambia and Zimbabwe.
38
6. Viramune® Donation Programme
Disease area(s): HIV/AIDS PMTCT
Company(ies): Boehringer Ingelheim
Partner(s): EGPAF, Governments, Rotary International, UNICEF
Since 2000
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): 60 developing countries
Boehringer Ingelheim's Viramune® Donation Programme was announced in July 2000 as a
programme that offers the antiretroviral medicine Viramune® free-of-charge to developing
countries and has been designed for prevention of mother-to-child transmission (PMTCT) of
HIV-1. There are 114 countries eligible according to the World Bank list of developing and
transient economies.
Boehringer Ingelheim donates Viramune® in accordance with the WHO Guidelines for
Medicine donations, free of charge, based on the expressed interest of governments, NGOs,
charitable organizations or other healthcare providers with comprehensive mother-to-child
transmission prevention programmes. As well as Viramune® tablets and suspension, the
donation includes oral syringes for the paediatric dose and pouches in which filled oral
syringes can be taken home by mothers.
Partners: Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), Rotary International, United
Nations Children´s Fund (UNICEF), Angola Ministry of Health, Antigua and Barbuda Ministry of
Health, Benin Ministry of Health, Botswana Ministry of Health, Burundi Ministry of Health, Burkina
Faso Ministry of Health, Cameroon Ministry of Health, Central African Republic Ministry of
Health, China Ministry of Health, Côte d'Ivoire Ministry of Health, Democratic Republic of
Congo Ministry of Health, Dominican Republic Ministry of Health, Djibouti Ministry of Health,
Ecuador Ministry of Health, Eritrea Ministry of Health, Ethiopia Ministry of Health, Gabon Ministry
of Health, Gambia Ministry of Health, Ghana Ministry of Health, Guyana Ministry of Health,
Honduras Ministry of Health, Indonesia Ministry of Health, Jamaica Ministry of Health, Laos
Ministry of Health, Lesotho Ministry of Health, Liberia Ministry of Health, Kenya Ministry of Health,
Malawi Ministry of Health, Mali Ministry of Health, Mozambique Ministry of Health, Madagascar
39
Ministry of Health, Namibia Ministry of Health, Niger Ministry of Health, Nigeria Ministry of Health,
Papua New Guinea Ministry of Health, Peru Ministry of Health, Russia Ministry of Health, Rwanda
Ministry of Health, Senegal Ministry of Health, Sierra Leone Ministry of Health, South Africa
Ministry of Health, Swaziland Ministry of Health, Tanzania Ministry of Health, Togo Ministry of
Health, Ukraine Ministry of Health, Uganda Ministry of Health, Vietnam Ministry of Health,
Zambia Ministry of Health, Zimbabwe Ministry of Health
Countries: Angola, Antigua and Barbuda, Benin, Botswana, Burundi, Burkina Faso, Cambodia,
Cameroon, Central African Republic, Chad, China, Côte d'Ivoire, Republic of Congo,
Democratic Republic of Congo, Dominican Republic, Djibouti, Ecuador, Eritrea, Ethiopia,
Gabon, Gambia, Georgia, Ghana, Guinea-Bissau, Guinea, Guyana, Haiti, Honduras,
Indonesia, Jamaica, Laos, Lesotho, Liberia, Kazakhstan, Kenya, Malawi, Mali, Mozambique,
Madagascar, Namibia, Niger, Nigeria, Papua New Guinea, Peru, Russia, Rwanda, St. Vincent
and the Grenadines, Senegal, Sierra Leone, South Africa, Suriname, Swaziland, Tanzania, Togo,
Ukraine, Uganda, Vietnam, Zambia, Zimbabwe
40
7. Abbott Fund Programme to Strengthen Tanzania's Healthcare System
Disease area(s): HIV/AIDS
Company(ies): Abbott
Partner(s): Tanzania Ministry of Health
Since 2003
Programme type(s): Access - Donation, Capacity Building - Support & Training
Developing country(ies): Tanzania
The Abbott Fund and the Government of Tanzania have formed a unique public-private
partnership to modernize the country's healthcare system. In total, Abbott has invested more
than USD 60 million in Tanzania.
More than 15,000 healthcare workers have been trained or re-trained to date in Tanzania. At
Muhimbili, 200 physicians now serve as trainers for other health staff. More than 250 staff has
been trained in lab equipment operation, while 600 senior doctors and hospital directors have
received management training.
Facilities, systems and training have been upgraded at 90 sites throughout the country to
improve voluntary counseling and testing (VCT) services. Due to these improvements, more
than 300,000 people have received VCT services. The Abbott Fund also donated 1 million HIV
tests to President Kikwete's National Testing campaign. The Abbott Fund is modernizing all 23 of
the country's regional hospital laboratories; the project was launched in 2008 and is expected
to be completed in 2010.
The Abbott Fund is working with the Touch Foundation to support 105 lab technology students
pursuing university degrees, and also is providing funds to upgrade the laboratory at Bugando
Medical Centre, a referral hospital for a population of 13 million in the Lake Zone.
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8. African Comprehensive HIV/AIDS Partnerships (ACHAP)
Disease area(s): HIV/AIDS
Company(ies): Merck & Co. Inc.
Partner(s): Bill and Melinda Gates Foundation, Botswana Ministry of Health
Since 2000
Programme type(s): Access - Donation, Capacity Building - Support & Training,
Education
Developing country(ies): Botswana
The African Comprehensive HIV/AIDS Partnerships (ACHAP) was established in 2000 by the
Government of Botswana, The Merck Company Foundation/Merck & Co., Inc. and the Bill &
Melinda Gates Foundation, to support and enhance Botswana's response to the HIV/AIDS
epidemic through a comprehensive approach to prevention, care, treatment and support.
The two foundations have each committed USD 56.5 million to the partnership and Merck is
donating its antiretroviral (ARV) medicines to Botswana's national ARV treatment programme,
Masa (New Dawn), for the partnership's duration.
As of April 2008, more than 100,000 people were receiving ARV treatment. The programme has
strengthened local healthcare infrastructure, transferred technical skills, and supported the
development of laboratory capacity, which has grown to enable more than 20,000 patients
per year to be tested.
The partnership has worked with Harvard University and the Botswana Ministry of Health to
provide training for more than 5,500 of Botswana's healthcare workers, while more than 3,200
physicians, nurses and other healthcare professionals have received hands-on, clinic-based
training through the partnership's preceptorship programme.
In 2007, ACHAP expanded its support to target co-infection of HIV and tuberculosis (TB), as 6086% of TB patients in Botswana are HIV positive, and TB is the leading cause of death among
adult AIDS patients.
42
9. GlaxoSmithKline's Positive Action on HIV/AIDS
Disease area(s): HIV/AIDS
Company(ies): GlaxoSmithKline
Partner(s): AMREF, CRS, EGPAF, IHAA, NEPHAK
Since 1992
Programme type(s): Capacity Building - Support & Training, Education
Developing country(ies): 21 developing countries
Positive Action is helping the Reach India project to make HIV/AIDS prevention, financial and
business education available to millions of poor women in rural India. GSK is giving USD 595,000
over four years to develop the capacity of community organizations and self-help groups to
reach 500,000 women and 2.5 million family members in rural areas. Reach India is a Freedom
from Hunger project, supported by Catholic Relief Services (CRS) and Positive Action.
In Kenya, GSK is giving USD 2.2 million over four years to integrate HIV/AIDS treatment and
support services into 38 general healthcare clinics, to enable patients to avoid the stigma of
visiting an HIV clinic. Fewer than 10% of Kenyans know their HIV status and fear of
stigmatization is a significant barrier to seeking testing. Positive Action also helps to train
healthcare professionals and create patient self-help groups, to increase awareness and
adherence to treatment. Other partners include the African Medical and Research
Foundation (AMREF), Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) and the National
Empowerment Network of People Living with HIV and AIDS in Kenya (NEPHAK).
In Mexico, GSK is working on a four-year project with the International HIV/AIDS Alliance (IHAA)
and its Mexican partner, Colectivo Sol, to improve quality of life for people with HIV/AIDS,
reduce stigma and discrimination, and educate people about HIV/AIDS.
Partners: African Medical and Research Foundation (AMREF), Catholic Relief Services (CRS),
Colectivo Sol, Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), International HIV/AIDS
Alliance (IHAA), Foundation for AIDS Research (amfAR), National Empowerment Network of
People Living with HIV and AIDS in Kenya (NEPHAK), Positive Action
Countries: Belize, Botswana, Cambodia, China, India, Indonesia, Jamaica, Kenya, Mexico,
Nigeria, Philippines, Romania, Russia, Rwanda, South Africa, Ukraine, Thailand, Vietnam
43
10. GSK - Other HIV/AIDS Capacity-Building Initiatives
Disease area(s): HIV/AIDS
Company(ies): GlaxoSmithKline
Partner(s): AMREF & other partners
Since 1998
Programme type(s): Capacity Building - Support & Training, Education
Developing country(ies): 17 African countries
Since 1998, the GSK France Foundation has supported 86 programmes to improve healthcare
through prevention, education and training in 14 developing countries.
During 2007, nine new programmes were implemented in five countries with grants of USD
1,091,461. The GSK Foundation Canada also supports community programmes in Africa,
including AIDS Orphans Uganda, working with the African Medical Research Foundation
(AMREF).
GSK supports community programmes in Botswana, Cote d'Ivoire, Democratic Republic of
Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Namibia, Nigeria, Senegal, South
Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. These provide treatment for
HIV/AIDS patients, counseling and testing, home-based care, training for healthcare
professionals and community volunteers, life skills training for orphans, hospice care, day care
centres, feeding schemes, as well as support for basic primary healthcare and HIV/AIDS clinics.
For example, GSK has supported the AIDS Care Treatment and Support (ACTS) initiative in
Masoyi, South Africa, since 1999. GSK provided funds to buy land, build a dedicated HIV/AIDS
primary healthcare clinic and training centre, and to cover all running costs for the first three
years. The ACTS clinic opened in May 2001 and by the end of 2007 more than 20,000 patients
had entered its doors. It is now a specialist HIV primary care clinic, complemented by a homebased care team and an eight-bed community hospice. There are currently 1,700 patients on
ARVs, 100 of which are children under 12. Nearly 2,000 patients are seen each month.
44
In 2004, GSK's US Business launched a project called “Hope after HIV: Africa”. Through the
Children's AIDS Fund, GSK has helped open six clinics in Uganda, Malawi, Zambia and South
Africa that have treated more than 9,000 HIV/AIDS patients. The sponsored clinics offer testing,
medicines, education, mother-to-child transmission care, counseling and follow-up. Patients
are also supported by more than 1,500 volunteers who provide adherence counseling, disease
education for family members and palliative care.
GSK has also established the “Hope after HIV Fund”, a charitable programme that allows
employees and others to donate funds to support life-enhancing, non-medical needs of
patients receiving care at the clinics. The fund has been used to improve nutrition and
generate income for patients and their families; provide bicycles, pumps and refrigerators;
provide education for promising young HIV-positive people.
45
11. Merck & Co., Inc. HIV/AIDS Programmes - Africa
Disease area(s): HIV/AIDS
Company(ies): Merck & Co. Inc.
Partner(s): Various partners - including universities and NGOs
Since 1998
Programme type(s): Capacity Building - Training, Education
Developing country(ies): 24 African countries
Since 2006, Merck & Co., Inc. has supported the Health Economics and HIV/AIDS Research
Division (HEARD) of the University of KwaZulu-Natal, South Africa in a study of factors
influencing participation rates, voluntary counseling and testing services. Merck has supported
the Regional AIDS Initiative of Southern Africa (RAISA), a project of Voluntary Services Overseas
(VSO), since 2002 to strengthen the capacity of in-country partners to respond to the HIV and
AIDS pandemic by providing the building blocks to develop programmes and coordinate
efforts. In 2008, Merck helped RAISA launch the "Glove Campaign" aimed at protecting the
women and girls who care for those who are living with HIV and AIDS.
Since 2004, Merck has supported the UN Refugee Agency’s (UNCHR's) Strategic Plan for HIV,
AIDS and Refugees. Support has focused on strengthening HIV and AIDS interventions in
refugee operations in Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia, South
Africa, Swaziland, Zambia and Zimbabwe.
Merck has supported the Community Health and Information Network’s (CHAIN's) efforts since
1998 to develop outreach programmes including treatment literacy and life skills programme
for people living with HIV, orphans and vulnerable children. CHAIN is also working to inform
uniformed forces personnel about HIV and AIDS
Merck and DHL announced an agreement in 2004 to team up to expand access to critically
needed HIV and AIDS medicines in countries throughout sub-Saharan Africa. Under this
agreement, DHL is currently delivering Merck's HIV and AIDS medicines at cost by air express to
designated treatment centres in 35 countries.
Since 2005, Merck has supported the African Medical & Research Foundation (AMREF) in its
efforts to improve health of young people living with HIV and AIDS in the Nakasangola District
of Northern Uganda. In 2008, Merck provided support to AMREF to scale up the HIV and AIDS
intervention in Uganda where HIV prevalence among young women in Kawempe Division is at
24%.
46
12. Merck & Co., Inc. HIV/AIDS Programmes - Asia-Pacific
Disease area(s): HIV/AIDS
Company(ies): Merck & Co. Inc.
Partner(s): China Ministry of Health and other partners
Since 2005
Programme type(s): Capacity Building - Training, Education
Developing country(ies): China
In 2005, Merck & Co., Inc. and China's Ministry of Health established the China-MSD HIV/AIDS
Partnership (C-MAP), to address HIV and AIDS prevention, patient care, treatment and
support.
The Merck Company Foundation has committed USD 30 million to support this partnership. The
Government of China, through the leadership of the Ministry of Health, is providing staff,
facilities and equipment. C-MAP is led by two co-national directors and has project offices in
Beijing, Sichuan Province and Liangshan Prefecture.
13. Merck & Co., Inc. HIV/AIDS Programmes - Caribbean
Disease area(s): HIV/AIDS
Company(ies): Merck & Co. Inc.
Partner(s): USAID and other partners
Since 2003
Programme type(s): Capacity Building - Training, Education
Developing country(ies): Jamaica, Mexico, Venezuela
In 2007, Merck and The Merck Company Foundation granted USD 36,500 to the Caribbean
Coalition of National AIDS Programme Coordinators (CCNAPC), a peer-based organization
working to improve national AIDS Programmes in 35 Caribbean countries. The grant was to
support efforts to increase prevention and awareness. Also in 2007, Merck sponsored an
exchange between Caribbean and Botswana business leaders to promote understanding of
the private sector role in fighting HIV/AIDS.
47
14. Pfizer - Infectious Diseases Institute
Disease area(s): HIV/AIDS
Company(ies): Pfizer, Gilead
Partner(s): Various partners, including universities
Since 2002
Programme type(s): Capacity Building - Support & Training
Developing country(ies): Uganda
Pfizer, the Academic Alliance, Accordia Global Health Foundation, Makerere University, the
Infectious Diseases Society of America, Pangaea Global AIDS Foundation and others
partnered to establish the Infectious Diseases Institute (IDI) in Uganda in 2004.
The IDI, a major medical training and research centre headquartered within Uganda's
Makerere University, aims to improve health in Africa by training medical professionals in the
treatment and prevention of HIV/AIDS and related infectious diseases and providing them with
skills and resources to use in their communities. It provides care and treatment to almost 9,000
patients each year.
IDI has trained more than 3,500 healthcare workers from 27 African countries since 2004, 98%
of whom are providing antiretroviral therapy and other care for patients with HIV/AIDS. IDItrained workers indicate they have trained, on average, 20 additional healthcare workers per
month
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15. Diflucan Partnership
Disease area(s): HIV/AIDS
Company(ies): Pfizer
Partner(s): Axios International, International Dispensary Association (IDA), IMA
World Health, governments and NGOs
Since 2000
Programme type(s): Capacity Building - Support & Training
Developing country(ies): Developing countries
The aim of the partnership is to provide treatment for AIDS-related fungal infections in
developing countries where HIV/AIDS is endemic.
Pfizer's has committed to provide Diflucan® (fluconazole), an antifungal to treat two fungal
opportunistic infections associated with AIDS, free of charge to government and
nongovernment organizations in developing countries with a greater that 1% prevalence of
HIV/AIDS.
More than USD 840 million in medicine has been donated to more than 2000 sites in 60
countries in Africa, Asia, the Caribbean and Latin America
More than 20,000 health professionals have been trained in the diagnosis and treatment of
fungal opportunistic infections
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16. Tibotec Cost Recovery Distribution Programme
Disease area(s): HIV/AIDS
Company(ies): Johnson & Johnson
Partner(s): CCBRT in Tanzania
Since 2003
Programme type(s): Access - Pricing, Capacity Building - Support
Developing country(ies): Sub-Saharan Africa
Johnson & Johnson's Tibotec subsidiary makes Tibozole$ Miconazole MAT (micMAT), a mucoadhesive buccal tablet that can treat oral thrush in AIDS patients.
To date, Tibotec has sold at cost or donated over two million patient treatments of Miconazole
nitrate 10 mg MAT for use in sub-Saharan Africa. Of these, more than 1,300,000 treatment units
have been sold to international procurement agencies for distribution in resource poor
settings, through Tibotec's cost recovery distribution programme.
Tibotec collaborates with major not-for-profit suppliers to the developing world, such as IDA
and MSF, to maximize access and ensure sustainable product supply. Pilot collaborations with
voluntary organizations have led to an increase in donations of patient treatments in a
number of sub-Saharan African countries.
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17. PEPFAR Partnership for Paediatric AIDS Treatment
Disease area(s): HIV/AIDS
Company(ies): Abbott, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, Merck &
Co. Inc.
Partner(s): PEPFAR, UNAIDS, UNICEF, WHO
Since 2006
Programme type(s): Access - Pricing, R&D
Developing country(ies): 15 developing countries
The US President's Emergency Plan for AIDS Relief (PEPFAR) Partnership for Paediatric AIDS
Treatment was launched in 2006. This public-private partnership includes innovator and
generic pharmaceutical companies and multilateral organizations such as UNAIDS, WHO and
UNICEF. The initiative will identify scientific obstacles to treatment for children, take practical
steps to address key barriers, share best practices and develop systems for clinical and
technical support.
Abbott is working with PEPFAR to advance treatment for children with HIV in developing
countries by actively participating in the PEPFAR Partnership for Paediatric AIDS Treatment, In
addition to making medicines available at preferential prices to PEPFAR.
Bristol-Myers Squibb is an active partner in the PEPFAR Partnership for Paediatric AIDS
Treatment, working to find solutions to issues concerning paediatric HIV treatment, formulations
and access. In 2004, Bristol-Myers Squibb agreed to allow the FDA to make right of reference
to its confidential dossiers and product registration files to facilitate approval of generic
combination products under the PEPFAR programme.
Gilead is an active member of the Accelerating Access Initiative and several United Nations´
agency working groups, as well as the PEPFAR Partnership for Paediatric AIDS Treatment.
GlaxoSmithKline is a major supplier of ARVs to PEPFAR at no-profit prices and has also
participated in the State Department's programme to expand the number of paediatric
formulations for HIV medicines that are appropriate for PEPFAR and other child access
programmes in the developing world.
Merck & Co., Inc. is an active member of the PEPFAR Partnership for Paediatric AIDS
Treatment, working to identify scientific and technical solutions to improving access to
antiretroviral treatment for children living with HIV/AIDS in resource-limited settings.
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18. Improving Neonatal Survival in Kosovo
Disease area(s): Maternal Care
Company(ies): Abbott Fund
Partner(s): Dartmouth Medical School and the United Church of Christ (UCC)
Since 2007
Programme type(s): Access - Pricing, R&D
Developing country(ies): Kosovo
To help improve neonatal survival, the Abbott Fund has partnered with neonatal specialists
from Dartmouth Medical School and the UCC to support installation of a new oxygen system
in the Neonatal Intensive Care Unit (NICU) in Kosovo’s main hospital.
In 2007, the Abbott Fund, in partnership with AmeriCares and a grant of USD 86,800, helped
purchase advanced ventilators, 15 CPAP machines, incubators, pulse oximeters and gas
analyzers to equip four patient units within the NICU.
The grant also supported training on respiratory care intervention and on how to administer
Survanta, Abbott's surfactant replacement therapy, used to prevent or treat respiratory distress
syndrome in premature infants.
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19. Operation Smile
Disease area(s): Facial Deformation
Company(ies): Abbott Fund
Partner(s): Operation Smile
Since 1993
Programme type(s): Access - Pricing, R&D
Developing country(ies): Worldwide
For more than 16 years, Abbott has supported the work of Operation Smile, a global
organization dedicated to improving the health and lives of children and young adults
suffering from facial deformities. The organization's volunteer medical professionals travel the
globe to help strengthen healthcare systems for both children and families. Since Operation
Smile's inception in 1982, volunteers have provided free reconstructive surgery to more than
140,000 children and young adults around the world.
Since 1993, Abbott has donated more than USD 5.4 million in grants and products. In 2002,
Operation Smile elected to use sevoflurane, Abbott’s leading anesthesia product, for all of
their missions, and since that time, donations of the product have helped treat thousands of
patients in more than 30 countries.
In 2007, in celebration of Operation Smile's 25th anniversary, Abbott donated product valued
at almost USD 500,000 that was used to treat more than 3,000 children during a two-week, 25country event.
In 2005, the Abbott Fund expanded its partnership with Operation Smile by supporting the
Paediatric Advanced Life Support and Advanced Cardiovascular Life Support training
programme, conducted in nine developing countries. Over the course of four years, the
programme has expanded to 30 countries. The goal of the programme is to help strengthen
the expertise of medical professionals in the developing world and provide quality services for
children and adults requiring emergency critical care. To date, Operation Smile has been able
to train more than 11,700 medical professionals in critical lifesaving techniques and purchase
related training equipment.
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20. Care and Prevention of Mother-to-Child Transmission of HIV/AIDS in Zambia
Disease area(s): PMTCT
Company(ies): Bristol-Myers Squibb
Partner(s): Adventist Development and Relief Agency
Since ---Programme type(s): Access - pricing, R&D
Developing country(ies): Zambia
A USD 433,000 Bristol-Myers Squibb grant to the Adventist Development and Relief Agency for
two districts in Zambia will promote programmes for the prevention of mother-to-child HIV
transmission.
21. mothers2mothers
Disease area(s): PMTCT
Company(ies): Merck
Partner(s): mothers2mothers
Since 2008
Programme type(s): Access
Developing country(ies): Africa
Merck is a sponsor of mothers2mothers (m2m) and has provided grants to the organization
since 2008.
m2m Milestones
"
In 2009, "mentor mothers" employed by m2m to provide counselling and support
received salaries totalling more than USD 5 million (USD). Nearly every penny goes
directly into local economies to purchase necessities including food, schooling and
secure housing for their families.
"
m2m currently offers services in almost 644 sites in South Africa, Lesotho, Zambia, Kenya,
Rwanda, Swaziland and Malawi, employs about 1,625 HIV-positive mothers, and
currently reaches approximately 300,000 HIV-positive pregnant women and new
mothers in one year.
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INITIATIVES AGAINST TUBERCULOSIS
1. AstraZeneca & Red Cross: Fight against TB in Africa
Disease area(s): Tuberculosis
Company(ies): AstraZeneca (AZ)
Partner(s): British Red Cross
Since 2006
Programme type(s): Capacity Building - Training, Education
Developing country(ies): Lesotho, Liberia, South Africa
To help the British Red Cross broaden its approach to TB and TB/HIV co-infection, AstraZeneca
further expanded its partnership in 2006 to support the charity in its work to help local
communities combat the threat in South Africa and Lesotho. Following a TB training
programme for 500 Red Cross volunteers, over 1,800 people affected by TB or TB/HIV have
now successfully completed their treatment, with default rates averaging between 3 and 4%.
This is being achieved through daily one-to-one contact with patients by trained volunteers
who, when required, also collect treatment from clinics and oversee the patient’s compliance.
Volunteers also distribute TB prevention information. Between June and August 2008 alone,
volunteers made over 7,500 home TB education visits - including providing information tailored
to orphans and vulnerable children.
During 2008, the partnership’s geographic coverage was expanded with a new project in
Liberia, where TB incidence rates have almost tripled since 1990 (from 113 to 310 per 100,000).
Project development began in April 2008 and field implementation began in December 2008.
In Central Asia
The company joined forces against TB in 2002. Work initially targeted Kyrgyzstan and
Turkmenistan - countries with widespread poverty and seriously high levels of TB incidence.
55
Progress up to 2009 includes:
"
Over 10,000 people living with TB or TB/HIV successfully completing their TB treatment.
"
TB treatment completion rates reaching 89% and 92% in Turkmenistan and Kyrgyzstan
respectively.
"
A significant increase in community awareness following media campaigns and health
education sessions in schools and public places that have reached nearly 2 million
people.
"
Between January and September 2009, over 800 consultations, 68 group discussion and
73 home visits took place and some 1,800 food parcels were distributed.
"
Treatment completion rates increased to 73% from 54% in 2008.
In Sub-Saharan Africa
With the support of AZ, the South African Red Cross Society (SARCS) is helping to deliver
improved care and support to people living with TB or TB/HIV in 10 areas, including the
provinces of KwaZulu Natal, Western Cape, Eastern Cape, Limpopo, Gauteng and Free State.
To date, some 2,500 people affected by TB or TB/HIV have successfully completed their
treatment and over 6,000 suspected cases of TB identified and sent for screening.
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2. Lilly MDR-TB Partnership
Disease area(s): Tuberculosis
Company(ies): Lilly
Partner(s): WHO and other partners
Since 2003
Programme type(s): Access - Pricing & Licensing, Capacity Building - Support &
Training, Education
Developing country(ies): Partnership activities in over 60 countries
The Lilly MDR-TB Partnership was created to help address the challenge of multi-drug resistant
tuberculosis (MDR-TB). The public-private partnership mobilizes 18 global partners on five
continents. Eli Lilly and Company is contributing USD 120 million in cash, medicines and
technology and has also donated USD 15 million to the Lilly TB Drug Discovery Initiative to
accelerate TB drug discovery.
The World Health Organization (WHO) provides technical assistance to MDR-TB countries and
its Green Light Committee has enrolled 50,000 patients in over 60 countries. Several thousand
health workers have been trained in MDR-TB diagnosis, treatment and prevention.
Partners: Advocacy Partnership, Aspen Pharmacare, Harvard Medical School in USA, Hisun
Pharmaceutical, International Council of Nurses (ICN), International Federation of Red Cross &
Red Crescent Societies (IFRC), International Hospital Federation (IHF), Partners In Health,
Purdue University in USA, Results Educational Fund, Shasun Chemicals and Drugs, SIA
International/Biocom, Stop TB Partnership, TB Alert, Tuberculosis Survival Project, US Centres for
Disease Control and Prevention (CDC), World Economic Forum (WEF), World Health
Organization (WHO), World Medical Association (WMA).
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3. Novartis TB DOTS Donation
Disease area(s): Tuberculosis
Company(ies): Novartis
Partner(s): WHO
Since 2003
Programme type(s): Access - Donation
Developing country(ies): Tanzania
In 2003, the Novartis Foundation for Sustainable Development signed a Memorandum of
Understanding (MOU) with the World Health Organization (WHO) committing itself to donate
the WHO-recommended tuberculosis treatment for 500,000 patients over 5 years.
Novartis donates rifampicin-based fixed-dose combination tablets for the intensive and
maintenance phases of treatment. The medicines are given to the Global Drug Facility
(GDF)of the Stop TB Partnership for use in programmes supported by the Global Fund to fight
against AIDS, Tuberculosis and Malaria.
Novartis also funds logistics and independent quality control, in addition to its own quality
control.
A needs assessment found that knowledge of tuberculosis was extremely poor, leading to
false beliefs, improper treatment and rejection of TB patients by the population. A pilot
corrective social marketing campaign was conducted, which led to a significant increase in
demand for treatment. Sixty percent of interviewees identified the campaign as their primary
source of information on TB.
The Global Plan to Stop TB
The Stop TB Partnership has built an effective network to promote and coordinate the
contributions of a wide and increasing range of stakeholders. A thriving partnership, its global
membership grew to over 400 organizations in 2005, regional and national.
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Stop TB partnerships are now being formed to support long-term expansion of DOTS at country
level.
The Global Drug Facility, established by the partnership, has provided treatment for more than
4.5 million patients, at the same time as catalyzing a worldwide improvement in the quality of
TB drugs, and a reduction in their cost. In addition, the Green Light Committee (GLC) promotes
access to, and rational use of, second-line drugs with activity against multi-drug resistant TB. It
has secured price reductions of 95% for some second-line drugs. To help prevent misuse of
these drugs, the GFATM selected the GLC as its mechanism for procurement of second-line
drugs and monitoring of approved projects. The GDF and the GLC are merging in a phased
programme.
Implementation of the plan will save some 14 million lives over the next 10 years, using only
existing tools. But it will also be the precursor for future gains. Because TB dynamics are slow,
implementation activities from 2006 to 2015 will yield benefits later as well as those shown here
as occurring within the period of the plan. Even more dramatically, the investment in new
drugs, new diagnostic tests and new vaccines will begin to pay rich dividends beyond 2015.
The real prize will be the elimination of TB.
The total cost of the Global Plan for 2006–2015 is estimated as USD 56.1 billion.
•
80% (USD 44.3 billion) is for country-level activities, especially in Africa.
•
A large part of the cost (USD US28.9 billion) is for DOTS programmes.
•
DOTS-Plus and TB/HIV activities will cost about USD 5.8 and USD 6.7 billion respectively.
•
Research and development of new tools requires USD 9 billion.
•
USD 25.3 billion is currently estimated as available, leaving a funding gap of USD 30.8
billion.
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4. Sanofi-Aventis : TB Free & Other Initiatives
Disease area(s): Tuberculosis
Company(ies): Sanofi-Aventis
Partner(s): Nelson Mandela Foundation and other partners
Since 2002
Programme type(s): Capacity Building - Support & Training, Education
Developing country(ies): India, Kenya, South Africa
In March 2002, Sanofi-Aventis and the Nelson Mandela Foundation established the TB Free
programme, a EUR 15 million effort to increase detection and treatment rates for tuberculosis
in South Africa. Initially planned to finish in 2007, it has now been extended to 2010. The
partnership trains volunteers to encourage patient compliance during the 6-month treatment,
using the WHO-recommended DOTS (Directly Observed Therapy Short-Course) strategy.
The actions would help to increase the TB cure rate by as much as 80% through improved
compliance to TB treatment. In each of the country's nine provinces, a TB Free Centre has
been established, which works closely with the Ministry of Health. By 2008, nine training centres
had been opened, in which 20,000 “DOTS supporters” have been trained and 500,000 patients
treated since 2005.
In Kenya, Sanofi-Aventis works with the Kenya Association for the Prevention of Tuberculosis
and Lung Diseases to train health-care workers in 200 targeted treatment centres. SanofiAventis also supports the Kenya's World TB day awareness activities.
In India, Sanofi-Aventis formed a partnership with the Association Père Ceyrac in 2007 to fight
tuberculosis and support TB-affected families living in the slums of Mumbai, Navi-Mumbai and
Pune. Sanofi-Aventis supports the Inter-Aide NGO through local partners by means of 51 DOTS
centres, 11 centres for collecting samples, and 4 testing laboratories located in the heart of
the slums, which manage to treat almost 4,000 patients a year.
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5. Stop TB Partnership
Disease area(s): Tuberculosis
Company(ies): AstraZeneca, GlaxoSmithKline, Lilly, Novartis
Partner(s): International Federation of Red Cross & Red Crescent Societies IFRC,
Médecins sans Frontières MSF, Stop TB Partnership
Since 2000
Programme type(s): Access - Donation & Pricing, R&D
Developing country(ies): Endemic countries and vulnerable populations
The Stop TB Partnership was established in 2000 to realize the goal of eliminating tuberculosis
(TB) as a public health problem. It comprises a network of more than 500 international,
government, non-government and private sector organizations and individuals with an interest
in working together to achieve this goal. The Partnership is a global movement to accelerate
social and political action to stop the spread of TB around the world. A number of member
companies of the International Federation of Pharmaceutical Manufacturers and Associations
(IFPMA), including AstraZeneca, GlaxoSmithKline, Lilly, Novartis, Pfizer, and IFPMA itself are
currently partners of the Stop TB Partnership, and actively contribute to its aims and
programmes.
The targets set by the Stop Partnership are:
"
By 2005: 70% of people with infectious TB will be diagnosed and 85% of them cured;
"
By 2015: the global burden of TB disease will be reduced by 50% relative to 1990 levels
(Millennium Development Goal);
"
By 2050: The global incidence of TB disease will be less than 1 per million population
(Elimination of TB as a global public health problem).
The Global Drug Facility, run by the Stop TB Partnership, is expanding access to medicines for
DOTS scale up; in just 5 years it has committed over 7 million TB treatments. Projects managing
MDR-TB can apply through the Green Light Committee (GLC) for access to quality MDR-TB
medicines at reduced prices - in some cases by as much as 99%. The Committee is operated
by WHO and the Stop TB Partnership. Lilly has a programme to make two critical medicines for
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treatment of drug-resistant strains available in developing countries and will supply 1.4 million
vials of capreomycin at concessionary prices to the GLC in 2009. Novartis is donating 500,000
fixed dose combinations to the Global Drug Facility during 2005-2009.
Partners: International Federation of Red Cross & Red Crescent Societies IFRC, Médecins sans
Frontières MSF, Stop TB Partnership.
6. Lilly TB Drug Discovery Initiative
Disease area(s): Tuberculosis
Company(ies): Lilly, Jubilant Biosystems, Summit plc
Partner(s): IDRI, NIAID & other partners
Since 2007
Programme type(s): R&D
Developing country(ies): India
Created in June 2007, the Lilly TB Drug Discovery Initiative is a not-for-profit public-private
partnership to accelerate the research and development of new treatments for TB, including
drug-resistant strains. The primary partners are Eli Lilly and Company, the Infectious Disease
Research Institute (IDRI), and the National Institute of Allergy and Infectious Diseases (NIAID),
which is part of the U.S. National Institutes of Health (NIH).
Lilly has given USD 15 million to establish the Initiative, including USD 9 million in-kind, including
fully equipped high throughput screening and chemistry laboratories, research tools,
databases, and scientific and technical expertise, plus USD 6 million in cash over five years to
seed the organization. Lilly is also providing access to its library of 500,000 compounds and is
making available its expertise in drug discovery and chemistry.
Partners: Infectious Disease Research Institute (IDRI), National Institute of Allergy and Infectious
Diseases (NIAID), Seattle Biomedical Research Institute (SBRI), Microbial Chemistry Research
Foundation, University of Washington in the USA, YourEncore
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7. Novartis Institute for Tropical Diseases (NITD)
Disease area(s): Tuberculosis
Company(ies): Novartis
Partner(s): Global Alliance for TB Drug Development and other partners
Since 2003
Programme type(s): R&D
Developing country(ies): Indonesia and research in Singapore
The USD 122 million Novartis Institute for Tropical Diseases (NITD) research centre in Singapore is
a public-private partnership between Novartis and the Singapore Economic Development
Board (SEDB) and focuses exclusively on the discovery of innovative medicines for the
treatment of diseases that are endemic to developing countries. With more than 100 scientists
employed, and activities that range from target discovery, screen development and
compound optimization to preparation for clinical testing, NITD also offers teaching and
training in the field of tropical diseases.
The goal of NITD's Tuberculosis Unit is to apply new genomic and bioinformatic technologies to
develop novel treatments for multi-drug resistant TB.
In 2006, NITD and ten other collaborators led by the Imperial College received a grant from
the Grand Challenges for Global Health Initiative to discover new targets for latent and
persistent TB infection.
A recent Collaboration and Licence Option Agreement between NITD and the Global
Alliance for TB Drug Development aims at accelerating development of potential costeffective new drugs towards clinical use.
To secure direct access to hospitals and patients in a real-life context, in 2007 NITD also
teamed up with the Hasanuddin University and Eijkman Institute in Indonesia to form NEHCRI a clinical research initiative that aims to strengthen translational research in tuberculosis, but
also malaria and dengue fever, two other diseases NITD is working on.
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INITIATIVES AGAINST MALARIA
1. GSK & Access to Malaria Care
Disease area(s): Malaria
Company(ies): GlaxoSmithKline
Partner(s): Various partners
Since 2003
Programme type(s): Access - Pricing, Capacity Building - Support, Education
Developing country(ies): 13 developing countries
GlaxoSmithKline offers its anti-malarials at not-for-profit prices to public sector customers and
not-for-profit organizations in 64 countries - all the least developed countries and all of subSaharan Africa. All Country Co-ordinating Mechanism (CCM) projects fully funded by the
Global Fund to fight AIDS, TB and Malaria are also eligible. GSK does not make a profit at these
prices, but it does cover its costs, so it can sustain supply of these high-quality products for as
long as they are needed. These prices apply to orders of any size and include insurance and
freight costs.
GSK's African Malaria Partnership was set up in 2003 to support education programmes in eight
African countries, through partnerships with Freedom from Hunger, AMREF and Plan
International. These focused on prevention and prompt treatment, particularly among
children and pregnant women. GSK funding for these initiatives has now ended, but the
investment will have a long-term positive impact.
The scale of the malaria problem requires a significantly bigger response, so in 2005, GSK gave
a USD 1.5 million three-year grant to a new partner, the Malaria Consortium, to launch the
Mobilizing for Malaria initiative. The aims are to increase awareness and generate political
commitment and sustained funding to combat the disease. It will increase the number of
NGOs engaged in tackling malaria, and give more African communities the knowledge and
tools they need to prevent transmission of malaria.
Partners: Freedom from Hunger, African Medical and Research Foundation (AMREF), Plan
International
Countries: Benin, Burkina Faso, Cameroon, Democratic Republic of Congo,
Ethiopia, Ghana, Mali, Mozambique, Nigeria, Senegal, Sudan, Tanzania, Togo.
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2. Millennium Villages Project
Disease area(s): Malaria
Company(ies): Novartis
Partner(s): Ilolangulu Village
Since 2007
Programme type(s): Access - Donation, Capacity Building - Support
Developing country(ies): Tanzania
As three out of eight Millennium Development Goals (MDGs) are health-related, the Novartis
Foundation for Sustainable Development agreed in 2007 to support the Millennium Villages
Project (MVP) in health-related research. The MVP was founded with the goal of helping
impoverished communities in rural Africa achieve the MDGs formulated and agreed to by all
member countries of the United Nations. The MVP is active at twelve sites in ten African
countries.
In 2007, the Novartis Foundation started financing one of the six Millennium Villages in
Tanzania, the Ilolangulu Village. For a five-year-period, the Novartis Foundation will invest in the
village's transition from subsistence farming to self-sustaining commercial activity. Challenges
facing Ilolangulu Village included inadequate water supply, extreme hunger, failed crops and
a high prevalence of malaria.
After one year, positive results have been seen. The project has distributed more than 20,000
bed nets to prevent malaria and free malaria treatment (Coartem®). Two new schools were
built and the project has launched a school feeding programme for more than 7,000 children,
using community crop surpluses. The villagers restored water points and built new ones.
Despite many challenges, the Tanzanian MVP villages increased their crop yield by 500%.
About 8,000 to 9,000 patients are treated per month in their clinics and mobile clinics. In
addition, other services such as immunization, birth deliveries, pre- and post-natal care and
growth monitoring cover 1,500 additional people.
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3. Novartis Coartem®
Disease area(s): Malaria
Company(ies): Novartis
Partner(s): WHO and MMV
Since 2001
Programme type(s): Access - Pricing, Capacity Building - Training, Education
Developing country(ies): 34 developing countries
Coartem® is fast-acting and cures over 97% of patients after a 3-day treatment course.
Since 2001, Novartis has provided more than 200 million treatment courses - without profit - for
public sector use in Africa. These treatments have helped save an estimated 550,000 lives.
In early 2009, Novartis and Medicines for Malaria Venture introduced Coartem® Dispersible,
the first artemisinin-based combination therapy (ACT) developed especially for children with
malaria, to address specific treatment needs of millions of children with malaria. Coartem®
Dispersible contains the same amounts of artemether and lumefantrine as Coartem® tablets
(20mg/120mg) and delivers the same high cure rates.
4. Roll Back Malaria Partnership
Disease area(s): Malaria
Company(ies): GlaxoSmithKline, Novartis, Sanofi-Aventis
Partner(s): Roll Back Malaria RBM, United Nations Children's Fund UNICEF,
United Nations Development Programme UNDP, World Bank, (WHO).
Since 1998
Programme type(s): Access - Pricing, Capacity Building - Support
Developing country(ies): 35 developing countries
The Partnership promotes high-level political commitment and keeps malaria high on the
global agenda by enabling, harmonizing and amplifying partner-driven advocacy initiatives.
Founded by UNICEF, WHO, the World Bank and UNDP and strengthened by the expertise,
resources and commitment of more than 500 Partner organizations. The Partnership secures
policy guidance and financial and technical support for control efforts in countries and
monitors progress towards universal goals.
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5. Sanofi-Aventis : Impact Malaria
Disease area(s): Malaria
Company(ies): Sanofi-Aventis
Partner(s): Various national and international partners, including universities
Since 2001
Programme type(s): Access - Pricing, Capacity Building - Training, Education,
R&D
Developing country(ies): Benin, Madagascar, Republic of Congo, Tanzania
Sanofi-Aventis seeks to improve access to its anti-malarials, by making them available at a “no
profit, no loss” prices to needy populations. In 2008, 6 million artemisinin-based combination
treatments were sold at preferential prices to over 20 malaria-endemic countries.
Sanofi-Aventis and Drugs for Neglected Diseases initiative (DNDi) launched a new artesunateamodiaquine combination treatment in early 2007. The company has relinquished its patents
and will supply drugs at prices scaled to income. In the poorest countries, this is less than USD 1
for an adult treatment and a less than USD 0.5 for a paediatric treatment. Tablets are soluble,
facilitating their use with children.
In 2008, Sanofi-Aventis provided 20 African health professionals with high-level malaria training.
In addition, information, education and communication tools have been developed with
national malaria control programmes and NGOs, while the www.impact-malaria.com website
provides disease, prevention and treatment information, plus educational tools and an online
library.
Partners: Actions de Solidarité Internationales, Agence de Médecine Préventive, Caritas,
CFAO, Drugs for Neglected Diseases initiative (DNDi), Epicentre, Lille University in France,
Jeremi, Médecins sans Frontières (MSF), Medicines for Malaria Venture (MMV), Montpellier
University in France, Palumed, PlanetFinance, Total, World Health Organization (WHO).
67
6. Mobilize Against Malaria
Disease area(s): Malaria
Company(ies): Pfizer
Partner(s): Clinton Global Initiative and others
Since 2007
Programme type(s): Access - Pricing, Capacity Building - Training, Education,
R&D
Developing country(ies): Ghana, Kenya, Senegal
At the 2006 Clinton Global Initiative, Pfizer announced a five-year programme (2007-2012),
Mobilize Against Malaria, focused on improving access to prompt and effective treatment,
and preventing infection and the spread of malaria by improving symptom recognition,
treatment, and referral through local grassroots training, education and awareness.
In April 2009, Pfizer and Medicines for Malaria Venture (MMV) signed an agreement which
gives MMV access to Pfizer's vast chemical compound library in order to test approximately
200,000 compounds for activity against P. falciparum.
Partners: London School of Hygiene and Tropical Medicine, KEMRI-Wellcome Trust, Population
Services International (PSI), Health Partners Ghana, Family Health International/Ghana Social
Marketing Foundation (GSMF), Intrahealth International
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INITIATIVES AGAINST TROPICAL DISEASES
1. Bayer HealthCare & African Sleeping Sickness
Disease area(s): Sleeping sickness
Company(ies): Bayer HealthCare
Partner(s): WHO
Since 2002
Programme type(s): Access - Donation
Developing country(ies): Democratic Republic of Congo, India, Kenya, Malawi,
Mozambique, Sudan, Tanzania, Uganda
In 2002, Bayer HealthCare agreed to supply - at no cost and for an initial five-year period - as
much of the sleeping sickness medicine Germanin® (suramin) as the World Health
Organization (WHO) determines is needed to eliminate the disease. The initial donation
comprised 50,000 ampoules. Bayer is also in favor of supporting an “Integrated Sleeping
Sickness Initiative” fostered by a broad base of institutions and covering all aspects of the
disease from infection, diagnosis and therapy to prevention.
The agreement was renewed in 2008, whereby Bayer will provide, free-of-charge, 50,000
ampoules of Germanin® to the WHO, over a five-year period.
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2. Bayer HealthCare: Fight Against Chagas Disease
Disease area(s): Chagas disease
Company(ies): Bayer HealthCare
Partner(s): WHO
Since 2004
Programme type(s): Access - Donation
Developing country(ies): Argentina, El Salvador, Honduras, Nicaragua, Chile,
Guatemala, Uruguay
In April 2007, Bayer signed a new agreement to provide WHO with 2.5 million Lampit® tablets
and additional funding for the distribution of the drug. The latest agreement assures the supply
of Lampit® until 2012.
To widen access of patients to affordable medicines, Bayer HealthCare signed agreements
with WHO in 2004 and 2005 for donations of its medicine Lampit® (nifurtimox) to combat
Chagas disease, the form of sleeping sickness found in Latin America. A total of 500,000 tablets
was given to WHO, which informs the governments of disease endemic countries of the
availability of the free supplies, including the procedure to be followed for obtaining such
supplies, and decides about its distribution.
The goal of the WHO is to distribute Lampit® in all 21 endemic countries in Latin America.
Currently, the medicine is approved in Argentina, El Salvador, Honduras, Nicaragua, Chile,
Guatemala and Uruguay. Lampit® will also be provided in small quantities, as needed, in
some non-endemic countries, like Canada, France, Japan, Spain, UK and the USA.
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3. Gilead - AmBisome for Leishmaniasis
Disease area(s): Leishmaniasis
Company(ies): Gilead
Partner(s): WHO
Since ----Programme type(s): Access - Pricing, R&D
Developing country(ies): Endemic countries
Gilead's therapeutic AmBisome (amphotericin B) liposome for injection has shown potent antiparasitic and fungicidal activity against multiple pathogens, including mucosal and visceral
leishmaniasis in clinical studies.
Gilead's goal is to expand access to AmBisome for the treatment of leishmaniasis in settings
where the disease has the largest impact. Gilead works closely with the World Health
Organization and NGOs to provide AmBisome at a preferential price for the treatment of
leishmaniasis in resource-limited settings. Gilead also actively supports multiple clinical
research studies aimed at elucidating the best treatment course for visceral leishmaniasis.
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4. Global Alliance to Eliminate Lymphatic Filariasis (GAELF)
Disease area(s): Lymphatic filariasis
Company(ies): GlaxoSmithKline, Merck & Co. Inc.
Partner(s): Global Alliance to Eliminate Lymphatic Filariasis (GAELF), World
Health Organization (WHO)
Since 1998
Programme type(s): Access - Donation, Capacity Building - Support & Training
Developing country(ies): 47 out of 80 endemic countries
The Global Alliance to Eliminate Lymphatic Filariasis (GAELF) was created to eliminate one of
the world's leading causes of disability and disfigurement as a public health problem by the
year 2020. An estimated 120 million people in at least 80 countries of the world suffer from the
disease, and one billion (20% of the world's population) are at risk of infection.
Initiated by the World Health Organization (WHO) and GlaxoSmithKline in 1998, the Global
Alliance has evolved into a global partnership between international organizations in the
public and private sectors, academia and non-government organizations working in
partnership with ministries of health in tropical countries where lymphatic filariasis (LF) is
endemic. Merck & Co., Inc. joined the elimination effort in 1998, when it widened the scope of
its Mectizan® Donation Programme to include LF in African countries where river blindness and
LF co-exist.
The WHO recommends that lymphatic filariasis be prevented with a combination of
albendazole (donated by GSK) with either DEC or Mectizan® (donated by Merck). Drug
administration for people living in endemic areas is recommended by WHO once a year for at
least five years to break the cycle of transmission.
In 2008, GSK donated 266 million treatments of albendazole to prevent transmission in 30
countries. To date, GSK has donated over one billion treatments to 48 countries. Over the 20
year life of the programme, GSK expects to donate up to 6 billion preventative albendazole
treatments across the 80 endemic countries that are accepted into the programme by the
WHO. Merck approved 88 million treatments of Mectizan® to LF elimination programmes in 14
African countries and Yemen in 2008, bringing the cumulative total to 303 million. Merck and
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GSK have also provided financial grants to support partners in research programmes, coalition
building, workshops and communications. WHO estimates that over 100 million people - 30
million of whom are children - have begun to be protected from LF.
In the twelve years since its initiation, the GAELF has become the most rapidly scaled-up
medicine administration programme in public health history. The WHO reported that during
2007, over 546 million people were treated worldwide. In a study published in October 2008 in
PLoS Neglected Tropical Diseases, researchers found that the LF elimination effort has
prevented 6.6 million children from acquiring the disease.
Countries: American Samoa, Bangladesh, Benin, Burkina Faso, Cambodia, Cameroon,
Comoros, Cook Islands, Côte d'Ivoire, Dominican Republic, Egypt, Fiji, French Polynesia,
Ghana, Guinea Bissau, Haiti, India, Indonesia, Kenya, Kiribati, Laos, Madagascar, Malawi,
Malaysia, Maldives, Mali, Myanmar, Nepal, Niger, Nigeria, Niue, Papua New Guinea,
Philippines, Samoa, Senegal, Sierra Leone, Sri Lanka, Tanzania, Thailand, Timor Leste, Togo,
Tonga, Tuvalu, Uganda, Vanuatu, Vietnam, Yemen
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5. Guinea Worm Eradication Programme (GWEP)
Disease area(s): Dracunculiasis (Guinea worm)
Company(ies): Johnson & Johnson
Partner(s): Carter Centre, World Health Organization (WHO), United Nations
Children's Fund (UNICEF), US Centres for Disease Control and Prevention (CDC),
World Bank
Since 1986
Programme type(s): Access - Donation, Capacity Building - Support, Education
Developing country(ies): 9 African countries
Established in 1986 and operating under the auspices of the Carter Centre's Global 2000
Programme, the Guinea Worm Eradication Programme (GWEP) aimed to rid future
generations of Guinea worm by the year 2005. This multilateral partnership brings together
organizations like the WHO, UNICEF, the CDC and the World Bank, as well as national
governments and the pharmaceutical industry in a programme combining eradication efforts,
training and research. To accelerate the eradication of Guinea worm disease, the partners
target specific interventions (provision of safe water, health education, community
mobilization, filter distribution, and treatment of selected water sources) like:
"
Maintain global and national dracunculiasis databases;
"
Monitor the epidemiological situation and map all endemic villages;
"
Conduct advocacy for eradication of the disease;
"
Certify dracunculiasis eradication country-by-country worldwide.
Today, through the joint efforts of many partners, the incidence of this disease has been
reduced worldwide by 99%, from an estimated 3.5 million cases in 1986 to less than 35,000
reported cases in 2003. Today, the last 1% of the disease is being fought.
Johnson & Johnson has donated enough medical supplies, such as Tylenol®, forceps and
gauze, to treat more than 3,000 villages in the endemic countries. In 2007, J&J donated
medical supplies to the GWEP, for use in Sudan, the country most affected by Guinea worm.
The donation included Tylenol® painkiller, to make the excruciating process of removing the
worms from victims more bearable; Neosporin® and Savlon® antiseptics for disinfecting the
wounds; and scissors, gloves, tape, gauze and sterile bandages for wrapping the wounds.
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6. International Trachoma Initiative (ITI)
Disease area(s): Trachoma
Company(ies): Pfizer
Partner(s): Edna McConnell Clark Foundation and other partners
Since 1998
Programme type(s): Access - Donation, Capacity Building - Support & Training,
Education
Developing country(ies): 15 developing countries
The International Trachoma Initiative (ITI) was founded in 1998 by Pfizer and the Edna
McConnell Clark Foundation to treat and prevent blinding trachoma, the world's leading
cause of preventable blindness. In March 2009, ITI and the Task Force for Child Survival and
Development announced that they will join forces to scale up efforts to eliminate trachoma. ITI
supports the implementation of the WHO-recommended SAFE strategy, a comprehensive
public health approach that combines treatment with prevention, involving sight-saving
surgery, mass treatment with the Pfizer-donated antibiotic Zithromax®, facial cleanliness, and
environmental improvement to increase access to clean water and improved sanitation.
ITI supports the WHO's Alliance for Global Elimination of Trachoma by 2020 (GET 2020) as well
as Vision 2020: The Right to Sight. Other ITI partners include AmeriCares, the Carter Centre,
Helen Keller International, Lions Club, the United Nations Children's Fund (UNICEF), WaterAid,
and World Vision.
The International Trachoma Initiative involves the following activities:
"
Providing patients in developing countries with antibiotics and surgery to treat
advanced cases of trachoma;
"
Educating communities about trachoma prevention and training healthcare workers to
conduct surgeries for advanced trachoma cases;
"
Providing training and technical assistance to support national trachoma control
campaigns;
"
Advocating for increased funding for trachoma control and catalyzing partnerships to
work towards trachoma elimination.
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Since 1998, Pfizer has provided over 145 million treatments of Zithromax® for treatment and
prevention of the disease in 18 countries. With Pfizer's support, ITI has trained thousands of
healthcare workers who have performed more than 416,000 surgeries to treat advanced
cases of trachoma. With the support of the ITI, Morocco became the first country to complete
the campaign for trachoma control in 2006, and is now working toward WHO certification to
signify that blinding trachoma has been eliminated as a public health problem.
Partners: AmeriCares, Carter Centre, Edna McConnell Clark Foundation, Helen Keller
International, Lions Club, Task Force for Child Survival and Development, United Nations
Children´s Fund (UNICEF), WaterAid, World Health Organization (WHO), World Vision
Countries: Burkina Faso, Eritrea, Ethiopia, Gambia, Ghana, Guinea-Bissau, Kenya, Mali,
Mauritania, Morocco, Nepal, Niger, Nigeria, Senegal, Sudan, Tanzania, Vietnam, Uganda
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7. Leprosy Elimination
Disease area(s): Leprosy
Company(ies): Novartis
Partner(s): WHO
Since 2000
Programme type(s): Access - Donation, Capacity Building - Support
Developing country(ies): 66 developing countries
Recommended by the World Health Organization, multi-drug therapy (MDT) cures patients,
interrupts the transmission of leprosy and prevents disabilities. Novartis developed two of the
three medicines in MDT and has provided MDT, free of charge, for all patients in the world
through the WHO since 2000. This is a core element in the WHO Elimination Strategy of creating
awareness of the early signs, improving patients' access to free diagnosis and treatment, and
close monitoring.
The Novartis-WHO collaboration has led to the cure of more than 4.5 million people to date.
The prevalence rate has dropped by over 90% since 1985, from 21 per 10,000 inhabitants to
less than 1 per 10,000 inhabitants worldwide, the threshold of elimination as a public health
issue. All but three countries in the world have successfully eliminated leprosy at a national
level. Detection of new leprosy cases has decreased by 20% per year over the past three
years.
Novartis and the Novartis Foundation for Sustainable Development also cover the costs of
freight, insurance and independent quality control, in addition to that carried out by Novartis.
The value of the first donation, 2000-2005, was USD 40 million. In 2005, Novartis and WHO signed
a new MOU to ensure the continued uninterrupted supply of high quality MDT, free-of-charge
for all patients in the world, until the end of 2010. Novartis has expressed its willingness to help
anyone affected by this disease until leprosy is eradicated.
The small remaining number of patients has changed the challenge of fighting leprosy. New
approaches have to be developed to move towards a world free of leprosy. The Novartis
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Foundation has started a new world-wide study to shed light on what is needed to further
improve the control of leprosy, with special emphasis on improving early detection.
Partners: World Health Organization (WHO)
Countries: Afghanistan, Angola, Argentina, Bangladesh, Bhutan, Brazil, Burkina Faso, Burundi,
Cape Verde, Cambodia, Cameroon, Central African Republic, China, Colombia, Costa Rica,
Cuba, Democratic Republic of Congo, Dominican Republic, Egypt, El Salvador, Eritrea,
Ethiopia, Gambia, Gabon, Ghana, Guatemala, Haiti, Honduras, India, Indonesia, Iran, Kenya,
Laos, Liberia, Madagascar, Malawi, Mali, Marshall Islands, Mexico, Micronesia, Mozambique,
Myanmar, Nepal, Nicaragua, Nigeria, Pakistan, Panama, Papua New Guinea, Paraguay, Peru,
Philippines, Republic of Congo, Rwanda, Senegal, Sierra Leone, Somalia, Sri Lanka, Sudan,
Timor Leste, Togo, Uganda, Venezuela, Vietnam, Yemen, Zambia, Zimbabwe
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8. Merck Mectizan® Donation Programme
Disease area(s): Lymphatic filariasis, onchocerciasis
Company(ies): Merck & Co. Inc.
Partner(s): WHO, World Bank and other partners
Since 1987
Programme type(s): Access - Donation, Capacity Building - Support & Training
Developing country(ies): 33 endemic countries in Africa, Latin America, and
the Middle East
Onchocerciasis, or river blindness, is a leading cause of infectious blindness in the developing
world. The Merck Mectizan® Donation Programme (MDP) was launched in 1987, when Merck
& Co., Inc. announced that it would donate as much Mectizan® (ivermectin), for the
treatment of onchocerciasis to all who needed it for as long as necessary. A multi-sectoral
partnership was established with governments in countries where onchocerciasis is endemic,
their ministries of health and other national and international stakeholders, including the World
Health Organization, to ensure appropriate infrastructure, distribution and support.
Since the inception of the programme, Merck has donated more than 2.5 billion tablets of
Mectizan® for river blindness, with nearly 700 million treatments approved since 1987. The
programme currently reaches more than 100 million people annually through river blindness
programmes in Africa, Latin America and Yemen.
In 2007, Merck re-affirmed its pledge to donate as much Mectizan® as necessary for the
elimination of river blindness globally. With this renewed pledge, Merck's donation of
Mectizan® for river blindness is estimated to reach 100 million treatments annually by 2010.
Also in 2007, Merck announced a donation of USD 25 million over eight years as part of an
initiative with the World Bank to raise approximately USD 50 million in support of river blindness
elimination in Africa.
The MDP has made a substantial impact in the fight against onchocerciasis:
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"
In 2007, public health officials announced that transmission of river blindness had been
halted in Colombia: the first time that the disease has been eliminated as a public
health problem on a country-wide basis anywhere in the world.
"
Health officials also announced that river blindness transmission has been halted in
certain endemic areas in Ecuador and Guatemala, and new cases of eye disease
caused by river blindness have been eliminated in 9 of the 13 foci in the Americas.
"
The success of the programme in Latin America means that 74,476 people in 190
communities are now free of the threat of river blindness.
While much progress has been made in the treatment and progress toward elimination, a
number of additional challenges remain that Merck and its partners are actively addressing.
Partners: United Nations Children's Fund (UNICEF), World Health Organization (WHO), World
Bank
Countries: Angola, Benin, Brazil, Burkina Faso, Burundi, Cameroon, Central African Republic,
Chad, Côte d'Ivoire, Democratic Republic of Congo, Ecuador, Equatorial Guinea, Ethiopia,
Ghana, Guatemala, Guinea, Guinea-Bissau, Liberia, Malawi, Mali, Mexico, Niger, Nigeria,
Republic of Congo, Senegal, Sierra Leone, Sudan, Tanzania, Togo, Uganda, Venezuela,
Yemen
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9. Merck Praziquantel Donation Programme
Disease area(s): Schistosomiasis
Company(ies): Merck KGaA
Partner(s): WHO
Since 2007
Programme type(s): Access - Donation
Developing country(ies): 6 African priority control countries
According to the World Health Organization (WHO), up to 300 million people suffer from
schistosomiasis, a worm disease caused by schistosomes, parasitic worms that multiply as
swimming eggs in certain fresh water snails. Human infection occurs when the skin comes into
contact with schistosome parasites released into the water by infected snails. The parasites
migrate to the liver, mature into adult worms and reproduce, with their eggs being ejected
from the body in the feces. Schistosomiasis causes anemia, stunted growth and learning
disabilities. It is the second-most common tropical disease in Africa after malaria and is also
prevalent in Asia, Africa, the Caribbean, the Middle East and South America. Some 600 million
people are at risk and around 200,000 people die of this disease every year.
In April 2007, Merck KGaA signed a partnership agreement with the WHO to supply 200 million
tablets of Cesol® 600 (praziquantel) for the treatment and prevention of schistosomiasis over a
10 year period. Some 27 million African school children will benefit from the Merck donation,
with an estimated value of approximately USD 80 million, which is focused on Sub-Saharan
African countries. Angola, Benin, Cameroon, Central African Republic, Madagascar, Nigeria,
Senegal and Yemen have been designated by WHO/AFRO for priority control of neglected
tropical diseases (NTDs).
Partners: World Health Organization (WHO)
Countries: Angola, Benin, Cameroon, Central African Republic, Madagascar, Senegal,
Nigeria, Yemen
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10. Sanofi-Aventis “Most Neglected Diseases” Programme
Disease area(s): Buruli ulcer, Chagas disease, leishmaniasis
Company(ies): Sanofi-Aventis
Partner(s): WHO and other partners
Since 2006
Programme type(s): Access - Pricing, Capacity Building - Support
Developing country(ies): Brazil, Chad, Ethiopia, Panama, Sudan, Togo, MiddleEast countries
As part of its 5-year agreement with the World Health Organization (WHO) in 2006 to extend its
partnership in sleeping sickness (see separate entry), Sanofi-Aventis also supported a
collaborative programme with WHO to improve treatment for some “most neglected
diseases”, namely leishmaniasis, Chagas disease and Buruli ulcer.
Sanofi-Aventis is providing USD 6.4 million to WHO over 5 years for development of training,
diagnostics and optimization of treatment for leishmaniasis. It will transfer the worldwide
production of its leishmaniasis medicine Glucantime® to its Brazilian subsidiary, to optimize
product price. Sanofi-Aventis will also provide Glucantime® at a tiered-price of USD 1.2 per
ampoule in all developing countries. In 2008, Sanofi-Aventis also helped the WHO with import
licences in some critical endemic countries.
Sanofi-Aventis’s Humanitarian Partnership Department is developing a joint leishmaniasis
control programme with the Aggeu Magalhaes Research Centre and the Oswaldo Cruz
Foundation to set up a screening, care and follow-up programme for 4,000 poor families in
Pernambuco, to fight leishmaniasis and other endemic diseases in the region, such as
tuberculosis and dengue. Other programmes on leishmaniasis are also being developed with
the governments of Panama and Bolivia.
Sanofi-Aventis is also giving WHO USD 2 million for new programmes to intensify disease
management of Buruli ulcer and Chagas disease and USD 4 million to support field activities of
its Innovative and Intensified Disease Management programme.
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In addition to the above-mentioned agreement with WHO, Sanofi-Aventis has partnered in
2007 with Handicap International to set up a five-year national campaign in Togo to reduce
the death rate and the serious post-disease effects caused by Buruli ulcer. In 2008, 98 health
professional were trained, and 194 patients treated under this programme.
Partners: Aggeu Magalhaes Research Centre in Brazil, Oswaldo Cruz Foundation in Brazil,
Handicap International, World Health Organization (WHO)
Countries: Brazil, Chad, Ethiopia, Panama, Sudan, Togo
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11. Sanofi-Aventis Sleeping Sickness Programme
Disease area(s): Sleeping sickness
Company(ies): Sanofi-Aventis
Partner(s): WHO and other partners
Since 2001
Programme type(s): Access - Donation, Capacity Building - Support, R&D
Developing country(ies): Sub-Saharan African countries
Sleeping sickness has re-emerged in Africa as a major health threat. In 2001, Sanofi-Aventis
committed USD 25 million over the years 2001-2006 to help the World Health Organization
implement a strategy of adequate medicine supplies, disease surveillance and management,
plus R&D for new treatments.
After five years, WHO and Sanofi-Aventis’ efforts were estimated to have saved 110,000 lives. In
2006, the company renewed its contract with WHO and expanded it to address several
additional “most neglected diseases” (see separate entry). It has committed to provide a
further USD 14 million over the years 2006-2011, with continued medicines being donated for
sleeping sickness, and funding for training, control and diagnostic programmes. It is also
working to make eflornithine a more “ready to use” and safer treatment.
By the end of 2008, more than 1,250,000 vials of eflornithine, pentamidine and melarsoprol had
been distributed and WHO estimates that the number of new patients identified per year, via
the WHO-Sanofi-Aventis partnership, is 11,000.
Sanofi-Aventis has delivered donated medicines to Médecins sans Frontières, which provides
storage, distribution and sometimes administration of the medicines on behalf of WHO, for
national control programmes and NGO use.
Sanofi-Aventis also helped fund development of new therapies through the UNDP-World BankWHO Special Programme for Research and Training in Tropical Diseases (TDR). These included
an oral form of eflornithine (stopped in 2007) and a combination of eflornithine and nifurtimox.
Based on promising results from early clinical trials, the development of this combination has
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been continued. Bayer HealthCare provides nifurtimox for free for the clinical trials, while
Sanofi-Aventis is providing free eflornithine.
Bristol-Myers Squibb funded the supply of the active ingredient for eflornithine during the first
year of the donation and, in 2002, provided a complementary USD 400,000 cash donation to
the WHO.
Partners: Médecins sans Frontières MSF, UNICEF-UNDP-World Bank-WHO Special Programme for
Research and Training in Tropical Diseases (TDR), United Nations Development Programme
(UNDP), World Bank, World Health Organization (WHO)
Countries: Angola, Central African Republic, Chad, Democratic Republic of Congo, Republic
of Congo, Sudan, Tanzania, Uganda
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12. Soil-Transmitted Helminthiasis
Disease area(s): Soil-transmitted helminthiasis
Company(ies): Johnson & Johnson
Partner(s): Task Force for Child Survival and Development
Since 2007
Programme type(s): Access - Donation
Developing country(ies): Bangladesh, Cameroon, Cape
Nicaragua, Uganda, Zambia
Verde,
Laos,
Globally, up to 400 million children suffer from Soil-Transmitted Helminthiasis (STH), an infection
of intestinal worms, but fewer than 20% of at-risk children were reached with de-worming
treatment in 2005, falling far short of the World Health Assembly's target to treat 75% of at-risk
children by 2010. STH is especially dire for children because it causes malnutrition, increases
susceptibility to other serious infections, and stunts growth during a critical development
period.
STH has been identified by the WHO and the US Centres for Disease Control and Prevention as
a “target of opportunity”, meaning that with existing diagnostic tools and treatments and
greater support, it can be prevented, treated and controlled.
In 2007, Johnson & Johnson partnered with the Task Force for Child Survival and Development
to develop and launch a programme to donate up to 50 million doses of mebendazole in
2007 to treat children with or at high risk for STH. Mebendazole is one of a class of medicines
known as antihelmintics that are used to treat numerous kinds of worm infections. The
governments of Bangladesh, Cameroon, Uganda and Zambia received donations in 2007,
and four additional countries - Cambodia, Cape Verde, Laos and Nicaragua - are receiving
membedazole donations in 2008. This is the largest pharmaceutical donation, to date, to treat
intestinal worms.
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13. GSK - DNDi Collaboration
Disease area(s): Chagas disease, leishmaniasis, sleeping sickness
Company(ies): GlaxoSmithKline
Partner(s): DNDi and other partners
Since 2008
Programme type(s): R&D
Developing country(ies): Pre-clinical research in Spain and the UK
In March 2008, GlaxoSmithKline (GSK) and the Drugs for Neglected Diseases initiative (DNDi)
announced a collaborative research effort targeting visceral leishmaniasis (kala azar), human
African trypanosomiasis (sleeping sickness) and Chagas disease.
The collaboration, which has been established for an initial period of two years, will focus on
identifying and developing compounds from existing GSK programmes and will leverage the
expertise of researchers at GSK's Tres Cantos facility and leading academic centres like the
London School of Hygiene & Tropical Medicine (LSHTM).
The collaboration has been formed to address unmet patient needs, as current treatments for
these diseases have significant drawbacks, such as difficulty of administration, severe side
effects, length of treatment, cost and emerging parasitic resistance.
Partners: Drugs for Neglected Diseases initiative (DNDi), London School of Hygiene & Tropical
Medicine (LSHTM)
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14. Roche Foundation for Anaemia Research (RoFAR)
Disease area(s): Anaemia
Company(ies): Roche
Partner(s): Independent research facility
Since 2004
Programme type(s): R&D
Developing country(ies): Worldwide
RoFAR was founded in 2004 as an independent, scientist-led, international medical research
charity. RoFAR has committed 20 million Swiss francs since the Foundation began. It has so far
awarded around 15 million Swiss francs to 68 research projects around the world. RoFAR will
conclude its last cycle of funding in 2011.
15. West Africa Hydrocele Surgical Training Programme (WAHSTP)
Disease area(s): Hydrocele
Company(ies): Johnson & Johnson
Partner(s):
Since 2005
Programme type(s): Training – capacity building
Developing country(ies): Burkina Faso, Ghana, Mali, Niger, and Togo
Since the programme began in 2005, nearly 100 surgeons and surgical nurses have been
trained, and more than 2,100 men have benefited from the surgery. Johnson & Johnson
provides financial support that helps WAHSTP operate in targeted countries.
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INITIATIVES AGAINST PREVENTABLE DISEASES
Immunization reaches over 80% of children worldwide and is one of the most successful and
cost-effective public health interventions ever, eradicating smallpox, lowering the global
incidence of polio by 99% since 1988, and achieving dramatic reductions in illness and death
from diphtheria, tetanus and whooping cough. In 2008, measles partners announced that
mortality due to measles decreased by 74% globally between 2000 and 2007.
Between 2 and 3 million deaths from diphtheria, tetanus, pertussis (whooping cough), and
measles are estimated to be prevented annually as a result of immunization. Hepatitis B
vaccination prevents an additional 600 000 future deaths (from liver cirrhosis and liver cancer)
annually. However, an estimated 26.3 million of children under one year of age remained in
need of immunization in 2006. The cost of not immunizing is higher because people who are
not vaccinated as infants remain vulnerable for the rest of their lives.
In September 2005, the United Kingdom, France, Italy, Spain and Sweden committed nearly
USD 4 billion to immunization in developing countries over the next decade, using an
innovative new mechanism called the International Finance Facility for Immunization (IFFIm).
IFFIm and innovative finance mechanisms such as Advance Market Commitments (AMCs)
reflect a growing willingness on the part of developed countries to make significant financial
resources available to meet important health needs in resource-poor countries.
1. Bristol-Myers Squibb Foundation: Delivering Hope
Disease area(s): Hepatitis
Company(ies): Bristol-Myers Squibb
Partner(s): Various national and local foundations
Since 2002
Programme type(s): Capacity Building - Support & Training, Education
Developing country(ies): China and India
Delivering Hope is a comprehensive effort to fight Hepatitis B and C in Asia, sponsored by the
Bristol-Myers Squibb Foundation. Delivering Hope has drawn upon the proven models created
by the Foundation's work on HIV/AIDS in Africa to address a major healthcare challenge in
resource-constrained settings.
Since 2002, Bristol-Myers Squibb and the Bristol-Myers Squibb Foundation have provided USD
3.1 million in grants in China, already benefiting more than 700,000 people directly, and USD
1.7 million in India.
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2. GAVI Alliance
Disease area(s): Childhood diseases
Company(ies): Crucell, GlaxoSmithKline, Merck & Co. Inc., Sanofi-Aventis ,
Wyeth
Partner(s): GAVI Alliance, WHO and other partners
Since 2000
Programme type(s): Access - Donation & Pricing, Capacity Building - Support &
Training
Developing country(ies): Low-income countries
The Alliance's partners include industrialized countries vaccine manufacturers (Crucell,
GlaxoSmithKline, Merck & Co., Inc., Novartis, Sanofi Pasteur, the vaccines division of SanofiAventis , and Wyeth), developing countries vaccine industry, industrialized and developing
country governments, UNICEF, the WHO, the World Bank, charitable foundations and NGOs.
Industry partners invest in the development of new vaccines and in enhanced global vaccine
manufacturing capacity, including facilities in developing countries. They also help to educate
healthcare providers and develop technologies to facilitate vaccine distribution.
Crucell’s support for GAVI includes supplying large quantities of the first internationally
available thiomersal-free fully liquid pentavalent (5-in-1) vaccine Quinvaxem™ which protects
children against 5 diseases (DTP-HepB-Hib) in one single shot. Country applications for Hibcontaining combinations grew to their historical high in 2008 and over half a billion doses of
liquid pentavalent vaccine have been requested for 2009-2012.
Of the 1.1 billion vaccine doses GSK supplied in 2008, almost 80% went to developing
countries. GSK has actively supported GAVI since its inception and was its main pentavalent
and tetravalent vaccine supplier during GAVI Phase I. GSK has also developed new
pneumococcal, rotavirus and cervical cancer vaccines, which will be made available in
developing countries with help from GAVI. GSK is developing new vaccines for diseases which
are future GAVI targets, including dengue and malaria.
As part of its support for the GAVI Alliance, the Merck Company Foundation funds the Merck
Vaccine Network - Africa. Merck also provided 1 million doses of MMR II vaccine for mumps,
measles and rubella to Honduras over a three-year period and donated hepatitis B vaccine in
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support of GAVI. Merck is also providing rotavirus vaccination for all infants in Nicaragua for a
three-year period. In 2008, Merck contributed USD 2 million to the GAVI-supported Measles
Initiative of the UN Foundation, for disease surveillance activities in Africa. Since 2001, the
Measles Initiative has supported the vaccination of more than 600 million children in more than
60 countries.
Sanofi Pasteur supports GAVI's polio eradication efforts and has donated 120 million doses of
oral polio vaccine (OPV) since 1997. It also supports the GAVI yellow fever vaccine initiative for
Africa. In 2007, Sanofi Pasteur sponsored the first EPIVAC technical conference on yellow fever,
which drew 150 participants from Benin, Burkina Faso, Cameroon, Côte d'Ivoire, Guinea, Mali,
Senegal and Togo.
In November 2006, the GAVI Board approved investment in pneumococcal and rotavirus
vaccines. In February 2007, donor countries approved an Advance Market Commitment
(AMC) pilot programme to encourage development of new pneumococcal vaccines. In
2007, WHO recommended inclusion of PCV7 pneumococcal vaccine in immunization
programmes with priority for high-risk populations, mostly in the developing world. In November
2008, GAVI accepted Wyeth's proposal to donate more than 3 million doses of its Prevnar®
pneumococcal vaccine to protect children in Rwanda and Gambia, countries with very high
mortality from pneumococcal disease. Immunization should start in 2009 - the first time a
pneumococcal conjugate vaccine will have been used into the developing world.
GSK has become one of the first manufacturers to sign a unique agreement with the GAVI
Alliance that has the potential to save millions of children from dying in the world’s poorest
countries. GSK will supply up to 300 million doses of its vaccine Synflorix, for invasive
pneumococcal disease, to GAVI over a ten year period.
Over the ten year period of the
agreement, GSK will supply up to 300 million doses of its pneumococcal vaccine, valued at
approximately USD 1.3 billion.
Partners: GAVI Alliance, World Health Organization (WHO), World Bank, United Nations
Children's Fund (UNICEF) Countries: Benin, Burkina Faso, Cameroon, Côte d'Ivoire, Gambia,
Guinea, Honduras, Mali, Nicaragua, Rwanda, Senegal, Togo
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3. Global Polio Eradication Initiative
Disease area(s): Polio
Company(ies): Sanofi-Aventis
Partner(s): WHO and other partners
Since 1988
Programme type(s): Access - Donation, Capacity Building - Support
Developing country(ies): Afghanistan, Egypt, India, Indonesia, Nigeria, Pakistan
In January 2004, a new plan was unveiled to immunize 250 million children in the remaining
polio-endemic countries to eradicate finally a disease that once paralyzed hundreds of
thousands of children each year. Working in cooperation, the World Health Organization
(WHO), Rotary International, the US Centres for Disease Control and Prevention (CDC) and the
United Nations Children's Fund (UNICEF) agreed to accelerate efforts targeted at eradicating
polio.
In 2002, Sanofi Pasteur, the vaccines division of Sanofi-Aventis, announced that it would
donate 30 million doses of the Oral Polio Vaccine (OPV) to the Global Polio Eradication
Initiative through 2005. Sanofi Pasteur, the longest-standing corporate partner in the Initiative,
has donated 120 million OPV doses since 1997. At the WHO's request, Sanofi Pasteur
developed and licensed a new vaccine in record time in 2005 - Monovalent Oral Polio
Vaccine 1 or MOPV1 - for use first in Egypt as a critical part of a new WHO strategy to end
polio transmission. Sanofi Pasteur also provides bulk MOPV1 to a manufacturer in India, to fill
and package for local use. In 2007, Sanofi Pasteur donated 270,000 doses of inactivated polio
vaccine (IPV) to Indonesia for a WHO-sponsored study on IPV introduction in Lombok.
Partners: World Health Organization (WHO), Rotary International, United Nations Children's
Fund (UNICEF), US Centres for Disease Control and Prevention (CDC)
Countries: Afghanistan, Egypt, India, Indonesia, Nigeria, Pakistan
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4. HPV Vaccine & Cervical Cancer
Disease area(s): Cervical cancer
Company(ies): GlaxoSmithKline, Merck & Co. Inc.
Partner(s): PATH
Since 2005
Programme type(s): Access - Donation & Pricing
Developing country(ies): India, Peru, Uganda, Vietnam
Cervical cancer is the second most common cancer in women worldwide, with about 500,000
new cases and 250,000 deaths occurring each year. Almost 80% of cases occur in low-income
countries, where cervical cancer is the number one cause of cancer in women. Virtually all
cervical cancer cases (99%) are linked to genital infection with human papillomavirus (HPV), a
family of virus types which also causes genital warts and other forms of cancer.
PATH, the Programme for Appropriate Technology in Health, is an international, non-profit
organization that creates sustainable, culturally relevant health solutions, and works to
advance acceptable and affordable new technologies for low-resource settings. PATH is
partnering with GlaxoSmithKline and Merck & Co., Inc., both of which have developed HPV
vaccines, to conduct pilot HPV vaccination programmes in adolescent females, looking at
acceptance and accessibility. The countries selected are India, Peru, Uganda and Vietnam.
GSK expects its Cervarix™ HPV vaccine will secure WHO Pre-Qualification in 2009, allowing its
purchase by UN agencies on behalf of poorer countries. GSK works with partners to help
improve access to its vaccines and is committed to ensuring pricing is not a barrier-to-access
in the developing world. For example, it has made Cervarix™ available in Indonesia, South
Africa, the Philippines and Vietnam, with price reductions of up to 60%. GSK has long
practiced tiered pricing for vaccines supplied to government-led programmes, charging
lower prices in poorer countries. GSK is also supporting HPV pilot projects; for example, it
donated 50,000 doses of Cervarix™ to a PATH-led project in Uganda.
The GARDASIL® Access Programme plans to make available at least 3 million doses of
GARDASIL® [Human Papillomavirus Quadrivalent (Types 6, 11, 16, 18) Vaccine, Recombinant],
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to qualifying organizations and institutions in developing countries where approximately 80% of
the world's cervical cancer cases occur.
The GARDASIL® Access Programme enables organizations and institutions in eligible lowest
income countries to gain operational experience in the design and implementation of human
papillomavirus vaccination projects, with the goal of supporting the development of
successful child and adolescent immunization models.
The GARDASIL® Access Programme, which will run over a 5-year period, is made possible by a
pledge from Merck & Co., Inc., and overseen by Axios Healthcare Development (AHD), a US
non-profit organization. AHD administers the donation programme, reviews and approves
applications, and ensures prompt delivery of the vaccine to the recipients, with the technical
assistance of Axios International, a public health consultancy specializing in developing and
emerging countries.
Since the inception of the programme, organizations and institutions in Bhutan, Bolivia,
Cambodia, Cameroon, Georgia, Ghana, Haiti, India, Kenya, Lesotho, Moldova, Nepal,
Nicaragua, Papua New Guinea, Tanzania, Uganda and Uzbekistan have been approved to
receive more than 496,000 doses of GARDASIL®.
Partners: Programme for Appropriate Technology in Health (PATH)
Countries: India, Peru, Uganda, Vietnam
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5. Merck Vaccine Network - Africa (MVN-A)
Disease area(s): Vaccine-preventable diseases
Company(ies): Merck & Co. Inc.
Partner(s): Various partners
Since 2003
Programme type(s): Capacity Building - Training
Developing country(ies): Kenya, Mali, Uganda, Zambia
MVN-A training centre partners include: Indiana University School of Medicine and Moi
University Faculty of Health Sciences (Kenya); Centre for Vaccine Development, University of
Maryland School of Medicine and the Centre for Vaccine Development, Centre national
d'appui à la lutte contre la maladie (Mali); Task Force for Child Survival and Development,
Emory University and Makerere University School of Public Health (Uganda); and Brighton and
Sussex University Hospitals NHS Trust and the University of Zambia School of Medicine (Zambia).
To date, more than 350 health professionals in Kenya and Mali have completed MVN-A
training on a wide range of topics. Trainees have returned to their home medical facilities to
share their expertise and knowledge with fellow healthcare workers. In Kenya, MVN-A trainees
in the Ministry of Health worked to coordinate health services support, including mass
immunization campaigns to prevent outbreaks of measles and polio for large camps of
internally displaced persons. In Mali, the Ministry of Health leveraged the MVN-A programme
to help train immunization managers in preparation for the accelerated introduction of a new
Hib pentavalent vaccine (DTP-HepB+Hib), funded by GAVI. Since its successful expedited
introduction in 2005, more than 675,000 Malian children have received this new combination
vaccine.
Partners: Brighton and Sussex University Hospitals NHS Trust in UK, Emory University in USA,
Indiana University in USA, Makerere University School of Public Health in Uganda, Moi University
in Kenya, University of Maryland in USA, Centre national d'appui à la lutte contre la maladie in
Mali, University of Zambia
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6. Pandemic Influenza & Developing Countries
Disease area(s): Pandemic influenza
Company(ies): Biken, Gilead, GlaxoSmithKline, Roche, Sanofi-Aventis
Partner(s): WHO and other partners
Since 2006
Programme type(s): Access - Donation & Pricing
Developing country(ies): China, India, South Africa
GlaxoSmithKline (GSK) has invested over USD 2 billion in research and expanded production
capacity for its antiviral medicine, Relenza®, and for its pre-pandemic and pandemic
influenza vaccines. It has set a preferential price for Relenza® for least-developed countries
(Least developed countries) and has granted Simcere, China, a voluntary licence to make
zanamivir and sell it in China, Indonesia, Thailand, Vietnam and all Least developed countries.
In 2007, GSK announced it would donate 50 million doses of H5N1 vaccine to a WHO stockpile
and that it will also sell this vaccine at preferential prices to the WHO stockpile and poorer
countries. In May 2008, GSK obtained the first EU licence for a pre-pandemic influenza
vaccine, Prepandrix™, and has also been granted an EU licence for its mock-up pandemic
vaccine, Pandemrix™.
Roche has increased its capacity to make Tamiflu® (oseltamivir) antiviral medicine by 500%
since 2002; by 2007, it could make 400 million treatment courses per year if required. It sells
Tamiflu® at a reduced price for pandemic stockpiling and offers further price reductions to
low income countries. Production can be increased if key inventories drop below target levels
or the WHO declares a phase 4 pandemic (human-to-human transmission).
Roche and Gilead (which developed Tamiflu®) hold no patents on it in least developed
countries, whose governments are free to make generic versions. To further increase access to
Tamiflu® for pandemic use, Roche has granted sublicences to Shanghai Pharmaceuticals,
HEC Group, China, and Hetero Pharmaceuticals, India, to make oseltamivir, and has given
Aspen Pharmaceuticals, South Africa, information to facilitate local manufacturing of Tamiflu®
for pandemic stockpiling by African governments.
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Roche has also donated over 5 million treatment courses of Tamiflu® to WHO in 2009. It has
also donated 5 million doses in 2003, which were donated by WHO to needy countries. A WHO
central stockpile of 3 million courses will be used to extinguish or slow a pandemic at its site of
outbreak. The regional stockpiles, comprising 2 million courses, are being used to manage
current outbreaks of avian influenza and will augment the WHO central stockpile in a
pandemic containment effort.
In 2008, Sanofi Pasteur, the vaccines division of Sanofi-Aventis, announced it intends to
contribute 60 million doses of H5N1 vaccine over 3 years to the WHO emergency reserve
stockpile. Sanofi Pasteur is also expanding its manufacturing capacity, including building new
vaccine plants in China and Mexico, and is researching new approaches, such as adjuvants,
to allow more people to be protected using current capacity. In March 2009, Sanofi Pasteur's
H5N1 vaccine, Emerflu®, was granted a marketing authorization by the Australian Therapeutic
Goods Administration (TGA).
Other manufacturers are also increasing vaccine capacity in developing countries, building
new plants or through local partnerships. These include Biken in Indonesia and GlaxoSmithKline
in China.
In December 2009, AZ signed an agreement with the World Health Organization (WHO) which
committed at least 3 million doses of its live, attenuated intranasal vaccine for H1N1 to be
distributed at WHO’s discretion as well as a cash donation to help support those distribution
efforts. WHO has processes in place to allow for legal distribution and use of the product in
countries where it is not currently approved for marketing.
Partners: World Health Organization (WHO), Aspen Pharmacare in South Africa, Simcere in
China, Shanghai Pharmaceuticals in China, HEC Group in China, Hetero Pharmaceuticals in
India
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7. Rotavirus Vaccine Programme
Disease area(s): Rotavirus-induced gastroenteritis
Company(ies): GlaxoSmithKline, Merck & Co. Inc.
Partner(s): GAVI Alliance, WHO and other partners
Since 2003
Programme type(s): Access - Donation & Pricing
Developing country(ies): Brazil, El Salvador, Mexico, Nicaragua, Panama,
Venezuela
Rotavirus infection is the leading cause of severe diarrhoea and vomiting (gastroenteritis) in
children under two and kills around 600,000 children each year, mostly in developing
countries. With funding from the GAVI Alliance and the Vaccine Fund, the Programme for
Appropriate Technology in Health (PATH) established the Rotavirus Vaccine Programme (RVP)
in 2003. With its strategic partners, the World Health Organization (WHO) and the US Centres for
Disease Control and Prevention (CDC), RVP is working to accelerate introduction of the two
available vaccines.
GlaxoSmithKline's vaccine, Rotarix™ is a two-dose oral vaccine targeting one rotavirus strain.
Early in 2007, GSK obtained WHO pre-qualification for Rotarix™. GSK is helping Brazil to
implement a universal mass vaccination programme for rotavirus. It will supply enough
Rotarix™ to protect every baby in Brazil for the next five years and will transfer technology to
allow Brazil's Fiocruz to produce Rotarix™ under licence for the domestic market and for export
to other developing countries. The vaccination programme has already resulted in an 85%
reduction in rotavirus related hospitalizations, according to the Brazilian Ministry of Health.
In 2005, WHO moved to recommend rotavirus vaccination as one of the core list of childhood
immunizations. In late 2006, the GAVI Alliance committed to provide funding for the
introduction of rotavirus vaccines in eligible countries around the world.
Partners: Brazil Ministry of Health, FioCruz, GAVI Alliance, Nicaragua Ministry of Health,
Programme for Appropriate Technology in Health (PATH), US Centres for Disease Control and
Prevention (CDC), Vaccine Fund, World Health Organization (WHO)
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8. Sanofi-Aventis & EPIVAC
Disease area(s): Vaccine-preventable diseases
Company(ies): Sanofi-Aventis
Partner(s): GAVI Alliance, UNICEF, WHO and other partners
Since 2002
Programme type(s): Capacity Building - Training
Developing country(ies): 11 African countries
The programme is a Sanofi Pasteur, the vaccines division of Sanofi-Aventis , contribution to the
GAVI Alliance. Implemented by the Agence de Médecine Préventive, the programme was
developed in partnership with national governments of eligible countries and the participating
universities, in collaboration with the WHO, UNICEF, the Vaccine Fund and other partners
working in Africa. EPIVAC is coordinated with the GAVI subregional working group and
complements other GAVI support to African countries.
EPIVAC seeks to strengthen the GAVI process within each country in coordination with the
Interagency Coordinating Committee (ICC).
The EPIVAC programme monitors and evaluates the impact of training on immunization
delivery and management in the district. Between 2002 and 2008, approximately 350 doctors
have been enrolled in EPIVAC training. Doctors have been trained from Benin, Burkina Faso,
Cameroon, Côte d'Ivoire, Central Africa, Guinea, Mali, Mauritania, Niger, Senegal and Togo.
In 2008, Sanofi Pasteur also funded the launch of the EPIVAC Network (REI), which aims to
bring together the graduates of the EPIVAC programme for best-practice sharing and
continuous education in vaccination and logistics.
Partners: Agence de Médecine Préventive, EPIVAC (EPIdemiology & VACcinology), GAVI
Alliance, United Nations Children's Fund (UNICEF), Vaccine Fund, World Health Organization
(WHO).
Countries: Benin, Burkina Faso, Cameroon, Côte d'Ivoire, Central African Republic, Guinea,
Mali, Mauritania, Niger, Senegal, Togo
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9. Schering-Plough Vaccine Licence Agreement with WHO
Disease area(s): Pandemic influenza
Company(ies): Schering-Plough
Partner(s): WHO
Since 2009
Programme type(s): Access - Licensing
Developing country(ies): Developing countries
In February 2009, Schering-Plough announced a licence agreement between Nobilon,
Schering-Plough's human vaccine business unit, and the World Health Organization (WHO) to
provide access to pandemic influenza vaccine manufacturing technology to developing
countries.
Under the agreement, Nobilon has granted WHO a non-exclusive licence to develop, register,
manufacture, use and sell seasonal and pandemic live, attenuated, influenza vaccines (LAIV),
produced in embryonated chicken eggs. WHO will be permitted to grant a sub-licence to
vaccine manufacturers in developing countries working within the framework of the WHO
Global Vaccine Action Plan. Vaccine manufacturers to whom a sub-licence will be granted
will be able to provide vaccines to the public sector of developing countries royalty-free.
Egg-based LAIV technology is specifically considered attractive for this purpose because the
manufacturing technology process is easier to transfer, capital investment is lower and yields
are higher, as compared to inactivated influenza vaccines.
The WHO Global Vaccine Action Plan seeks to expand influenza vaccine manufacturing
capacity in developing countries and enhance the global supply for pandemic vaccines.
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10. Sigma-Tau & AMREF: “Uganda Project”
Disease area(s): Vaccine-preventable disease
Company(ies): Sigma-Tau
Partner(s): African Medical Research Foundation (AMREF)
Since 2008
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): Uganda
Sigma-Tau supports the African Medical Research Foundation (AMREF) in implementing the
“Uganda Project”, a vaccination and medical training programme in Northern Uganda, in the
areas most affected by the civil war of the 1990s.
The main aim of the project is to vaccinate more than 3,000 Ugandan children against the six
most common childhood diseases (tuberculosis, diphtheria, tetanus, poliomyelitis, hepatitis B
and measles). At the same time, it also aims to provide medical training for local health
workers, thus furnishing both immediate and long-term support for health development.
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11. Nicaragua Rotavirus Vaccine Programme
Disease area(s): Gastroenteritis
Company(ies): Merck
Partner(s): Nicaraguan Ministry of Health, UNICEF and others
Since 2006
Programme type(s): Access - Donation
Developing country(ies): Nicaragua
In 2006, Merck, the Nicaraguan Ministry of Health, UNICEF and leading health organizations
established a three-year partnership to provide free vaccinations against rotavirus
gastroenteritis to all eligible infants born in Nicaragua. Through the partnership – called the
Nicaraguan Rotavirus Vaccination Programme – Merck expects to donate more than one
million doses of ROTATEQ® (rotavirus vaccine, live, oral pentavalent) through the end of 2009,
representing a USD 75 million commitment.
Since the partnership was launched in October 2006, Merck has provided nearly 1 million free
doses of ROTATEQ® (rotavirus vaccine, live, oral pentavalent) to Nicaragua. Starting in March
2007, an estimated 27,720 doses of ROTATEQ® have been administered every month through
the national immunization programme; to date, more than 769,120 doses have been
administered. The country has achieved rates of rotavirus vaccination that are among the
highest in the world with the Ministry of Health reporting that approximately 81% of eligible
infants in Nicaragua were vaccinated with ROTATEQ® in 2008.
The aim is an 82-84 percent vaccination rate with ROTATEQ by the end of 2009.
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INITIATIVES FOR CHILD & MATERNAL HEALTH
1. Abbott Fund Programme to Fight Malnutrition in Vietnam
Disease area(s): Child & maternal health, malnutrition
Company(ies): Abbott
Partner(s): AmeriCares, Giao-Diem Humanitarian Foundation
Since 2006
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): Vietnam
According to UNICEF, more than 25% of Vietnamese children under five are underweight and
more than 10% of Vietnamese children suffer from vitamin A deficiency. To help improve the
overall nutritional health of children in rural areas of Vietnam, the Abbott Fund is working with
AmeriCares to support the Giao-Diem Humanitarian Foundation.
Together, the Abbott Fund and its partners are improving the nutritional status of school age
children in three rural provinces of Vietnam - Quang Tri, Hue, and Dong Thap - where
childhood malnutrition rates are among the highest in the country. This successful initiative
targets nutritional health early in life.
During the flooding and raining season, Abbott also donates paediatric nutritional products. In
2008, the Abbott Fund initiative reached 65 schools and more than 1,700 children.
For the second year in a row, the Quang Tri province has exceeded the national nutritional
health target, reducing the rate of malnutrition for children under five from 25% to 17%.
In association with the UN’s Millennium Development Goal 1 on extreme poverty and hunger,
Vietnam aims to reduce the proportion of people living under the food poverty line by 75% by
2010. In association with the UN’s Goal 4 on child mortality, the partnership is helping Vietnam
reduce the proportion of children under five who are malnourished down to 20% by 2010. This
programme serves as a sustainable model for improving paediatric nutrition in rural Vietnam.
Abbott is currently supporting efforts by other organizations to replicate this model programme
at five additional locations.
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2. Abbott Fund Programme to Improve Children's Health in Cambodia
Disease area(s): Child & maternal health
Company(ies): Abbott
Partner(s): Angkor Hospital for Children in Cambodia, Direct Relief International (DRI)
Since 2006
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): Cambodia
Malnutrition is a significant contributor of early morbidity and mortality among young children
in Cambodia. According to UNICEF, the mortality rate for children under five increased from
115 per 1,000 live births in 1990 to 143 in 2005; nearly 45% of all children under five are
underweight. Since 2006, Abbott and the Abbott Fund have partnered with DRI and Angkor
Hospital for Children in Siem Reap in an effort to reverse these troubling trends.
Abbott and
the Abbott Fund have provided grants and products to support the work of Angkor Hospital
for Children, a paediatric teaching hospital providing free comprehensive care for more than
180,000 children in Siem Reap and neighboring provinces.
The Abbott Fund is focused on improving health professional and caregiver awareness,
knowledge and ability to treat paediatric nutrition through formal training, local and regional
educational workshops, cooking demonstrations and donations of essential products. With the
Abbott Fund's support, in 2008 Angkor Hospital for Children also sent nurses to participate in
college-level “train the trainer” courses to strengthen the overall clinical teaching skills of the
hospital's nursing staff.
In 2008, more than 113,000 children received nutritional assessments, more than 3,000 families
participated in nutrition information workshops, and more than 120 health professionals were
trained. Abbott has also donated products to improve maternal and child health, including
rehydration solutions, antibiotics, multivitamins and nutritional supplements.
Since the
partnership began, more than 250,000 children have received nutritional assessments, more
than 6,000 families have participated in nutrition information workshops, and more than 400
health professionals have received nutrition training. The programme's success has helped
Angkor Hospital for Children serve as a role model for hospital nutrition programmes in
Cambodia.
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3. Abbott Fund Programme to Improve Maternal & Child Health in Afghanistan
Disease area(s): Child & maternal health
Company(ies): Abbott
Partner(s): Afghan Institute of Learning, Direct Relief International
Since 2005
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): Afghanistan
According to the World Health Organization, Afghanistan has the second highest maternal
mortality rate in the world, with 1,900 deaths per 100,000 live births. In addition, one in four
Afghan children will not live to see their fifth birthday. To improve the lives of women and
children in Afghanistan, Abbott and the Abbott Fund are partnering with the Afghan Institute
of Learning (AIL) and Direct Relief International to help reverse the country's high maternal
mortality rate, and increase the survival and overall health of infants and children.
The Abbott Fund has provided more than USD 400,000 in grants and assisted in coordinating
USD 3.7 million in product donations from Abbott to support the work of AIL, founded by Nobel
Prize nominee Sakena Yacoobi, a long-time advocate for women's rights in Afghanistan.
Direct Relief International, a global humanitarian assistance organization, manages the
distribution of Abbott's grants and product donations to AIL.
With three clinics serving mostly rural areas in Afghanistan (two in Herat province, one in Kabul
province), AIL is staffed and operated by Afghan women. Abbott Fund support is focused on
empowering Afghan women through the training of female nurses, midwives and health
educators to provide skilled assistance during labor and delivery, as well as care for infants
and children. The Abbott Fund also is supporting 5-day women's health workshops that provide
health education directly to Afghan women. In 2008, more than 129,000 women and children
received services and more than 70,000 individuals received training on health education.
Abbott has donated products to improve maternal and child health, including rehydration
solutions, antibiotics, multivitamins and nutritional supplements. Since the partnership began in
November 2005, more than 380,000 women and children have received services, and 46
nurses/midwives have been trained, with most now employed in clinics and hospitals. The
Abbott Fund is supporting the training of 25 additional women in 2008-2009.
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4. AstraZeneca - Promoting Safe Motherhood in India
Disease area(s): Maternal health
Company(ies): AstraZeneca
Partner(s): Federation of Obstetric & Gynaecological Societies of India
Since 2005
Programme type(s): Capacity Building - Training, Education
Developing country(ies): India
Every year some 600,000 women die of pregnancy-related causes and 99% of these deaths
occur in developing countries. India alone accounts for 25% of these deaths and the country
has the third highest maternal mortality rate.
AstraZeneca India's partnership with the Federation of Obstetric and Gynaecological Societies
of India (FOGSI) is focused on improving these statistics, through educational activities,
including conferences for healthcare professionals and public awareness campaigns.
Since the partnership began in 2005, activities have included a unique “walkathon” along the
river Ganges, to spread Safe Motherhood and other healthcare messages among rural
populations with high maternal mortality. A team of 27 doctors, accompanied by children
from local villages, covered five states in 108 days and met over 200,000 people.
Main achievements include:
"
Rubella vaccinations for over 1,000 teenage girls;
"
Distribution of medicines;
"
Educational films on anaemia, HIV/AIDS and female feticide shown to approximately
500 people almost every day;
"
Visits to over 100 schools covered around 80,000 children in rural areas;
"
One to one communication on education, marital age, gender bias, female feticide,
HIV/AIDS, sanitation, environment and nutrition.
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5. Bayer Schering Pharma & Family Planning
Disease area(s): Family planning
Company(ies): Bayer HealthCare
Partner(s): Governments, multilateral organizations, private organizations
Since 1961
Programme type(s): Access - Pricing, Capacity Building - Training, Education
Developing country(ies): Worldwide
For more than 46 years, Bayer Schering Pharma AG (part of Bayer HealthCare) has been
supporting family planning programmes in over 130 countries with its high quality products in
close co-operation with government organizations (BMZ - German Federal Ministry for
Economic Cooperation and Development, KFW - German Development Bank, GTZ - German
Association for Technical Co-operation, the UK's DFID and DANIDA), multilateral organizations
(UNFPA, the World Bank, the WHO, and USAID), and private organizations (International
Planned Parenthood Federation, Population Services International, Marie Stopes, IMRES and
Missionpharma). In that time, more than 2.6 billion cycle packs of oral contraceptives have
been provided to family planning organizations and users in the developing world.
Bayer is committed to making universal access to fertility control means a reality by 2015, as
recommended by the International Conference on Population and Development. Through its
long-term commitment to family planning, Bayer is making a substantial contribution to the UN
Millennium Development Goals, including empowering women, reducing child mortality and
improving maternal health by 2015.
Training programmes for family planning providers are also part of Bayer's commitment. Since
sexual education is vital to contraception, Bayer supports programmes like the CELSAM
project (Centro Latinoamericano Salud y Mujer), providing detailed information on sexual
education in all Latin American countries by radio, educational programmes for schools and
universities, telephone hotlines and information booths on the streets. In Asia, Bayer
cooperates with APCOC (Asia Pacific Council on Contraception).
Partners: Danish International Development Agency (DANIDA), German Association for
Technical Co-operation (GTZ), German Development Bank (KFW), German Federal Ministry for
Economic Cooperation and Development (BMZ), IMRES, International Planned Parenthood
Federation, Marie Stopes International, Missionpharma, Population Services International,
World Bank, WHO, UK Department for International Development (DFID), United Nations
Population Fund (UNFPA), US Agency for International Development (USAID)
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6. Bidan Delima Midwife Training Programme
Disease area(s): Child & maternal health
Company(ies): Johnson & Johnson
Partner(s): Indonesian Midwives Association
Since 2003
Programme type(s): Capacity Building - Training, Education
Developing country(ies): Indonesia
In Indonesia, 20,000 women die each year as a result of pregnancy or delivery, and 165,000
infants die before, during or directly after birth. Midwives are crucial to improving reproductive
health services.
Johnson & Johnson has supported this midwife training programme since its inception in 2003.
This past year, the company provided funds to train 1,200 midwives in the national clinical
standards of midwifery. These standards cover family planning services, infection prevention,
contraceptive technology and safe delivery care. The Association was also able to produce
an updated version of its national safe delivery training video, which is used to train 76,000
practicing midwives in Indonesia.
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INITIATIVES AGAINST CHRONIC DISEASES
Some 35 million deaths are attributable to chronic diseases each year; this is 60% of all deaths
worldwide. Principal chronic diseases include cardiovascular disease (17 million deaths),
cancer (7 million deaths), chronic respiratory disease (4 million deaths) and diabetes (1 million
deaths). About 80% of chronic disease deaths occur in low and middle income countries and
the number of people, families and communities affected is increasing. The impact of chronic
diseases in these countries will increase as they progressively control infectious diseases.
A significant proportion of chronic disease morbidity and mortality can be prevented if
medications are made accessible and affordable, which is a challenge in countries with large
populations of very poor people.
The chronic disease threat can be largely managed using existing knowledge and medicines.
Many solutions are effective – and highly cost-effective. Public-private partnerships have a
crucial role to play in accelerating progress with regard to specific diseases.
Nevertheless, access to medicines is not the only key to achieving success: inadequate
access to good-quality health services, including diagnostic and clinical prevention services, is
a significant cause of the social and economic inequalities in the burden of chronic diseases.
Investment in chronic disease prevention programmes and the development of services and
infrastructure are essential for many low and middle income countries.
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1. Abbott Programme to Advance Diabetes Care in Bolivia
Disease area(s): Diabetes
Company(ies): Abbott
Partner(s): Centro Vivir Con Diabetes, Direct Relief International
Since 2006
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): Bolivia
Since 2006, Abbott and the Abbott Fund have partnered with Direct Relief International to
support the education and outreach activities of Centro Vivir Con Diabetes, a nongovernmental organization dedicated to low-income adults and children living with both type
I and type II diabetes in Cochabamba, Bolivia.
The Abbott Fund has provided grants to support diabetes education, expand public outreach
campaigns, train healthcare personnel in diabetes management, and establish and expand
the number of core diabetes educators. Abbott also has donated glucose screening and
monitoring equipment, and disease-specific nutritional products.
In 2008, the partnership screened more than 19,000 people, successfully trained 300
healthcare personnel, and provided patient education workshops to more than 800 patients.
Since the partnership began, more than 26,000 people have been screened for diabetes.
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2. AstraZeneca Breast Cancer Programme in Ethiopia
Disease area(s): Breast cancer
Company(ies): AstraZeneca
Partner(s): Axios, Ethiopian Cancer Association, Ethiopia Ministry of Health
Since 2005
Programme type(s): Access - Donation, Capacity Building - Support & Training
Developing country(ies): Ethiopia
In Ethiopia, AstraZeneca has been working since 2005 to build local capability in managing
breast cancer - the second most common cancer among young women in the country. The
company's partner in this project is Axios, an organization that works with the private sector to
advance healthcare in developing countries.
The programme has focused on strengthening diagnosis and treatment capabilities at Tikur
Anbessa University Hospital in Addis Ababa. In the last three years, with company help, the
hospital has become a centre of reference for breast cancer treatment across Ethiopia.
Activities have included developing treatment guidelines, strengthening the referral system,
setting up an institutional-based cancer registry, raising awareness of the facilities amongst
healthcare professionals and providing training for other physicians in Ethiopia. AstraZeneca is
also donating its breast cancer medicines, tamoxifen and anastrazole.
During the course of the programme:
"
3,122 patients have been screened, diagnosed, or treated and followed up;
"
Guidelines developed and morphine infusion now available at Tikur Anbessa Hospital;
"
New mammography equipment installed and 13 staff trained;
"
Tamoxifen available free of charge from March 2006 - 1,706 patients benefited so far;
"
Anastrazole available for first time in Ethiopia July 2007 and provided free of charge 175 patients benefited so far.
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3. Bayer HealthCare Nexavar® Access Programme
Disease area(s): Diabetes
Company(ies): Bayer HealthCare
Partner(s): Various partners
Since 2007
Programme type(s): Access - Donation
Developing country(ies): Asia-Pacific region
In 2007, Bayer HealthCare, in partnership with local authorities and charitable organizations,
started the first patient access programme for Nexavar® (sorafenib) in Asia for the treatment
of renal cell carcinoma and is planning further implementation in this region. Bayer HealthCare
donates its medicine Nexavar® to facilitate access for patients who cannot afford the cost of
a full course of therapy.
In 2008, after the approval of Nexavar® for the treatment of hepatocellular carcinoma, Bayer
HealthCare initiated another patient access programme for this indication.
4. Circle of Care: Mental Health in Malaysia
Disease area(s): Mental health
Company(ies): Johnson & Johnson
Partner(s): Circle of Care
Since 2004
Programme type(s): Education
Developing country(ies): Malaysia
Since its inception three years ago, Circle of Care has helped more than 1,000 families in
Malaysia cope with mental illness. Individuals released from mental health institutions are often
unable to reintegrate into society because of stigma. Circle of Care provides job placement
support programmes in nine cities, while families educated about mental illness and are
connected to local support groups through the Family Link programme. Johnson & Johnson
supports Circle of Care's efforts to educate and support families through Family Link, assist
patients in finding jobs and re-entering their communities.
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5. Glivec® International Patient Assistance Programme (GIPAP™)
Disease area(s): Leukaemia
Company(ies): Novartis
Partner(s): Axios International, Max Foundation
Since 2002
Programme type(s): Access - Donation
Developing country(ies): 80 developing countries
GIPAP™ was initiated in 2002, and operates in about 80 developing countries in Africa, Asia,
Eastern Europe, South America and the Caribbean that have no comprehensive
reimbursement system or available generics. Patients must be properly diagnosed, not
covered by local reimbursement or insurance, and have no other financial resources. Since
the programme's launch, Novartis has provided Glivec® at no cost through GIPAP™ to more
than 35,000 patients in more than 80 countries. In 2008, Novartis provided USD 751 million worth
of Glivec® to more than 25,000 patients who otherwise would not have been able to afford
treatment.
GIPAP™ operates through a global network of almost 1,000 registered physicians and more
than 300 qualified treatment centres, including the leading oncology treatment centres and
medical opinion leaders in each country.
Novartis' main partners in GIPAP™ are The Max Foundation (TMF) and Axios International.
Novartis is responsible for programme development, drug donation and provision of medicine
to treatment centres. TMF, a non-profit organization, is responsible for verifying and screening
patients for eligibility, case management and providing emotional support and education in
about 35 developing countries.
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6. IDF BRIDGES Programme
Disease area(s): Diabetes
Company(ies): Lilly
Partner(s): International Diabetes Federation
Since 2007
Programme type(s): Education, R&D
Developing country(ies): Worldwide
Eli Lilly and Company has agreed to support the International Diabetes Federation's
programme “Bringing Research In Diabetes to Global Environments and Systems” (BRIDGES)
with USD 10 million funding over seven years. The BRIDGES grant research programme will
provide the opportunity to “translate” lessons learned from clinical research to those who can
benefit most: people with diabetes.
7. India Diabetes Educator Project
Disease area(s): Diabetes
Company(ies): Bayer HealthCare, Lilly
Partner(s): Becton Dickinson BD, Project HOPE
Since 2007
Programme type(s): Capacity Building - Training
Developing country(ies): India
In November 2007, Bayer HealthCare, Becton Dickinson (BD) and Eli Lilly and Company
agreed to support Project HOPE's “India Diabetes Educator Project”. This four-year, multi-million
dollar collaborative programme aims to help healthcare workers in India reduce morbidity
and mortality related to diabetes and to combat the rapidly growing threat of diabetes. With
an estimated 40.9 million people currently living with the condition, India leads the world in the
prevalence of diabetes.
The India Diabetes Educator Project offers a comprehensive and sustainable approach that
will provide diabetes training to more than 5,000 healthcare professionals, including nurses,
dieticians and nutritionists in India. The project includes mentoring support for newly trained
Diabetes Educators and also addresses the role of the educator in empowering the patient to
take responsibility for daily self-care and to help prevent the onset of diabetes among those at
risk.
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8. Novo Nordisk: Best Possible Pricing on Insulin
Disease area(s): Diabetes
Company(ies): Novo Nordisk
Partner(s): Health Ministries
Since 2001
Programme type(s): Access - Pricing
Developing country(ies): 32 developing countries
Novo Nordisk offers human insulin to the public health systems in least developed countries at
prices which do not to exceed 20% of the average price in Europe, Japan and North America.
In 2008, Novo Nordisk offered this pricing scheme to all 50 least developed countries, of which
32 used it to buy insulin at or below this price, compared to 36 in 2007. For reasons that are
unclear, four least developed countries purchase insulin outside this pricing scheme. Overall,
99% of the units of insulin sold to Least developed countries by Novo Nordisk are sold under the
Best Possible Pricing scheme. The amount of insulin supplied to these 32 countries (plus another
four) was enough to treat between 150,000 and 390,000 patients, depending on the daily
dose.
Countries: Angola, Bangladesh, Benin, Burkina Faso, Burundi, Cape Verde, Central African
Republic, Chad, Democratic Republic of Congo, Djibouti, Gambia, Guinea, Haiti, Kiribati,
Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Myanmar, Niger,
Rwanda, Senegal, Somalia, Sudan, Tanzania, Togo, Uganda, Yemen, Zambia
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9. Novo Nordisk Haemophilia Foundation
Disease area(s): Haemophilia
Company(ies): Novo Nordisk
Partner(s): Health Ministries, NGOs, healthcare professionals,
organizations
Since 2005
Programme type(s): Capacity Building - Support & Training, Education
Developing country(ies): 23 developing countries
patient
The Novo Nordisk Hemophilia Foundation (NNHF) was created in 2005 to address the
significant need for improving hemophilia care in the developing world, where hemophilia is
currently not a healthcare priority and many hemophilia patients go undiagnosed or are
inadequately treated.
NNHF is an independent trust, located in Zurich, Switzerland, and funds programmes to
improve hemophilia care, treatment and awareness in the developing world.
NNHF cooperates with partners in these countries, such as health ministries and authorities,
non-government and patient organizations, healthcare professionals, other foundations and
trusts.
Countries: Algeria, Brazil, Bulgaria, Chile, China, Cuba, India, Iraq, Jordan, Lebanon,
Macedonia, Malaysia, Pakistan, Panama, Poland, Romania, South Africa, Thailand, Uruguay,
Uzbekistan, Venezuela, Vietnam, West Bank, Gaza
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10. Novo Nordisk: World Partner Project
Disease area(s): Diabetes
Company(ies): Novo Nordisk
Partner(s): Health Ministries and local NGOs
Since 2001
Programme type(s): Capacity Building - Training, Education
Developing country(ies): Bangladesh, China, El Salvador, India, Indonesia,
Malaysia, Mexico, Nigeria, Tanzania, Zambia
The World Partner Project (WPP) was launched in 2001 to establish a foundation on which
developing countries can build their own diabetes healthcare strategies and ultimately
improve access to proper care. The WPP works with local partners, usually health ministries
and/or patient organizations, and is funded by a grant from Novo Nordisk.
WPP and its partners have driven 31 projects in seven focus countries (Bangladesh, China, El
Salvador, India, Malaysia, Tanzania and Zambia), organizing clinics, providing distance
learning for healthcare professionals, educating people with diabetes and raising diabetes
awareness.
It is estimated that WPP projects have trained 104,000 healthcare professionals, while 122,000
people with diabetes have been educated or treated.
During 2008, Novo Nordisk assisted the partners in various projects in the focus countries to
consolidate efforts in order to continue the projects. Also new activities were instigated in
Indonesia, Mexico and Nigeria, focusing on partnership building, participation in national
diabetes programmes, awareness building and education.
WPP will continue to support established projects in the focus countries until it is satisfied that
these projects can be self-sustaining.
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11. Pfizer Global Health Partnerships
Disease area(s): Oncology, tobacco control
Company(ies): Pfizer
Partner(s): Various partners
Since 2006
Programme type(s): Capacity Building - Support & Training, Education
Developing country(ies): 15 developing countries
Pfizer and the Pfizer Foundation will provide more than USD 47 million over four years (20072010) to address emerging challenges in cancer and tobacco control in 46 countries across
five continents. The programme collaborates with local experts to improve the diagnosis and
treatment of cancer and reduce its incidence and burden. Technical assistance and
evaluation support is provided by the Bloomberg School of Public Health at Johns Hopkins
University.
Partners: Action on Smoking and Health International (ASH), Akebono-Kai, Alianca de Controle
do Tabagismo /Tobacco Control Alliance, American Cancer Society, China Tobacco Control
Association, Cause Marketing Fundraisers of South Africa, Comprehensive Cancer Centre at
the Freiburg University Medical Centre, European Organization for Research and Treatment of
Cancer (EORTC), FCA/ASH International, George Washington University Cancer Institute, Give
2 Asia, Heart and Stroke Foundation of Ontario, Health Promotional Foundation, Hellenic
Respiratory Society, Hungarian Academy of Teaching Family Physicians, International Union
Against Cancer (UICC), Irish Cancer Society, Japan Dental-Medical Association for Tobacco
Council, King Baudouin Foundation, Korean National Council of Women, Mexican Council on
Tobacco, New Hope in Health Foundation, Philippine Business for Social Progress, QUIT
UK/European Network of Quitlines, Ralph Lauren Centre for Cancer Care and Prevention,
Resource Foundation, SAMBA, Shanghai Centre for Disease Control and Prevention, TCC
Group, Veronesi Foundation, Bloomberg School of Public Health at Johns Hopkins University
Countries: Algeria, Argentina, Brazil, Canada, Colombia, Costa Rica, Egypt, Germany,
Greece, Hungary, Kuwait, Lebanon, Malaysia, Mexico, Morocco, Philippines, Poland, Saudi
Arabia, Singapore, South Africa, Sweden, Thailand, Tunisia, Turkey, United Arab Emirates,
United States, Venezuela
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12. Sanofi-Aventis Diabetes Prevention
Disease area(s): Diabetes
Company(ies): Sanofi-Aventis
Partner(s): Handicap International, Santé Diabète Mali
Since 2006
Programme type(s): Capacity Building - Support
Developing country(ies): Burundi, India, Kenya, Madagascar, Mali, Nicaragua,
Philippines, Thailand
In 2006, Sanofi-Aventis launched pilot programmes to help improve diabetes disease
management in developing countries, in conjunction with the NGO Handicap International,
Santé Diabète Mali and other local NGOs in Africa, Asia and Latin America. Several projects
were set up in 2007 in Burundi, India, Kenya, Madagascar, Nicaragua, Philippines and
Thailand. The programme aims to help local healthcare systems to manage the disease
better, prevent the onset of complications and so avoid the subsequent need for surgical
interventions such as amputation.
Since the beginning of the programme, Handicap International has trained 600 health
professionals, who in turn have treated 3,000 patients.
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13. Sanofi-Aventis : Impact Epilepsy Programme for Developing Countries
Disease area(s): Epilepsy
Company(ies): Sanofi-Aventis
Partner(s): Association des Médecins de Campagne, Kenya Association for the
Welfare of People with Epilepsy, Santé Sud, French Institute of Tropical
Medicine
Since 2004
Programme type(s): Access - Pricing, Capacity Building - Training
Developing country(ies): Cambodia, Kenya, Laos, Madagascar, Mali
Sanofi-Aventis, one of the major actors in the fight against epilepsy in the developed world, is
also committed to the treatment of epilepsy worldwide using its two major treatments,
Gardenal® and, more importantly, Depakine® / valproate Winthrop.
In Mali, Sanofi-Aventis is working with Santé Sud and the Association des Médecins de
Campagne (AMC) which have created the Réseau Action Recherche contre l´Epilepsie
(RARE). More than 2,000 patients have been diagnosed and treated, thanks to these NGOs'
highly motivated general practioners.
Two further programmes are underway:
1. Kenya (with the Kenya Association for the Welfare of People with Epilepsy): since the
2nd trimester of 2007 until end of 2008, 260 healthcare professionals have been
trained thanks to the multi-partnership developed by the KAWE and 10,000 patients
treated;
2. Cambodia: where support has been provided to create the first association in the
country to combat epilepsy; three training sessions already have been developed.
In all these programmes, medicines such as Depakine® / VPA are provided on a “no-profit,
no-loss” basis.
An agreement has been signed at the end of 2008 to develop a new programme in Laos with
the IFMT (French Institute of Tropical Medicine).
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14. Sanofi-Aventis : Mental Health Disorders (Schizophrenia)
Disease area(s): Schizophrenia
Company(ies): Sanofi-Aventis
Partner(s): Mauretania Ministry of Health, Morocco Ministry of Health, Vietnam
Ministry of Health
Since 2008
Programme type(s): Access - Pricing
Developing country(ies): Mauritania, Morocco, Vietnam
Sanofi-Aventis, one of the major actors in the central nervous system therapeutic field in the
developed world, is developing new programmes to help provide better care for
schizophrenia - one of the most severe mental disorders - in developing countries There,
patients not only suffer from the disabling and potentially life-threatening symptoms of their
illness, but they are also victims of ignorance, discrimination and social stigma. Sanofi-Aventis ,
which has a broad portfolio of anti-psychotic medicines, is committed to help treat this
disease with its Largactil®, Nozinan®, Piportil L4® and Solian® products.
Two pilot programmes have been set up in Mauritania and Morocco in liaison with the
national
health
ministries
and
universities,
combining
information,
education
and
communication, training and medicines at preferential prices. The programme has also been
endorsed by the World Association of Social Psychiatry (WASP).
The first stage of a similar programme has been ongoing in Vietnam since the end of 2008.
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15. Sanofi-Aventis : My Child Matters
Disease area(s): Childhood cancers
Company(ies): Sanofi-Aventis
Partner(s): International Union Against Cancer UICC
Since 2004
Programme type(s): Capacity Building - Training, Education
Developing country(ies): 21 developing countries
In 2004, Sanofi-Aventis and the International Union Against Cancer (UICC) launched a
mobilization and awareness programme called “My Child Matters”, to fight against childhood
cancers in emerging countries. The objective is to encourage institutions (hospitals, NGOs,
etc.) to develop pragmatic approaches to improve awareness, early diagnosis, access to
care and treatment, pain control and better management of the social and cultural aspects
of the disease for both children and families.
This programme has already been launched in 16 developing countries - Bangladesh, Bolivia,
Egypt, Honduras, Indonesia, Kenya, Mali, Morocco, Peru, Philippines, Rumania, Senegal,
Tanzania, Ukraine, Venezuela and Vietnam - via 26 paediatric oncology projects. In 2008, 8
new childhood cancer projects have been launched in Burkina Faso, Colombia, Côte d'Ivoire,
Pakistan and Paraguay.
In 2008, 12,875 children benefited from this programme and 2,849 health professionals were
trained.
Countries: Bangladesh, Bolivia, Egypt, Honduras, Indonesia, Kenya, Mali, Morocco, Peru,
Philippines, Senegal, Tanzania, Ukraine, Venezuela, Vietnam, Burkina Faso, Colombia, Côte
d'Ivoire, Pakistan, Paraguay, Romania
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16. Schering-Plough & National Cancer Coalition
Disease area(s): Brain cancer
Company(ies): Schering-Plough
Partner(s): National Cancer Coalition
Since 2007
Programme type(s): Access - Donation
Developing country(ies): Dominican Republic,
Guatemala, Honduras, Nicaragua, Peru
Ecuador,
El
Salvador,
In 2007, Schering-Plough began a partnership with the NGO National Cancer Coalition to treat
five brain cancer patients at Hospital Escuela, a public hospital in Tegucigalpa, Honduras. In
2008, the National Cancer Coalition's international medical assistance programme requested
further pharmaceutical donations for those in need in developing countries. Schering-Plough
responded by supplying enough of its brain cancer drug, Temodar®, to treat 115 patients in 13
hospitals in the following seven countries: Dominican Republic, Ecuador, El Salvador,
Guatemala, Honduras, Nicaragua and Peru.
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17. The World Diabetes Foundation (WDF)
Disease area(s): Diabetes
Company(ies): Novo Nordisk
Partner(s): WHO and Health Ministries
Since 2002
Programme type(s): Capacity Building - Support & Training
Developing country(ies): 83 developing countries
WDF was established by Novo Nordisk in 2002 through a grant of up to DKK 650 million to be
spent over a 10-year period. In March 2008, the shareholders approved an additional
endowment of up to DKK 575 million, for a total of up to DKK 1.2 billion (USD 227 million) in the
period 2001-2017. The WDF has grown into a leading international funding agency, devoted
solely to funding projects for diabetes care and prevention in the developing world.
To date, WDF has funded 182 projects in 83 countries, focusing on diabetes awareness,
education and capacity-building. At present, 156 projects are ongoing. A projection of the
impact of the WDF's work shows that the projects it funds will positively impact 66 million
people in the developing countries. WDF funding has a multiplier effect, as it helps to secure
other sources of funding. This gives an estimated current project portfolio value of USD 191.4
million, of which WDF has donated USD 62.2 million.
To date, at least 2,876,565 people have been screened for diabetes in 4,427 screening camps.
More than 229,829 people have been treated at the 754 established clinics funded by the
foundation. More than 32,090 cases of diabetic retinopathy have been detected, and 21,991
eyes and 18,232 feet saved, rescuing their owners from disability and their families from lifelong
indebtedness. Training healthcare professionals in proper screening and care of diabetic foot
and eye conditions is essential for preventing avoidable amputations and blindness. To date,
the WDF has supported the training of 14,433 doctors, 12,835 nurses and 27,852 paramedics.
Partners: World Health Organization (WHO), International Diabetes Federation, World Bank,
Danish International Development Assistance Agency (DANIDA), Global Alliance for Women's
Health, DanChurchAid, Insulin Foundation, Fundacion para la Diabetes
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Countries: Afghanistan, Anguilla, Antigua and Barbuda, Bangladesh, Barbados, Belize, Bhutan,
Bolivia, Brazil, Burundi, Cambodia, Cameroon, Chile, China, Colombia, Costa Rica, Cuba,
Democratic People's Republic of Korea, Democratic Republic of Congo, Ecuador, Egypt, El
Salvador, Eritrea, Fiji, Ghana, Grenada, Guatemala, Guinea, Guyana, Honduras, India,
Indonesia, Iran, Jamaica, Jordan, Kenya, Mali, Mauritius, Mexico, Mozambique, Nepal,
Nicaragua, Nigeria, Pakistan, Peru, Congo, Rwanda, Seychelles, South Africa, St. Kitts and
Nevis, St. Lucia, St. Vincent and the Grenadines, Sudan, Suriname, Tanzania, Thailand, Togo,
Tonga, Trinidad and Tobago, Uganda, Vanuatu, Venezuela, Vietnam, West Bank and Gaza,
Yemen
18. 2009 Alliance to Reduce Disparities in Diabetes
Disease area(s): Diabetes
Company(ies): Merck
Partner(s): The Merck Company Foundation
Since 2009
Programme type(s): Access-Donation
Developing country(ies): USA
To address the growing problem of healthcare disparities in the context of type 2 diabetes in
the United States among low-income and underserved adult populations, The Merck
Company Foundation - the philanthropic arm of Merck & Co., Inc. - launched the Alliance to
Reduce Disparities in Diabetes (Alliance) with a commitment of USD 15 million through 2013.
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19. Alliance for a Healthy Border
Disease area(s): Diabetes
Company(ies): Pfizer
Partner(s): Multiple
Since 2006
Programme type(s): Access-Donation
Developing country(ies): USA-Mexico Border
During the 3 year duration of the programme (2006-2008), the goal was to improve care for
and prevention of diabetes and cardiovascular disease (CVD) – two of the most common
health challenges facing the Hispanic population
Pfizer's Committed USD 4.5 million over three years to support 12 federally qualified community
health centres in the U.S. as well as several nonprofit organizations in Mexico as they establish
or expand prevention programmes designed to reduce the incidence of diabetes and
cardiovascular disease among the Hispanic population.
Successes:
"
More than 50,000 individuals have been reached with diabetes and CVD prevention
messages.
"
The University of Texas – Pan American has evaluated a subset of programme
participants and has reported increases in healthy eating habits and exercise resulting
in weight loss and lower blood sugar levels.
"
A conference focused on strengthening the capacity of healthcare organizations to
deliver effective diabetes and cardiovascular disease prevention programmes in the
U.S.–Mexico border region involved the participation of more than 170 people
representing 70 community health centres, government agencies and Latino
organizations.
Partners: National Association of Community Health Centres, University of Texas – Pan
American and local partners in the following states: (Arizona) El Rio Community Health Centre
in Tucson and Mariposa Community Health Centre in Nogales; (California) Clinicas de Salud
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del Pueblo in Calexico, La Maestra Community Health Centre and Family Health Centres in
San Diego and San Ysidro Health Centre in San Ysidro; (New Mexico) Ben Archer Health Centre
in Columbus and La Clinica de Familia in Las Cruces; (Texas) Centro de Salud Familiar La Fe in
El Paso, United Medical Centre in Eagle Pass, Gateway Community Health Centre in Laredo
and Nuestra Clinica del Valle in Pharr
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ADDITIONAL HEALTH INITIATIVES
1. Arogya Parivar Programme - A Rural Health Initiative
Disease area(s): Multiple diseases
Company(ies): Novartis
Partner(s): Rural Connect
Since 2006
Programme type(s): Access - Pricing, Education
Developing country(ies): India
In 2006, Novartis' Consumer Health and Sandoz divisions launched an initiative in India to
address the neglected health needs of rural populations. The Arogya Parivar (healthy family)
programme started with pilot sites in the states of Uttar Pradesh and Maharashtra
In the pilot phase, products focused on tuberculosis, other respiratory infections, coughs, colds,
allergies, skin and genital infections, malnutrition in mothers and children, diabetes, intestinal
worms and digestive problems - all important health challenges in these communities.
The intent is to collaborate with third parties to broaden the product portfolio to include
medicines for additional therapeutic areas and items such as anti-malarial bed-nets. To be
included, products need to be easy-to-use, relevant and have instructions in local languages.
Packages are reduced in size so that weekly individual treatment costs are kept below USD
1.25.
The initial phase of Arogya Parivar will address 120 of India's more than 600 districts, selected
using criteria ranging from population and purchasing power to transportation infrastructure
and density of private doctors. By the end of 2008, Arogya Parivar had increased the number
of cells to cover a population of around 25 million villagers in seven states.
Arogya Parivar health advisors speak to villagers about diseases and help them recognize
symptoms. Periodic health camps bring in doctors to do examinations and make referrals to a
treating doctor. A single health camp can attract from 200 to 2,000 people.
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2. AstraZeneca Product Donations
Disease area(s): Multiple diseases
Company(ies): AstraZeneca
Partner(s): Food for the Poor, Health Partners International
Since 2000
Programme type(s): Access - Donation
Developing country(ies): Developing countries
AstraZeneca's product donation and patient assistance programmes make its medicines
available to those who cannot afford them, either free-of-charge or at reduced prices. In
2008, AstraZeneca donated a total of USD 646 million in product. The total spend on charitable
contributions was USD 72 million (this includes the figure for “employee commitment” which is
defined as “total company spend to support employee working days committed to company
endorsed community activities”; the employee commitment figure does not represent a value
assigned to the employee time committed).
AstraZeneca donated USD 1.3 million to Food for the Poor, an international organization that
provides food, housing, healthcare, education, water projects and emergency relief to those
in need.
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3. Boehringer Ingelheim: Strengthening Healthcare Capacity
Disease area(s): Multiple diseases
Company(ies): Boehringer Ingelheim
Partner(s): Botswana and Papua New Guinea Ministries of Health and other
partners
Since 2005
Programme type(s): Capacity Building - Support & Training
Developing country(ies): Botswana, Papua New Guinea, South Africa,
Venezuela
The Boehringer Ingelheim Lung Institute at the University of Cape Town has been set up to
support clinical trials in infectious and respiratory diseases. Through its Student Education
Programme with the University of Cape Town, South Africa, Boehringer Ingelheim provides full
financial support for medical students from disadvantaged backgrounds.
In Uganda, the company helps the Community Health and Information Network (CHAIN) in
HIV/AIDS prevention, as well as care and treatment seminars and training. This has helped to
strengthen the advocacy strategies at national and community level. The aim is to broaden
CHAIN's activities among vulnerable populations.
In 2007, some 46,000 of Papua New Guinea's 5.3 million inhabitants were infected with HIV.
With other pharmaceutical companies, the Catholic AIDS Office, the Australasian Society for
HIV Medicine (ASHM) and the government of Papua New Guinea, Boehringer Ingelheim has
implemented a project to train healthcare workers under the auspices of the Collaboration for
Health in Papua New Guinea.
In Venezuela, the company provides training to doctors at the respiratory care centres in the
Chacao neighbourhood and the Pérez de León Hospital in Caracas. The hospital also receives
free medicines and equipment.
Boehringer Ingelheim has developed a database where all relevant activities executed by all
operating units globally can be found.
Partners: Australasian Society for HIV Medicine, Botswana Ministry of Health, Catholic AIDS
Office, Papua New Guinea Ministry of Health, Rhodes University
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4. Bristol-Myers Squibb Medical Product Donations
Disease area(s): Multiple diseases
Company(ies): Bristol-Myers Squibb
Partner(s): 9 specialized NGO partners
Since ---Programme type(s): Access - Donation
Developing country(ies): Developing countries
During the past five years, BMS has donated USD 243 million of medical products, valued at
wholesale, to support programmes throughout the world. In 2008, BMS product donations
totaled USD 33 million.
There are three main areas where the company's product donations are used:
1. Medical Mission Boxes: In partnership with Direct Relief International, this programme
supplies healthcare products in parcels that can be carried by individual physicians
to remote locations to treat indigent local populations;
2. Healthcare
Infrastructure
Support:
With
nine
major
international
non-profit
organizations, this programme supports a wide range of community-based
healthcare infrastructure initiatives in regions around the world;
3. Disaster Relief: Focused solely on supplying needed medicines following major
disasters, either natural or man-made (see Emergency Relief Efforts).
Partners: AmeriCares, Catholic Medical Mission Board (CMMB), Direct Relief International,
Heart to Heart International, IMA World Health, International Aid, MAP International, Medical
Teams International, Project HOPE
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5. GSK & Leonard Cheshire Disability in Sri Lanka
Disease area(s): Disability
Company(ies): GlaxoSmithKline
Partner(s): Leonard Cheshire Disability
Since 2004
Programme type(s): Capacity Building - Support
Developing country(ies): Sri Lanka
GlaxoSmithKline supports Leonard Cheshire Disability (LCD) in Galle, southern Sri Lanka.
Following the devastating tsunami in 2004, LCD set up the Disability Resource Centre, the first
of its kind in the area to support disabled peoples access to health and rehabilitation services,
inclusive education and livelihood opportunities.
Help from GSK will enable Leonard Cheshire Disability to support 500 people with disabilities
access crucial faculties and services. It will also increase awareness of these services to 1,000
family members of people with disabilities. It is further hoped that 200 young people with
disabilities will take part in their “Young Voices Programmes”, a global initiative campaigning
for the implementation of the United Nations Convention on the Rights of People with
Disabilities.
6. GSK Nurse Training in Tamil Nadu
Disease area(s): Nurse training
Company(ies): GlaxoSmithKline
Partner(s): Direct Relief International, Sri Ramakrishna Math
Since 2007
Programme type(s): Capacity Building - Training
Developing country(ies): India
In the aftermath of the devastating Indian Ocean tsunami of 2004, GSK is providing USD
133,509 of funding from June 2007 to June 2009 to help Sri Ramakrishna Math, a local NGO in
the Chennai region of Tamil Nadu, to enroll an additional 420 local girls in its Nursing Training
Course.
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7. Health Training at Egypt's National Training Institute
Disease area(s): Multiple diseases
Company(ies): Pfizer
Partner(s): Egypt Ministry of Health, Project HOPE
Since 2006
Programme type(s): Capacity Building - Training
Developing country(ies): Egypt
Pfizer works with the Egyptian Ministry of Health and Project HOPE to equip Egypt's National
Training Institute (NTI) to provide state-of-the-art training for physicians, nurses and health
professionals in Egypt and the Middle East in infection control, family medicine,
ophthalmology,
urology,
general
surgery,
research
methodology,
and
healthcare
management. Pfizer also helped upgrade laboratories and training equipment. Nearly 15,000
physicians have been trained through 220 training courses and 21 symposia.
Pfizer will also support the development of distance learning options for new and existing
courses. Pfizer will also help introduce leadership and management training in the NTI training
curriculum. In 2007, NTI established some revenue generating capacity but these efforts need
to be expanded and so Pfizer will help to develop a sustainability strategy and plan for the NTI.
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8. Healthy Communities, Healthy Ecosystems
Disease area(s): Multiple diseases
Company(ies): Johnson & Johnson
Partner(s): Family Health International, Kenya Ministry of Health, World Wide
Fund for Nature (WWF)
Since 2003
Programme type(s): Education
Developing country(ies): Democratic Republic of Congo, Kenya, Nepal
Since 2003, J&J has supported the innovative “Healthy Communities, Healthy Ecosystems”
projects run by the World Wide Fund for Nature (WWF) in East Africa, the Congo Basin and the
Eastern Himalayas.
Over the past year in the Congo, the WWF has conducted sex education and HIV/AIDS
training in eight villages. It has also established five wildlife management committees as well
as two primary schools reaching 400 students.
Recent activities in Kenya include building a dispensary clinic for target communities, provision
of safe drinking water and family planning education by newly trained healthcare workers
from the Ministry of Health and Family Health International. Mobile clinics reach villages that
have no access to quality healthcare, and people are receiving prenatal and postnatal care,
immunizations, nutritional counseling and education about environmental health and
conservation efforts.
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9. Johnson & Johnson Burn Treatment Centre in Soweto
Disease area(s): Multiple diseases
Company(ies): Johnson & Johnson
Partner(s): Chris Hani Baragwanath Hospital
Since 1992
Programme type(s): Capacity Building - Support & Training
Developing country(ies): South Africa
In 1992, the J&J built the Johnson & Johnson Burn Treatment Centre at the Chris Hani
Baragwanath Hospital in Soweto, South Africa. This state-of-the-art unit treats more than 1,500
patients annually for serious and complicated burns, and has succeeded in reducing the
mortality rate among critically ill patients. J&J continues to support the facility with
management support, essential equipment, quality products, and education for nursing and
medical personnel. Less visible, but of equal importance, are the investments and expertise
provided at the community level with the establishment of clinics and training of caregivers.
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10. Merck Medical Outreach Programme
Disease area(s): Multiple diseases
Company(ies): Merck & Co. Inc.
Partner(s): AmeriCares, Catholic Medical Mission Board, Direct
International, IMA World Health, MAP International, Project HOPE
Since 1958
Programme type(s): Access - Donation
Developing country(ies): Developing countries
Relief
Founded in 1958, the Merck Medical Outreach Programme (MMOP) is the primary mechanism
through which Merck donates its pharmaceuticals and vaccines for humanitarian assistance
in the developing world and in support of disaster relief and emergency situations worldwide.
Donations of Merck medicines (with the exception of Mecitzan® for which there is a separate
and dedicated programme) are made primarily through AmeriCares, Catholic Medical
Mission Board (CMMB), Direct Relief International, IMA World Health, MAP International and
Project HOPE.
In 2008, Merck donated USD 43.4 million in market value of medicines and vaccines through
well-established partnerships to help patients throughout the developing world. These
donations supported sustained chronic-care health programmes in Central Asia; enabled
immunization programmes in Central and Southeast Asia, the Caribbean and Africa; provided
disaster assistance in, Myanmar, India, Honduras and the U.S.; and reached many thousands
more worldwide through the ongoing medical programmes of its partner private voluntary
organizations (PVOs).
In addition, Merck donated USD 549 million worth of Mectizan® (ivermectin) for the treatment
of river blindness and the prevention of lymphatic filariasis through the Merck Mectizan®
Donation Programme. The total value of medical donations through MMOP in 2008 was USD
592 million, a decrease of 2% from 2007. The decrease is due in part to a reduction in the
amount of requests from Merck’s PVO partners, and availability of pharmaceuticals and
vaccines for ongoing development projects and disaster relief efforts.
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11. Nursing Training in East Africa
Disease area(s): Multiple diseases
Company(ies): Johnson & Johnson
Partner(s): Aga Khan University
Since -------Programme type(s): Capacity Building - Training
Developing country(ies): Kenya, Tanzania, Uganda
Johnson & Johnson supports the Advanced Nursing Studies (ANS) and the Enrolled Nurses to
Registered Nurses (ER-RN) programmes at the Aga Khan University Health Sciences campus in
Nairobi, Kenya. The programme provides quality education and greater standards of
evidence-based care to nurses and midwives from Kenya, Tanzania and Uganda, to further
develop their professional skills. The training, which includes some distance-learning
approaches, prepares nurses to become registered nurses. About 200 nurses from 50 different
hospitals have been trained so far.
12. Otsuka Welfare Clinic
Disease area(s): Multiple diseases
Company(ies): Otsuka Pharmaceutical
Partner(s): Local partners
Since 2003
Programme type(s): Capacity Building - Support
Developing country(ies): Pakistan
In June 2003, Otsuka Pharmaceutical set up the Otsuka Welfare Clinic to help serve the health
needs of refugees in Peshawar, in Pakistan's Northwest Frontier District state. Medical doctors,
pharmacists, nurses and other medical professionals provide free treatment each day to some
300 patients requiring medical assistance.
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13. Phelophepa Healthcare Train
Disease area(s): Multiple diseases
Company(ies): Roche
Partner(s): Colgate, Transnet Foundation
Since 1994
Programme type(s): Capacity Building - Support
Developing country(ies): South Africa
The Phelophepa healthcare train provides basic healthcare services to poor patients in
remote rural areas of South Africa. The train is now 16 cars long and provides a pharmacy,
cancer screening and education, psychology and dental and eye clinics, as well as diabetes
and smear tests. It serves more than 45,000 people a year and has reached nearly 13 million in
total since its inception in 1994.
The train is run by the government-owned Transnet group. The Transnet Foundation funds
about two-thirds of the train's running costs and provides staff, rail access and rolling stock.
Roche is the lead outside sponsor which includes other corporations such as Colgate.
Phelophepa also improves rural health education through its Edu-Clinic.
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14. Rabies Control in Tanzania
Disease area(s): Rabies
Company(ies): Schering-Plough
Partner(s): The Alliance for Rabies Control
Since 2004
Programme type(s): Access - Donation
Developing country(ies): Tanzania
In 2008 Schering Plough's animal health business continued its efforts to reduce the impact of
rabies, a fatal neurological disease, which is widespread throughout Africa. In Africa, more
than 25,000 people die from the disease each year. Bites from infected domestic dogs are the
main source of infection.
As in previous years Intervet/Schering-Plough Animal Health donated 200,000 doses of rabies
vaccine to the Afya Serengeti (Health of Serengeti) project in Tanzania, run by The Alliance for
Rabies Control. Afya Serengeti's vaccination programme has produced a significant reduction
of households reporting animal rabies cases, with the percentage dropping from 27% in 2003
to 2% in 2006. Injuries from rabid dogs have also declined, from 10% of households reporting
bite injuries in 2003 to less than 1% in 2006. These significantly reduced levels were maintained
in 2008.
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15. Schering-Plough Medicine Donations
Disease area(s): Multiple diseases
Company(ies): Schering-Plough
Partner(s): MAP International and other NGO partners
Since 1950s
Programme type(s): Access - Donation, Capacity Building - Training
Developing country(ies): Developing countries
Schering-Plough has long helped to provide essential medicines in countries affected by
natural disaster, disease, war and poverty. In 2008, Schering-Plough provided more than USD
500,000 in financial support and more than USD 14 million worth of antifungal creams, topical
creams, allergy medicines, vitamin-enriched ointments and other medicines for use in portable
boxes of medication called Travel Packs.
In 2008, MAP shipped more than 2,900 Travel Packs, which contained an average of 700
treatments each, for a total impact of approximately 2,000,000 patient treatments. These
Travel Packs were used by over 1,400 medical teams in 96 developing countries such as
Uganda, Haiti, Romania, Nicaragua, Venezuela, the Philippines and Zimbabwe. ScheringPlough also donated an additional USD 14 million worth of pharmaceutical and over-thecounter products to other US-based NGOs in 2008, including AmeriCares, Catholic Medical
Missions Board, Direct Relief International, International Aid, MAP International and Project
HOPE.
Medical Assistance Programme (MAP) International has created a “Global Health Promoter”
programme, which trains volunteer healthcare workers to provide basic medical care and
health education within their communities. Schering-Plough provided USD 75,000 to this
programme to train a total of 300 healthcare workers in 2007 and 2008. These health
promoters provide health services in six countries in Africa, Asia and Latin America, where
more formal health services are often not available.
Countries: Bangladesh, Cambodia, Cameroon, Côte d'Ivoire, Dominican Republic, Ecuador, El
Salvador, Ethiopia, Gambia, Ghana, Guatemala, Haiti, Honduras, Kenya, Malawi, Mongolia,
Mozambique, Nicaragua, Paraguay, Philippines, Romania, Rwanda, Sierra Leone, Tanzania,
Uganda, Venezuela, Zimbabwe
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16. Tanzanian Training Centre for International Health
Disease area(s): Multiple diseases
Company(ies): Novartis
Partner(s): Swiss Tropical Institute, Tanzania Ministry of Health
Since 2003
Programme type(s): Capacity Building - Support
Developing country(ies): Tanzania
The Tanzanian Training Centre for International Health (TTCIH) was founded as the Ifakara
Health Training Centre in 1961. To strengthen human resource development in the Tanzanian
health sector and beyond, the Novartis Foundation for Sustainable Development has helped
to remodel the centre.
Moreover, in order to increase its financial self-reliance, the TTCIH has developed additional
courses of its own curriculum in various health fields and also offers its facilities and services to
other organizations wishing to hold their courses in Ifakara. In 2008, the TTCIH generated
revenue of USD 480,000, excluding grants from third parties.
The improved quality of training as well as the enhanced facilities and support services will
contribute to a better medical and public health expertise, which is needed to improve the
overall health situation of the population, especially in rural areas. The ultimate goal is to
develop the centre into one of the leading training centres in Tanzania and East Africa.
141
Other commitments by research-based pharmaceutical companies
1. GSK
The company committed to reinvest 20 per cent of its profits from the sale of medicines in least
developed countries back into projects that address priority healthcare challenges, provide
support to governments to remove barriers that stop patients accessing quality healthcare,
and strengthen basic healthcare infrastructure.
2. AstraZeneca
In 2009, the company spent a total of USD 882 million (2008: USD 718 million) on community
sponsorships and charitable donations worldwide, including product donation and patient
assistance programmes which make its medicines available free of charge or at reduced
prices.
3. Sanofi-Aventis
In 2009, under various programmes, the retail value of products provided for free exceeded
USD 200 million.
4. Novartis
In 2009, their access-to-medicine programmes, valued at USD 1.5 billion, reached 79.5 million
patients around the world.
5. Eli Lilly & Company
In 2008, the total giving by the company was about USD 350 million. About 80 percent of that
amount was in the form of product donations. In October 2008, Forbes ranked Lilly among
America's five most generous companies, based on donations as a percentage of operating
income.
142
Major Global Initiatives
in which Pharmaceuticals
Play a major Role
143
1. The Global Fund
The Global Fund to Fight AIDS, tuberculosis and malaria was launched as a unique partnership
to support improved access to life-saving medicines in developing countries. The past decade
has also seen a dramatic turnaround in the fight against HIV/AIDS. Together, the U.S.
President’s Emergency Plan for AIDS Relief, the Global Fund and the international community
have helped expand access to antiretroviral treatments (ARTs) for people once deemed too
poor to receive HIV treatment.
"
"
"
In 2002, approximately 300,000 people living in low- and middle-income countries were
on ART.
By end-2008, according to UNAIDS, more than 4 million people in these countries were
on this life-saving treatment. This includes an increase of 36% in the most recent year
and a tenfold increase over five years.
The largest increase in access between 2007 and 2008 took place in sub-Saharan
Africa, where approximately two-thirds of global HIV infections occur. During this period,
an additional 800,000 people in the region received ART, boosting total access to 2.9
million people, a 39% increase in one year alone.
HIV
%
%
%
%
%
At the end of December 2009, programmes financed by the Global Fund were
providing antiretroviral therapy (ART) to 2.5 million people.
Approved HIV proposals have totalled close to USD 10.8 billion covering 140 countries.
The Global Fund is estimated to have contributed about one-fifth of all disbursements
by bi- and multi-laterals for the HIV response in low- and middle-income countries in
2008.
In addition to providing ART, programmes funded by the Global Fund have also
distributed 1.8 billion male and female condoms;
Provided 790,000 HIV-positive pregnant women with treatment to prevent mother-tochild transmission of HIV, as well as 4.5 million basic care and support services to
orphans and other children made vulnerable by AIDS, and 105 million HIV counselling
and testing sessions.
There is a growing body of evidence showing that Global Fund financing - alongside that of
other financiers - has resulted in declines in AIDS mortality in countries in which provision of ART
has been scaled up rapidly, accompanied by other significant impacts, such as improved
survival and productivity of key professionals and other workers, and system-wide
improvements in healthcare delivery.
144
Tuberculosis
%
%
%
%
Through 2009, programmes funded by the Global Fund have provided treatment to 6
million people who had active TB.
The Global Fund provides 63% of the external financing for TB and multi-drug resistant TB
(MDR-TB) control efforts in low- and middle-income countries.
Approved TB proposals have totalled close to USD 3.2 billion covering 112 countries,
contributing 48% of the projected coverage required to achieve the Stop TB Partnership
targets for the detection and treatment of new smear-positive TB cases.
TB programmes supported by the Global Fund have also provided 1.8 million TB/HIV
services.
In many countries in which the Global Fund supports programmes, TB prevalence is declining,
as are TB mortality rates.
Malaria
%
%
%
By the end of 2009, Global Fund-supported programmes had distributed 104 million
insecticide-treated nets (ITNs) to prevent malaria.
They also supported indoor residual spraying of insecticides in dwellings more than 19
million times and treated 108 million cases of malaria in accordance with national
treatment guidelines.
Approved malaria proposals have totalled USD 5.3 billion covering 83 countries.
In 2008, the Global Fund contributed 57% of international disbursements for malaria control.
Global Fund investments have played a critical role in introducing and expanding coverage
of novel, effective malaria treatments in many countries where drug resistance to older
treatments is high.
In conjunction with re-energized national and international efforts to combat malaria,
increased Global Fund financing is having a substantial impact on malaria morbidity and
mortality worldwide, with an increasing number of countries reporting a reduction in malaria
deaths of more than 50%.
The coming years will see even more results, as half of the total disbursements by the Global
Fund were delivered in 2008 and 2009. Much of the USD 5.4 billion of financing approved in
Rounds 8 and 9 will reach countries in 2010 and 2011, and will continue to significantly boost
health outcomes.
145
2. UNITAID
Since its inception, 29 governments have joined France in contributing finances to UNITAID,
which raises approximately USD 300 million every year. UNITAID, together with UNICEF, will
provide 20 million bed nets for eight African countries in 2009 and 2010, leading to an
estimated 20% increase in bed net coverage.
UNITAID Action on HIV/AIDS – 2006-2009
Programme
Partner
Funding (USD m)
Patients treated
Paediatric HIV/AIDS
Paediatric HIV/AIDS
CHAI
Global Fund
235.5
----
255,970
28,870
Second-line HIV/AIDS
CHAI
241.1
175,270
Second-line HIV/AIDS
Global Fund
----
7,480
First-line tenofovir
CHAI
PMTCT
UNICEF
49,835
72.0
----
Women receiving treatment
----
234,000
Opportunistic infections (OI) prophylaxis
Total committed to treatments and testing
---548.7
205,280
1,424,295
Rational use of HIV-related inputs
15.9
----
Total committed to HIV/AIDS projects
USD 564,600,000
TB Projects
Areas
Funding support
Number of patients targeted
Paediatric TB treatments
USD 11,603,952
750,175
First line TB Treatments
USD 26,841,025
866,273
MDR-TB Diagnostics
USD 26,129,897
74,000
MDR-TB treatments
USD 81,652,000
25,286
Total amount committed
USD 146,226,874
146
3. UK Department for International Development
DFID's aid will increase to GBP 7.9 billion by 2010/11. It is helping to lift about three million
people out of poverty permanently every year.
The aid spending on Africa is set to more than double from GBP1.3 billion in 2004 to at least
GBP 2.6 billion by 2010, meeting all the commitments to increase aid to Africa that were made
at in 2005.
The department is also on track to meet the commitment to increase aid spending to 0.7% of
their national income by 2013.
The UK has written off 100% of the debt owed by the world's most heavily indebted poor
countries.
Other examples of DFID successes include:
Globally: The proportion of people in developing countries living in extreme poverty fell from
28% in 1990 to 22% ion 2010. Each year, DFID helps to reduce permanently the number of
people living in poverty by 3 million.
Uganda: Between 2003 and 2006, 1.4 million people have been lifted out of poverty in
Uganda, building on earlier achievements; 31% of Ugandans now live below the poverty line
compared to 39% in 2002/03 and 56% in 1992/93.
Tanzania: Nine out of ten children are now enrolled in school; in 1999 it was less than six in ten.
The DFID’s support to buy bed nets to protect people from malaria is helping to save 20,00040,000 lives per year.
Kenya: HIV/AIDS prevalence has fallen from over 11% to 5.9% over the past eight years. UK has
provided GBP 43 million towards the fight against HIV/AIDS, including support to a national
strategy for access to prevention, treatment and care.
Mozambique: Between 2000 and 2005, poverty was reduced from 70% to 55% and the number
of children in school has doubled, with the help of GBP 274 million in aid.
147
Bangladesh: DFID action on maternal mortality includes a GBP100 million contribution to
Bangladesh’s Health, Nutrition and Population Support Programme, in which maternal health is
a key priority.
Rwanda: Primary school enrolment is high at 92.5% with girls and boys enrolling in equal
numbers. DFID has contributed to the recruitment of 2,600 new primary teachers and the
purchase of school materials.
Nepal: DFID is the leading donor to the national safe motherhood programme. The 2006
preliminary Demographic and Health Survey results show a 26% decline in under-5 mortality (to
65 per 1,000 live births). DFID played a key role in fight against AIDS, TB and malaria – including
the commitment to spend GBP1.5 billion from 2005 to 2008 on AIDS and to contribute GBP 360
million to the Global Fund to fight AIDS, TB and malaria in the period from 2002 to 2008.
148
4. Bill and Melinda Gates Foundation
The Approach
A global health mission to help ensure that technology based health solutions are created
and delivered to those who need them most with a focus on health problems in the
developing world that cause great harm but receive too little attention.
To date, it has committed nearly USD 10 billion in global health grants to:
• Discover scientific insights to fight serious diseases affecting developing countries.
• Develop effective and affordable vaccines, medicines, and other health
interventions.
• Deliver these solutions to the people who need them most.
Areas of Focus
Malaria
The world is making progress against malaria, one of the world’s oldest and deadliest killers.
Grantees are working to speed research and development on new prevention and treatment
methods, and to expand access to bed nets and other existing tools.
Grant examples include:
"
USD 202 million for the Medicines for Malaria Venture, which works with private industry
to develop new treatments.
"
USD 79 million for the Malaria Control and Evaluation Partnership in Africa, which is
working to expand effective malaria control programmes.
HIV/AIDS
Significant progress is being made in the prevention and treatment of HIV/AIDS.
The Foundation’s focus is on supporting prevention research through grants including:
"
USD 258 million for Avahan, an initiative to expand access to effective HIV prevention
programmes in India.
"
USD 151 million for research on microbicides to prevent HIV transmission.
149
"
USD 50 million to support the African Comprehensive HIV/ AIDS Partnerships, a national
HIV prevention and treatment initiative in Botswana.
Tuberculosis
Support for the development of new TB drugs, vaccines, and diagnostic tools, and work to
strengthen TB control programmes. Grant examples include:
"
USD 309 million to the Aeras Global TB Vaccine Foundation for vaccine development.
"
USD 33 million to improve TB control strategies in China.
"
USD 86 million for the Foundation for Innovative New Diagnostics to develop low-cost
methods of diagnosis.
Vaccine-Preventable Diseases
No public health tool has improved global public health more than vaccines. Grants to
expand access to immunization include:
"
USD 1.5 billion to the GAVI Alliance, a public-private partnership that helps developing
countries to purchase and deliver vaccines.
Polio
In the last 20 years, polio cases have declined by 99% and the disease has been eliminated
from most of the globe. The Gates’ have a strong commitment to polio, working closely with
partners in the Global Polio Eradication Initiative and advocating with governments to
increase their efforts toward eradicating polio. Some recent grants include:
"
USD 355 million to Rotary International to support global polio eradication activities
through the Rotary Foundation’s PolioPlus programme (USD 200 million to be matched
by Rotary).
"
USD 150 million to UNICEF and WHO to support operations for polio campaigns,
outbreak response activities, surveillance, and research to develop a safer, cheaper,
and more effective inactivated polio vaccine.
Pneumonia and Flu
Common respiratory illnesses, including pneumonia and flu, can often be prevented with
current vaccines and treatments. Grants to help fight these illnesses include:
150
"
USD 41 million to PATH to develop new vaccines to address pandemic influenza.
"
USD 4 million for the University of Maryland to introduce a vaccine for Hib pneumonia in
West Africa.
Nutrition
Good nutrition is critical for the healthy development of young children. The Foundation’s
partners are working to develop and produce foods fortified with essential nutrients, and to
develop staple crops with higher micronutrient levels. Examples include:
"
USD 109 million to GAIN (Global Alliance for Improved Nutrition) to fortify foods with
essential vitamins and minerals.
"
USD 15 million to UNICEF to eliminate iodine deficiency through universal salt iodization.
Diarrhoea
Diarrhoea and diarrhoea-related dehydration can be prevented and treated. The Foundation
has provided several grants to understand and address the underlying causes of diarrhoea,
such as:
"
USD 7 million for the International Centre for Diarrhoeal Disease Research to implement
a zinc treatment programme for children in Bangladesh and Ethiopia.
"
USD 50 million to PATH to develop vaccines against bacteria that causes diarrhoea.
Maternal and Neonatal Health
The Foundation works to improve the health of mothers and newborns by providing grants to
reduce pregnancy-related illness and death, improve healthcare for newborns and young
children, and increase access to contraceptives. Grant examples include:
"
USD 25 million to BRAC to demonstrate a model for improving maternal, newborn and
child health in poor urban communities of developing countries.
"
USD 110 million for Save the Children to expand access to simple, low-cost tools to
improve newborn health in developing countries.
151
Tobacco
Tobacco-caused diseases have emerged as one of the greatest health challenges facing
developing countries. Fortunately, a number of programmes and policies to reduce tobacco
use have proven highly effective. Investments include:
"
USD 125 million over 5 years to fight the global tobacco epidemic, including a USD 24
million grant to the Bloomberg Initiative to reduce tobacco use.
Bill and Melinda Gates Foundation Funding from 1994 to 2010
152
5. The US President's Emergency Plan for AIDS Relief (PEPFAR)
By the end of September 2008, PEPFAR was supporting treatment for over 2.1 million people
around the world, exceeding its target of 2 million. This includes 2,007,800 people in the
programme’s 15 focus countries. Treatment figures in some countries, however, have fallen
short of their intended targets. In Nigeria, for example, 211,500 people were receiving
treatment by the end of September 2008 compared to the goal of 350,000. The number on
treatment in Ethiopia fell short of the 210,000 target by over 90,000.
The Leadership against HIV/AIDS Act of 2003 refers to funding relating to combating HIV/AIDS
focusing on fourteen specific countries, now usually referred to as “focus” countries:
Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria,
Rwanda, South Africa, Tanzania, Uganda and Zambia.
When Congress appropriated the funding for fiscal year (FY) 2004, they required that a 15th
focus country should be added, and that it should be outside of Africa and the Caribbean.
Vietnam was added as an additional focus country in June 2004.
In his State of the Union Address in January 2003, President George W. Bush made a
commitment to substantially increase U.S. support for addressing HIV/AIDS worldwide:
"I ask the Congress to commit USD 15 billion over the next five years, to turn the tide
against AIDS in the most afflicted nations of Africa and the Caribbean".
In May 2003, the US Congress approved, and President Bush signed into law, the United States
Leadership against HIV/AIDS, Tuberculosis and Malaria Act of 2003. This legislation approved
expenditure of up to USD 15 billion over 5 years and it provided the legal and policy
framework for the expenditure.
The first "new" money of USD 350 million was made available by Congress in January 2004. Full
implementation of PEPFAR began in June 2004.
153
PEPFAR Funding 2004-2008
PEPFAR was re-authorized for a further five years when President Bush signed the “Tom Lantos
and Henry J Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria
Reauthorization Act of 2008”, in July 2008. The act authorized up to USD 48 billion for PEPFAR for
FYs 2009-2013. It was named in honour of two late congressmen, one Republican and one
Democrat, who authored the original 2003 act.
Under the original 2003 act Congress required that PEPFAR money should be divided in the
following way:
"
55% for the treatment of individuals with HIV/AIDS;
"
15% for the palliative care of individuals with HIV/AIDS;
"
20% for HIV/AIDS prevention (of which at least 33% is to be spent on abstinence until
marriage programmes);
"
10% for helping orphans and vulnerable children.
154
# of Patients Receiving ARVs by Year
5,000,000
4,500,000
4,000,000
3,500,000
3,000,000
2,500,000
2,000,000
1,500,000
1,000,000
500,000
0
2004
2006
2009
PEPFAR Latest Programme Results, 2010
"
Through its partnerships with more than 30 countries, as of September 30, 2009, PEPFAR
directly supported life-saving antiretroviral treatment for over 2.4 million men, women
and children. They represent more than half of the estimated four million individuals in
low- and middle-income countries on treatment.
"
In addition, through September 30, 2009, PEPFAR partnerships have directly supported
care for nearly 11 million people affected by HIV/AIDS, including 3.6 million orphans and
vulnerable children.
"
In FY 2009, PEPFAR directly supported prevention of mother-to-child transmission
programmes that allowed nearly 100,000 babies of HIV-positive mothers to be born HIVfree, adding to the nearly 240,000 babies born without HIV due to PEPFAR support
during FYs 2004-2008.
"
In FY 2009, PEPFAR also directly supported HIV counseling and testing for nearly 29
million people, providing a critical entry point to prevention, treatment and care.
155
"
From FY 2010 onward, PEPFAR will report on partner countries' national achievements in
service delivery and health systems strengthening, as well as PEPFAR direct contributions
to those achievements. The new national health systems indicators are being
developed in collaboration with partner countries and multilateral organizations.
Through September 30, 2009, the last point at which indirect results will be reported
before this transition to national indicators, PEPFAR indirectly supported treatment for
539,700 people in the 15 original PEPFAR focus countries.
The prime partners for PEPFAR in year 2007 were:
1. Partnership for Supply Chain Management
2. Family Health International
3. Catholic Relief Services
4. Columbia University
5. Government departments
6. US CDC
7. Elizabeth Glaser PAF
8. University of Maryland
9. Harvard University
10. USAID
156
List of Access to Pharmaceuticals Interventions
157
No.
1
2
3
4
5
6
7
8
Name of the
programme
Disease
Company
sponsoring
Countries
Medicines used/ Money
spent/ Cost incurred
Patients served or Doses
supplied
AAI Accelerating
Access Initiative
HIV/AIDS
9
companies
developing
countries
-----
773,803 patients undergoing
treatment till Sept 2008.
(446,000 in Africa)
Expanding
Access to
Treatment
HIV/AIDS
Abbott
Least
developed
countries
Invested more than USD
40 million in Tanzania;
providing Lopinavir/
ritonavir at USD 500 per
patient per year.
Since 2001, 500,000 families
have been supported.
Viramune®
Donation
Programme
HIV/AIDS
Boehringer
Ingelheim
59
developing
countries
Viramune®
1.7 million doses free of cost
in 2008.
Global Access
Programme
HIV/AIDS
Bristol-Myers
Squibb
Least
developed
countries
HIV medicines
At no profit
Gilead Access
Programme
HIV/AIDS
Gilead
Least
developed
countries
Viread® and Truvada®
Generic Viread = USD 7.25
per month
700,000 people were
treated in 2010 at low
prices.
Access to ARVs
HIV/AIDS
GSK
37
developing
countries
Abacavir and Combivir®;
up to 40% reduction in cost
70 million tablets in 2008 at
no profit
Access to ARVs
HIV/AIDS
Merck & Co.
Inc.
developing
countries
Crixivan™, Stocrin™,
Atripla™ and Isentress™
no profit
Treated 777,000 patients in
2008
Roche - Access
to ARVs
HIV/AIDS
Roche
All low &
lowermiddle
income
countries
Provides Invirase and
Viracept at no profit
88% of total AIDS patients.
The Cambodia
Treatment
Access
Programme
(CTAP)
HIV/AIDS
Roche
Cambodia
New outpatient treatment
centre was opened
Enrolled 1200 patients
Single Tablet
per Day
HIV/AIDS
9
10
Trained 400 healthcare
professionals
Bristol-Myers
Squibb,
Gilead,
Merck & Co.
developing
countries
Atripla®
at no profit
Tens of thousands of
patients are benefiting
158
11
12
13
14
15
Technology
Transfer & ARV
Licensing
HIV/AIDS
Bristol-Myers
Squibb
Kenya,
India,
S. Africa
Atazanavir
----
Technology
Transfer & ARV
Licensing
HIV/AIDS
Gilead
SubSaharan
Africa
Viread® and Truvada®
both generic and
branded
-----
Technology
Transfer & ARV
Licensing
HIV/AIDS
Gilead
95
countries
Tenofovir allowed as
Generic drug
-----
Technology
Transfer & ARV
Licensing
HIV/AIDS
GSK
Africa
Epivir® and Combivir®
279 million tablets in 2008
Diflucan
HIV/AIDS
Pfizer
developing
countries
Tibotec Cost
Recovery
Distribution
Programme
HIV/AIDS
Johnson &
Johnson
SubSaharan
Africa
Miconazole MAT
at low cost or free
-----
Programme for
Supporting
Children
Affected by
AIDS
Mother
and Child
care
initiatives
(HIV
related)
Abbott
10
developing
countries
on 3
continents
----
Since 2001 more than one
million families supported;
trained or retrained more
than 13,000 healthcare
professionals
PMTCT: Abbott
Rapid HIV Test
Donation
Programme
Mother
and Child
care
initiatives
(HIV
related)
Abbott
39
countries,
including
all of Africa
Shipped more than 15
million rapid HIV test units
till 2009
By 2009, 11 million pregnant
women tested for HIV;
averted more than 125,300
potential infections of
infants
Elizabeth Glaser
Paediatric AIDS
Foundation
Mother
and Child
care
initiatives
(HIV
related)
Abbott,
Boehringer
Ingelheim,
Johnson &
Johnson
17
developing
countries
USD 103 million spent in
2008
By march 2010, tested more
than 8.5 million women for
HIV, started more than
535,000 individuals on
antiretroviral and provided
services to more than 10
million women.
Partnership
16
17
18
19
Diflucan® (fluconazole)
Free of cost
USD 840 million spent on
medicines
20,000 health professionals
trained
159
20
21
22
23
24
25
26
27
PEPFAR
Partnership for
Paediatric AIDS
Treatment
Mother
and Child
care
initiatives
(HIV
related)
Abbott,
Bristol-Myers
Squibb,
Gilead, GSK,
Merck & Co.
Inc.
15
developing
countries
Over USD 26 billion
dedicated to HIV/AIDS
As of Sept, 2009, provided
antiretroviral to more than
2.4 million people; directly
supported over 11 million
people; nearly 340,000
babies born without HIV.
Programme for
Supporting
Children
Affected by
AIDS
Mother
and Child
care
initiatives
(HIV
related)
Baylor and
the Abbott
Fund
10
developing
countries
on 3
continents
Baylor Children's Clinical
Centres of Excellence
Network
More than 30,000 children
PMTCT:
Viramune®
Donation
Programme
Mother
and Child
care
initiatives
(HIV
related)
Boehringer
Ingelheim
60
developing
countries
Providing Viramune®
Free of cost; 1 million doses
provided;
----
Secure The
Future
Mother
and Child
care
initiatives
(HIV
related)
Bristol-Myers
Squibb’s
8
developing
countries in
Africa
Children´s Clinics &
Paediatric AIDS Corps was
established; committed
USD 150 million since 1999
1500 under treatment
Life Skills:
Community
Support for
Children
Affected by
HIV/AIDS
Mother
and Child
care
initiatives
(HIV
related)
Johnson &
Johnson
Thailand
USD 19.8 million spent in
2008
-----
Programme to
Strengthen
Tanzania's
Healthcare
System
Improve
Health
Systems
Abbott
Tanzania
Upgraded various facilities
and laboratories
More than 15,000
healthcare professionals
trained
African
Comprehensive
HIV/AIDS
Partnerships
(ACHAP)
HIV/AIDS
Merck & Co.
Inc.
Botswana
Committed USD 56.5
million
More than 100,000 patients
receiving treatment; saved
more than 50,000 lives.
African
Comprehensive
HIV/AIDS
Partnerships
(ACHAP)
Improve
Health
Systems
Merck & Co.
Inc.
Botswana
Developed a laboratory
Annual capacity of testing
20,000 patients
160
28
29
30
31
32
33
34
35
36
37
Positive Action
on HIV/AIDS
Improve
Health
Systems
GSK
21
developing
countries
Develop capacity of
community organisations;
USD 595,000 over four
years in India
Reaching 2.5 million people
Positive Action
on HIV/AIDS
Improve
health
systems
GSK
21
developing
countries
To integrate treatment
and support services
USD 2.2 million in Kenya;
Other HIV/AIDS
CapacityBuilding
Initiatives
Improve
health
systems
GSK
17 African
countries
Various activities done;
USD 1,091,461 in 2007;
committed
GBP 700,000 in new
initiatives in 2009 for Africa;
committed USD 280,000 in
2009 for Asia
----
HIV/AIDS
Programmes
Improve
health
systems
Merck &
Co., Inc.
24 African
countries
Supported various
universities and research
centres;
awarded more than USD
10 million in various
capacities since 1999.
----
HIV/AIDS
Programmes Asia-Pacific
Improve
health
systems
Merck &
Co., Inc.
China
USD 30 million donated
----
HIV/AIDS
Programmes Caribbean
Improve
health
systems
Merck &
Co., Inc.
Jamaica,
Mexico,
Venezuela
Supported Caribbean
Coalition of National AIDS
Programme Coordinators
(CCNAPC); donated
USD 36,500
----
Infectious
Diseases
Institute
Improve
health
systems
Pfizer,
Gilead
Uganda
Support to build a regional
treatment and R&D
institute in Kampala.
Treatment to 90,000 patients
annually
Trained more than 3500
workers
Fight against TB
in Africa
TB
AstraZeneca
Lesotho,
Liberia,
S. Africa
----
1800 people completing
their treatment
Fight against TB
in Africa
TB
AstraZeneca
Central
Asia
----
More than 10,000 treated
Fight against TB
in Africa
TB
AstraZeneca
Sub
Saharan
Africa
----
2500 patients treated and
6000 more identified
----
161
38
MDR-TB
Partnership
TB
Lilly
over 60
countries
USD 120 million in
medicines and USD 65
million for TB research in
2007; total USD 135 million
Enrolled over 50,000 patients
The Global Plan
to Stop TB
TB
Novartis
Tanzania
Total cost USD 56 billion for
10 years from 2006
Over 4.5 million treated till
2010
TB Free & Other
Initiatives
TB
SanofiAventis
Kenya,
South
Africa
Euro 15 million
By 2008, 500,000 patients
treated and 20,000 workers
trained
TB Free & Other
Initiatives
TB
SanofiAventis
India
----
Facilities to treat 4000
patients annually
Stop TB
Partnership
TB
AstraZeneca,
GSK, Lilly,
Novartis
Endemic
countries &
vulnerable
populations
TB
Lilly, Jubilant
Biosystems,
Summit plc
India
opened access to its
library of 500,000
compound; establishing
labs and facilities
----
Novartis
Institute for
Tropical
Diseases (NITD)
TB
Novartis
Indonesia
(research
in
Singapore)
USD 122 million for the
centre
----
GSK & Access
to Malaria Care
Malaria
GSK
13
developing
countries
At no profit
To increase awareness
GSK & Access
to Malaria Care
Malaria
GSK
13
developing
countries
USD 1.5 million to The
Malaria Consortium
To increase awareness
Millennium
Villages Project
Malaria
Novartis
Tanzania
Coartem®
Distributed bed-nets and
medicines
Novartis
Coartem
Malaria
Novartis
34
developing
countries
Coartem® Dispersible;
provided 320 million
treatments since 2001
saved 500,000 lives.
Roll Back
Malaria
Partnership
Malaria
GSK,
Novartis,
SanofiAventis
35
developing
countries
USD 3 million by GSK
-----
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40
41
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43
44
45
46
47
48
49
Lilly TB Drug
Discovery
Initiative
----
Lilly donating 1.4 million
vials; Novartis donating
500,000 doses
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55
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58
Impact Malaria
Malaria
SanofiAventis
Benin,
Madagascar,
Republic of
Congo,
Tanzania
In 2009, 23 million
treatments were
distributed;
artemisinin-based
combination
Provided training to 20
health professionals in 2008.
Bayer
HealthCare &
African
Sleeping
Sickness
Sleeping
sickness
Bayer
HealthCare
8
developing
countries
At no cost donated 50,000
ampoules of Germanin®
----
Fight Against
Chagas
Disease
Chagas
disease
Bayer
HealthCare
Endemic
countries in
Latin
America
Assured supply of 2.5
million tablets of Lampit®
till 2012
----
AmBisome for
Leishmaniasis
Leishmaniasis
Gilead
Endemic
countries
Provides AmBisome at a
preferential price
----
Global Alliance
to Eliminate
Lymphatic
Filariasis
(GAELF)
Lymphatic
filariasis
GSK,
Merck & Co.
Inc.
47 out of
80
endemic
countries
In 2009, 425 million
treatments of albendazole
were provided;
over 1.4 billion treatments
have been provided
Over 100 million people
have been protected.
Guinea Worm
Eradication
Programme
(GWEP)
Dracunculiasis
(Guinea
worm)
Johnson &
Johnson
9 African
countries
Donated enough medical
supplies, such as Tylenol®,
forceps and gauze, to
treat more than 3,000
villages
Today 99% of the disease
has been fought
International
Trachoma
Initiative (ITI)
Trachoma
Pfizer
15
developing
countries
Since 1998, donated over
145 million treatments;
trained thousands of
workers and performed
more than 416,000
surgeries
Morocco has become
totally free from the disease.
Leprosy
Elimination
Leprosy
Novartis
66
developing
countries
2 medicines free of cost;
donation 2000-2005 was
USD 40 million;
uninterrupted supply of
free medicine till 2010
Cured more than 5 million
people.
Prevalence rate has
dropped by over 90%.
Merck
Mectizan®
Donation
Programme
River
Blindness
Merck & Co.
Inc.
33
endemic
countries in
Africa,
Latin
America,
the Middle
East
Since 1987, 2.5 billion
tablets of Mectizan®;
700 million treatments;
Invested more than USD 35
million in direct financial
support; donation will
reach 100 million
treatments.
transmission of river
blindness had been halted
in Colombia and in certain
areas of Ecuador and
Guatemala
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Merck
Praziquantel
Donation
Programme
Schistosomiasis
Merck
KGaA
6 African
priority
control
countries
Will supply 200 million
tablets of Cesol® 600
between 2007 and 2017;
approx cost USD 80 million
Will help 27 million children
“Most
Neglected
Diseases”
Programme
Buruli
ulcer,
Chagas
disease,
leishmaniasis
SanofiAventis
Brazil,
Chad,
Ethiopia,
Panama,
Sudan,
Togo,
MiddleEast
countries
Donating USD 6.4 million to
WHO; providing
Glucantime® at low price;
donating USD 2 million for
new programme and USD
4 million to support field
activities.
In 2008, 98 health
professionals were trained
and 194 patients treated.
Sleeping
Sickness
Programme
Sleeping
Sickness
SanofiAventis
SubSaharan
African
countries
Committed
USD 25 million for 2001-06;
provided further USD 14
million for 2006-2011;
provided 171,000 vials of
medicines in 2009
Saved 140,000 lives; by the
end of 2009, 10,000 in 2009
only
Sleeping
Sickness
Programme
Sleeping
Sickness
Bristol-Myers
Squibb
SubSaharan
African
Provided active ingredient
and donated USD 400,000
----
Soil-Transmitted
Helminthiasis
Soil Transmitted
Helminthiasis
Johnson &
Johnson
Bangladesh,
Cameroon,
Cape
Verde,
Laos,
Nicaragua,
Uganda,
Zambia
From 2007 plan to donate
up to 50 million doses of
mebendazole
----
Neglected
Diseases
initiative (DNDi)
Chagas
disease,
leishmaniasis
sleeping
sickness
GSK
Pre-clinical
research in
Spain & UK
focus on identifying and
developing compounds
from existing GSK
programmes
----
Delivering Hope
Hepatitis
Bristol-Myers
Squibb
China,
India
Since 2002, provided USD
3.1 million to China and
USD 1.7 million to India.
Benefitted more than
700,000 people directly.
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74
GAVI Alliance
Childhood
diseases
Crucell,
GSK, Merck
& Co. Inc.,
SanofiAventis,
Wyeth
Lowincome
countries
Crucell providing
Quinvaxem™; in 2008 1.1
billion vaccine doses
supplied; Merck donated
USD 2 million for measles
programme; Sanofi
Pasteur donated 120
million doses of polio
vaccine; in 2008, Wyeth
provided 3 million doses of
Prevnar® pneumococcal
vaccine; GSK agreed to
supply up to 300 million
doses of its vaccine
Synflorix, for invasive
pneumococcal disease.
Vaccinated more than 600
million children since 2001
Global Polio
Eradication
Initiative
Polio
SanofiAventis
Afghanistan,
Egypt,
India,
Indonesia,
Nigeria,
Pakistan
Donated 120 million doses
since 1997;
30 million more in 2002;
in 2007, donated 270,000
doses to Indonesia.
----
HPV Vaccine &
Cervical
Cancer
Cervical
cancer
GSK
India, Peru,
Uganda,
Vietnam
Donated 50,000 doses of
Cervarix™;
----
Gardasil®
Access
Programme
Cervical
cancer
Merck & Co.
Inc.
Eligible
countries
Donate at least 3 million
doses of its recombinant
Gardasil® Human
Papillomavirus
Quadrivalent
----
Merck Vaccine
Network Africa (MVN-A)
Vaccinepreventable
diseases
Merck & Co.
Inc.
Kenya,
Mali,
Uganda,
Zambia
To provide training;
committed
USD 4.4 million through
2011
More than 510 professionals
have completed training;
more than 675,000 Malian
children benefited.
Pandemic
Influenza &
Developing
Countries
Pandemic
influenza
GSK
China,
India,
South
Africa
Invested USD 2 billion in
research; to donate 50
million doses of vaccine to
WHO
Pandemic
Influenza &
Developing
Countries
Pandemic
influenza
SanofiAventis
China,
India,
South
Africa
To donate 60 million doses
to WHO
----
Pandemic
Influenza &
Developing
Countries
Pandemic
influenza
AstraZeneca
China,
India,
South
Africa
In 2009, committed at least
3 million doses of vaccine
----
----
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Rotavirus
Vaccine
Programme
Rotavirusinduced
gastroenteritis
GSK
Brazil, El
Salvador,
Mexico,
Nicaragua,
Panama,
Venezuela
GSK will supply enough
Rotarix™ to protect every
baby in Brazil for the next
five years and will transfer
technology to allow Brazil's
Fiocruz to produce
Rotarix™ under licence.
Till 2009 more than 600,000
doses had been
administered in Nicaragua.
Sanofi-Aventis
& EPIVAC
Vaccinepreventable
diseases
SanofiAventis
11 African
countries
Between 2002 and 2008,
approximately 350 doctors
have been enrolled in
EPIVAC training.
----
Pandemic
Influenza &
Developing
Countries
Pandemic
influenza
Biken,
Gilead,
Roche,
China,
India,
South
Africa
Hold no patent in least
developed countries; sell
Tamiflu at reduced prices
for stockpiling; donated 5
million doses to WHO
----
ScheringPlough
Vaccine
Licence
Agreement
with WHO
Pandemic
influenza
ScheringPlough
developing
countries
Provided a non-exclusive
licence to WHO to
develop and sell its
influenza vaccine
----
Sigma-Tau &
AMREF:
“Uganda
Project
Vaccinepreventable
disease
Sigma-Tau
Uganda
Aim is to vaccinate more
than 3000 children
----
Abbott Fund
Programme to
Fight
Malnutrition in
Vietnam
Child &
maternal
health,
malnutrition
Abbott
Vietnam
Improving nutritional status
of children; donate
paediatric nutritional
products during flooding
and raining season
For the second year in a
row, the province has
exceeded the national
nutritional health target
Abbott Fund
Programme to
Improve
Children's
Health in
Cambodia
Child &
maternal
health
Abbott
Cambodia
Grants and products to
support free
comprehensive care;
formal training to improve
paediatric nutrition.
In 2008, more than 113,000
children received nutritional
assessment and 120 health
professionals were trained;
since 2001 the respective
figures are 250,000 and 400.
Abbott Fund
Programme to
Improve
Maternal &
Child Health in
Afghanistan
Child &
maternal
health
Abbott
Afghanistan
Provided more than USD
400,000 in grants and USD
3.7 million in donations;
focus of partnership is
empowerment of women
through improving health
education.
In 2008, more than 129,000
women and children
received services and more
than 70,000 individuals
received training on health
education; since 2005, more
than 380,000 women and
children have received
services.
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Promoting Safe
Motherhood in
India
Maternal
health
AstraZeneca
India
Awareness campaigns;
unique “walkathon” along
the river Ganges, to
spread Safe Motherhood
and other healthcare
messages among rural
populations; distribution of
medicines.
Rubella vaccinations for
over 1,000 teenage girls;
educational films on
anaemia, HIV/AIDS and
female feticide shown to
approximately 500 people
almost every day;
visits to over 100 schools
covered around 80,000
children in rural areas;
one to one communication
on education, marital age,
gender bias, female
feticide, HIV/AIDS,
sanitation, environment and
nutrition to many
beneficiaries.
Bayer Schering
Pharma &
Family Planning
Family
planning
Bayer
HealthCare
Worldwide
Focusing on fertility control
and family planning
through distribution of
contraceptives; training
programmes for sexual
education also
conducted
Since 1961, more than 2.6
billion cycle packs of oral
contraceptives have been
provided
Bidan Delima
Midwife
Training
Programme
Child &
maternal
health
Johnson &
Johnson
Indonesia
Supporting midwife
training programme;
In 2008, 1,200 midwives were
trained in national clinical
standards of midwifery
Abbott
Programme to
Advance
Diabetes Care
in Bolivia
Diabetes
Abbott
Bolivia
Grants to support diabetes
education, expand public
outreach campaigns, train
healthcare personnel in
diabetes management,
and establish and expand
the number of core
diabetes educators; also
donated glucose
screening and monitoring
equipment
In 2008, the partnership
screened more than 19,000
people, trained 300
healthcare personnel, and
provided patient education
workshops to more than 800
patients. Since the
partnership began, more
than 26,000 people have
been screened for diabetes
and there has been 260%
annual increase in
detection of diabetes.
Breast Cancer
Programme in
Ethiopia
Breast
cancer
AstraZeneca
Ethiopia
Focused on strengthening
diagnosis and treatment
capabilities; activities
include developing
treatment guidelines,
strengthening the referral
system, setting up an
institutional-based cancer
registry, raising awareness
and providing training
3,122 patients have been
screened, diagnosed, or
treated and followed up;
new mammography
equipment installed and 13
staff trained; Tamoxifen
available free of charge 1,706 patients benefited so
far; Anastrazole available
for first time in Ethiopia (Oct
2009)and provided free of
charge
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Bayer
HealthCare
Nexavar®
Access
Programme
Diabetes
Bayer
HealthCare
AsiaPacific
region
Donates medicine
Nexavar® to facilitate
access for patients who
cannot afford the cost of
a full course of therapy
----
Circle of Care
Mental
health
Johnson &
Johnson
Malaysia
Provides job placement
support programmes;
disseminates education
about mental illness;
connects to local support
groups.
Has helped more than 1,000
families in Malaysia cope
with mental illness.
Glivec®
International
Patient
Assistance
Programme
(GIPAP™)
Leukaemia
Novartis
80
developing
countries
Provided Glivec® at no
cost worth USD 751 million;
also help in programme
development and drug
donation
Helped 35,000 patients;
established a global
network of almost 1,000
registered physicians and
more than 300 qualified
treatment centres, including
the leading oncology
treatment centres
IDF BRIDGES
Programme
Diabetes
Lilly
Worldwide
Funding worth USD 10
million for research and
development; new grant
of USD 2million in 2010
----
India Diabetes
Educator
Project
Diabetes
Bayer
HealthCare,
Lilly
India
Offers a comprehensive
and sustainable approach
towards diabetes training;
spent USD 130 million on
aid
----
Best Possible
Pricing on
Insulin
Diabetes
Novo
Nordisk
32
developing
countries
Offers insulin at 20% cost;
99% of insulin sold to Least
developed countries is
under this scheme.
Supplies are enough to treat
between 150,000 and
390,000 patients, depending
on the daily dose.
Novo Nordisk
Haemophilia
Foundation
Haemophilia
Novo
Nordisk
23
developing
countries
World Partner
Project
Diabetes
Novo
Nordisk
10
developing
countries
Programmes include
awareness creation
through distribution of
educational material,
capacity building and
prevention of haemophilia
complications; 33 projects
going on; Euro 5 million
have been earmarked.
31 projects in seven focus
countries; organizing
clinics, providing distance
learning and educating
people
By 2010, 15,100 people had
been diagnosed.
Trained 104,000 healthcare
professionals, while 122,000
people with diabetes have
been educated or treated
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Global Health
Partnerships
Oncology
and
tobacco
control
Pfizer
15
developing
countries
Committed USD 47 million
over four years (20072010); improved diagnosis
and treatment facilities.
----
Sanofi-Aventis
Diabetes
Prevention
Diabetes
SanofiAventis
Burundi,
India,
Kenya,
Madagascar,
Mali,
Nicaragua,
Philippines,
Thailand
Several projects to help
local healthcare systems
to manage the disease
better and prevent the
onset of complications.
Since the beginning of the
programme, Handicap
International has trained 600
health professionals, who in
turn have treated 3,000
patients.
Sanofi-Aventis:
Impact Epilepsy
Programme for
Developing
Countries
Epilepsy
SanofiAventis
Cambodia, Kenya,
Laos,
Madagascar,
Mali
Medicines such as
Depakine® / VPA are
provided on a “no-profit,
no-loss” basis
In Mali , more than 2,000
patients have been
diagnosed and treated;
In Kenya, 260 healthcare
professionals have been
trained and 10,000 patients
treated
Mental Health
Disorders
(Schizophrenia)
Schizophrenia
SanofiAventis
Mauritania,
Morocco,
Vietnam
Providing Largactil®,
Nozinan®, Piportil L4® and
Solian® at preferential
prices.
Two pilot programmes have
been set up in Mauritania
and Morocco combining
information, education and
communication, training
and medicines.
My Child
Matters
Childhood
cancers
SanofiAventis
21
developing
countries
Work to develop
pragmatic approaches to
improve awareness, early
diagnosis, access to care
and treatment, pain
control and better
management of the social
and cultural aspects of the
disease.
In 2008, 12,875 children
benefited from this
programme and 2,849
health professionals were
trained
ScheringPlough &
National
Cancer
Coalition
Brain
cancer
ScheringPlough
Dominican
Republic,
Ecuador, El
Salvador,
Guatemala,
Honduras,
Nicaragua,
Peru
Supplying enough of its
brain cancer drug,
Temodar®.
Treating 115 patients in 13
hospitals
The World
Diabetes
Foundation
Diabetes
Novo
Nordisk
83
developing
countries
Total USD 227 million have
been provided since 2001.
Focusing on diabetes
awareness, education and
capacity-building.
As of2009 at least 2,876,565
people have been
screened for diabetes in
4,427 screening camps,
more than 229,829 have
been treated, and 14,433
doctors and 12,835 nurses
have been trained.
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106
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Arogya Parivar
Programme
Multiple
diseases
Novartis
India
The programme focuses
on tuberculosis, coughs,
colds, allergies, skin and
genital infections,
malnutrition in mothers
and children, diabetes,
intestinal worms and
digestive problems.
----
AstraZeneca
Product
Donations
Multiple
diseases
AstraZeneca
developing
countries
Donated USD 646 million in
product; total spend on
charitable contributions
was USD 72 million
----
Strengthening
Healthcare
Capacity
Multiple
diseases
Boehringer
Ingelheim
Botswana,
Papua
New
Guinea,
South
Africa,
Venezuela
Provide support to
develop community
health centres, provide
training, spread
awareness, and supply
medicine and equipment.
----
Bristol-Myers
Squibb Medical
Product
Donations
Multiple
diseases
Bristol-Myers
Squibb
developing
countries
Donated USD 243 million of
medical products since
2003; in 2008, the amount
of donation was
USD 33 million; focuses on
medical supplies;
healthcare infrastructure
and disaster relief.
----
GSK & Leonard
Cheshire
Disability in Sri
Lanka
Disability
GSK
Sri Lanka
Support disabled peoples
access to health and
rehabilitation services,
inclusive education and
livelihood opportunities.
Supported 500 people with
disabilities and increased
awareness to 1000 family
members of people with
disabilities.
GSK Nurse
Training in Tamil
Nadu
Nurse
training
GSK
India
Provided
USD 133,509 of funding
from June 2007 to June
2009
----
Health Training
at Egypt's
National
Training Institute
Multiple
diseases
Pfizer
Egypt
Provide state-of-the-art
training for physicians,
nurses and health
professionals
Nearly 15,000 physicians
have been trained through
220 training courses and 21
symposia.
Healthy
Communities,
Healthy
Ecosystems
Multiple
diseases
Johnson &
Johnson
Democratic
Republic of
Congo,
Kenya,
Nepal
Conducted sex education
and HIV/AIDS training; built
a dispensary clinic in
Kenya and established
mobile clinics.
----
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Johnson &
Johnson Burn
Treatment
Centre in
Soweto
Multiple
diseases
Johnson &
Johnson
South
Africa
Built the Johnson &
Johnson Burn Treatment
Centre, a state-of-art
facility to treat
complicated burn injuries.
Treats more than 1,500
patients annually;
succeeded in reducing the
mortality rate among
critically ill patients.
Medical
Outreach
Programme
Multiple
diseases
Merck & Co.
Inc.
developing
countries
Donations of Merck
medicines; in 2008,
donated medicines worth
USD 43.4 million; total USD
592 million donated in
Mectizan and medical
outreach programme.
-----
Nursing Training
in East Africa
Multiple
diseases
Johnson &
Johnson
Kenya,
Tanzania,
Uganda
Programme
provides quality education
and greater standards of
evidence-based care to
nurses and midwives.
About 200 nurses from 50
different hospitals have
been trained to date.
Otsuka Welfare
Clinic
Multiple
diseases
Otsuka
Pharmaceutical
Pakistan
Medical doctors,
pharmacists, nurses and
other medical
professionals provide free
treatment each day to
some 300 patients
requiring medical
assistance.
----
Phelophepa
Healthcare
Train
Multiple
diseases
Roche
South
Africa
Provides basic healthcare
services to poor patients in
remote rural areas
Serves more than 45,000
people a year and has
reached nearly 13 million in
total since 1994
Rabies Control
in Tanzania
Rabies
ScheringPlough
Tanzania
Donated 200,000 doses of
rabies vaccine;
USD 20,000 was provided
to replace a stolen vehicle
Significant reduction in
reported rabies cases from
26% to 2%; injuries from
rabies dogs have also
reduced.
ScheringPlough
Medicine
Donations
Multiple
diseases
ScheringPlough
developing
countries
More than USD 500,000 in
support; more than USD 14
million of medicines;
donated an additional
USD 14million of pharmaceuticals to other NGOs.
----
Tanzanian
Training Centre
for International
Health
Multiple
diseases
Novartis
Tanzania
The aim is to strengthen
human resource
development in the
Tanzanian health sector
and beyond
----
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Train mid-wife
programme
Training
Abbott
Afghanistan
To train mid-wives and
ensure safe and healthy
delivery of babies.
----
Operation
Smile
Facial
deformation
Abbott
developing
countries
To increase survival rates
of patients treated in
emergencies; donated
USD 5.4 million since 1993;
in 2007 donated products
worth USD 500,000
Since 1982, 140,000 children
have been treated; trained
more than 11,700 medical
professionals.
Improving neonatal care
Neo-natal
care
Abbott
Kosovo
A grant of USD 86,800,
helped purchase
advanced ventilators, 15
CPAP machines,
incubators, pulse oximeters
and gas analyzers to
equip four patient units
within the NICU.
----
Care and
Prevention of
Mother-to-Child
Transmission of
HIV/AIDS
PMTCT
Bristol-Myers
Squibb
Foundation
Zambia
A USD 433,000 grant to the
Adventist Development
and Relief Agency
----
2009 Alliance to
Reduce
Disparities in
Diabetes
Diabetes
Merck
USA
Commitment of USD 15
million through 2013
mothers
2
mothers
PMTCT
Merck
African
countries
Gave USD 5 million in
salaries
Employs 1625 HIV positive
mothers and serves another
300,000 HIV positive women.
Nicaragua
Rotavirus
Vaccine
Programme
Gastroenteritis
Merck
Nicaragua
USD 75 million; donated
more than 1 million doses
since 2006.
Approximately 81% of
eligible infants were
vaccinated in 2008.
AmpliCare
HIV/ AIDS
Roche
SubSaharan
African
countries
Offers an education
programme to keep local
doctors and nurses fully
informed about the latest
advances in HIV/AIDS
care.
In 2008, 450,000 infants were
tested for HIV and an
estimated 560,000 patients
had their HIV/AIDS
treatment monitored.
Pandemic
Planning
Influenza
Roche
WHO
In 2003, 5 million courses
were donated. In 2009,
donated another 5 million
courses.
WHO distributed these
courses in the developing
nations during 2009 outbreak.
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127
128
129
130
131
132
133
134
CARE
HIV/AIDS
Roche
Africa
A forum for healthcare
professionals to meet and
discuss their experiences of
managing HIV/AIDS
Exchange meetings have
brought together more than
600 healthcare workers –
including doctors, nurses,
counsellors, pharmacists
and laboratory managers –
from over 29 countries in
Africa and Asia.
Roche Organ
Transplantation
Research
Foundation
(ROTRF)
Organ
Transplant
Roche
_
More than 225 projects
have received funds worth
over 43 million Swiss francs
in total during the last 11
years.
----
Roche
Foundation for
Anaemia
Research
(RoFAR)
Anaemia
Roche
developing
world
Committed just under SFr
20 million francs since
2004; so far awarded
around SFr 15 million to 68
research projects around
the world.
----
West Africa
Hydrocele
Surgical
Training
Programme
(WAHSTP)
Hydrocele
Johnson &
Johnson
Burkina
Faso,
Ghana,
Mali, Niger
and Togo
----
Since 2005, nearly 100
surgeons and surgical nurses
have been trained, and
more than 2,100 men have
benefited from the surgery.
Mobilize
against malaria
Malaria
Pfizer
Ghana,
Kenya and
Senegal
In 2009, gave Medicines
for Malaria Venture access
to its library to test 200,000
compounds.
----
Alliance for a
Healthy Border
Diabetes
and CVD
Pfizer
US-Mexico
Border
USD 4.5 million over 3 years
from 2006 to 2008
More than 50,000 individuals
reached with diabetes and
CVD prevention messages.
HIV
The Global
Fund
----
Donated more than USD
10.8 billion for various
causes
Providing antiretroviral
therapy (ART) to 2.5 million
people; distributed 1.8 billion
male and female condoms;
provided 790,000 HIVpositive pregnant women
with treatment to prevent
mother-to-child transmission
of HIV, as well as 4.5 million
units of basic care and
support services to orphans
Tuberculosis
The Global
Fund
----
USD 3.2 billion and 1.8
million TB/HIV interventions
Treatment for 6 million
people who had active TB
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136
137
138
139
140
141
142
Malaria
The Global
Fund
----
Approved funding worth
USD 5.3 billion
Distributed 104 million
insecticide-treated nets
(ITNs) to prevent malaria;
treated 108 million cases of
malaria
Paediatric
HIV/AIDS
UNITAID
----
Donated funds close to
USD 235.5 million
More than 285,000 patients
treated by 2009
Secondline
HIV/AIDS
UNITAID
----
USD 241.1 million has been
donated to various
partnerships.
More than 180, 000 patients
have been treated
Tuberculosis
UNITAID
----
Total funds committed of
USD 146,226,874
Total number of patients
treated exceeds 1.7 million
Multiple
U.K.
Department
for
International
Development
Total funds committed to
various issues is GBP7.9
billion by 2010/11; written
off 100% of the debt owed
to DFID by the world's most
heavily indebted poor
countries.
Globally: proportion of
people in developing
countries living in extreme
poverty fell from 28% in 1990
to 22%.
Kenya: HIV/AIDS prevalence
has fallen from over 11% to
5.9% over the past eight
years.
Uganda: Between 2003 and
2006, 1.4 million people
have been lifted out of
poverty.
Malaria
Bill and
Melinda
Gates
Foundation
----
USD 202 million for the
Medicines for Malaria
Venture;
USD 79 million for the
Malaria Control and
Evaluation Partnership in
Africa
HIV/AIDS
Bill and
Melinda
Gates
Foundation
----
USD 258 million for Avahan;
USD 151 million for
research on microbicides
to prevent HIV
transmission;
USD 50 million to support
the African
Comprehensive HIV/ AIDS
Partnerships
----
Tuberculosis
Bill and
Melinda
Gates
Foundation
----
USD 309million to the Aeras
Global TB Vaccine
Foundation;
USD 33 million to improve
TB control in China;
USD 86 million for the
Foundation for Innovative
New Diagnostics
Approximately 32 million
patients were treated under
DOTS (directly-observed
treatment, short-course)
between 1995 and 2007
----
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143
144
145
146
147
148
149
Vaccine
Preventable
Diseases
Bill and
Melinda
Gates
Foundation
----
USD 1.5 billion to the GAVI
Alliance
The GAVI Alliance has
helped to immunize 213
million children, preventing
more than 3.4 million future
deaths
Polio
Bill and
Melinda
Gates
Foundation
----
USD 355 million to Rotary
International to support
global polio eradication
activities; USD 150 million
to UNICEF and WHO
----
Pneumonia
and Flu
Bill and
Melinda
Gates
Foundation
----
USD 41 million to PATH to
develop new vaccines;
USD 4 million for the
University of Maryland to
introduce a vaccine for
Hib pneumonia in West
Africa.
----
Nutrition
Bill and
Melinda
Gates
Foundation
----
USD 109 million to GAIN
(Global Alliance for
Improved Nutrition);
USD 15 million to UNICEF to
eliminate iodine
deficiency
Each year, GAIN’s
partnerships with the food
industry make it possible to
fortify 2.9 million metric tons
of flour and 100,000 metric
tons of soy sauce
Diarrhoea
Bill and
Melinda
Gates
Foundation
----
USD 7 million for the
International Centre for
Diarrhoeal Disease
Research to implement a
zinc treatment
programme;
USD 50 million to PATH
(Programme for
Appropriate Technology in
Health) to develop
vaccines against bacteria
that cause diarrhoea
----
Maternal
and
Neonatal
Health
Bill and
Melinda
Gates
Foundation
----
USD 25 million to the NGO,
BRAC, and
USD 110 million to Save the
Children to expand access
to simple, low-cost tools
to improve newborn
health
----
Tobacco
Bill and
Melinda
Gates
Foundation
----
Committed to investing
USD 125 million over 5
years to fight the global
tobacco epidemic,
including a USD 24 million
grant to the Bloomberg
Initiative to reduce
tobacco use.
----
175
150
HIV/AIDS
The
President's
Emergency
Plan for AIDS
Relief
(PEPFAR)
----
Started in 2003 with
funding of USD 15 billion;
In 2008, USD 48 billion was
authorized for a period of
5 years (2009 to 2013).
7,304,525 pregnant women
received HIV counselling
and testing services in 2009;
number of individuals
receiving counselling and
testing in 2009 are
21,236,500;
number of individuals on
antiretroviral treatment in
2009 are 2,485,300;
number of Individuals
trained or retrained in 2009
are 1,547,600;
number of individuals
reached with community
outreach HIV/AIDS
prevention activities is
77,653,600.
176
List of the 50
Least Developed Countries
177
178
Selected Socioeconomic Indicators For The 50 Least Developed Countries
Country
Population
(millions)
Infant
Estimated
Share of
mortality
Adult
Average life number of
total
GDP per
rate
people
literacy
expectancy
labour
capita (USD
(per
(aged 0-49
rate
at birth
force in
current)
1,000
years)
agriculture (%)
(years)
live
living with
(%)
births)
HIV/AIDS
(thousands)
2002
2002
2002
2000
2000-05
2000-05
end 2001
Afghanistan
22.9
..
66
36
162
43
..
Angola
13.2
863
71
42
140
40
350
Bangladesh
143.8
329
54
40
64
61
13
Benin
6.6
410
52
37
93
51
120
Bhutan
0.9
698
94
47
54
63
0c
Burkina Faso
12.6
225
92
24
93
46
440
Burundi
6.6
109
90
48
107
41
390
Cambodia
13.8
266
69
68
73
57
170
Cape Verde
0.5
1,390
22
74
30
70
..
Central African
Republic
3.8
282
71
47
100
40
250
Chad
8.3
232
73
43
115
45
150
Comoros
0.7
343
73
56
67
61
..
Dem. Rep. of the
Congo
51.2
111
62
61
120
42
1,300
Djibouti
0.7
861
78
65
102
46
..
Equatorial Guinea
0.5
4,517
69
83
101
49
6
Eritrea
4
146
77
56
73
53
55
179
Ethiopia
69
87
82
39
100
45
2,100
Gambia
1.4
280
78
37
81
54
8
Guinea
8.4
380
83
41
102
49
..
Guinea-Bissau
1.4
149
82
38
120
45
17
Haiti
8.2
437
61
50
63
50
250
Kiribati
0.1
512
26
..
..
..
..
Lao People’s Dem.
Rep.
5.5
304
76
65
88
54
1
Lesotho
1.8
405
39
83
92
35
360
Liberia
3.2
174
67
54
147
41
..
Madagascar
16.9
267
73
66
91
54
22
Malawi
11.9
158
82
61
115
38
850
Maldives
0.3
2,000
21
97
38
67
0c
Mali
12.6
251
80
26
119
49
110
Mauritania
2.8
350
52
40
97
52
..
Mozambique
18.5
211
81
44
122
38
1,100
Myanmar
48.9
..
70
85
83
57
..
Nepal
24.6
223
93
42
71
60
58
Niger
11.5
188
87
16
126
46
..
Rwanda
8.3
210
90
67
112
39
500
Samoa
0.2
1,482
33
99
26
70
..
Sao Tome and
Principe
0.2
321
63
..
32
70
..
Senegal
9.9
501
73
37
61
53
27
Sierra Leone
4.8
166
61
36
177
34
170
180
Solomon Islands
0.5
517
72
..
21
69
..
Somalia
9.5
..
70
24
118
48
43
Sudan
32.9
410
59
58
77
56
450
Timor-Leste
0.8
548a
81
43a
80a
57a
..
Togo
4.8
288
59
57
81
50
150
Tuvalu
0.0b
..
25
..
…
..
..
Uganda
25
235
79
67
86
46
600
United Rep. of
Tanzania
36.3
259
80
75
100
43
1,500
Vanuatu
0.2
1,133
35
..
29
69
..
Yemen
19.3
538
48
46
71
60
10
Zambia
10.7
344
68
78
105
32
1,200
Least developed
countries
699.6
281
69
52
97
50
13,348
All developing
countries
5,018.5
1,195
54
74
61
63
37,476
Source: UNCTAD The Least developed countries Report 2004
a
Data for 2001.
b
Population 10,466.
c
<100
181
The Cameron Institute is an alternative, not-for-profit, public policy think tank specializing in the independent study
of current health, social, and economic issues in Canada and internationally. The Institute researches policy
concerns in the health world related to the need for balance between patient safety and access to new,
innovative, affordable therapies. It is an objective of The Cameron Institute to provide decision makers with
analyses that will help inform choices. The Institute is also dedicated to educating and better preparing patients,
providers, and payers to make appropriate clinical choices.
Dr. D. Wayne Taylor has worked as an executive in the private sector, as a senior civil servant, as a political
assistant, and was the Founding Director of both the MBA Programme in Health Services Management and the
Health Leadership Institute at McMaster University. He remains a tenured faculty member in the DeGroote
School of Business at the Ron V. Joyce Centre for Advanced Management Studies while serving as the Executive
Director of The Cameron Institute and as president of his own private international consultancy as well as Finergy
Analytics.
182