Role of the Health System in Health Biotechnology Innovation in Developing Countries

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Role of the Health System in Health Biotechnology
Innovation in Developing Countries

• Halla Thorsteinsdóttir
• University of Toronto
• IKD Research Workshop,
• Bridging the gulf between policies for
  innovation, productivity industrial growth
  policies to reduce poverty
• London 18-20 November 2005

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Main questions

• Are the health biotechnology sectors in
  developing countries aimed at local health needs?
  
• If they are, are the roles of the health systems
  likely to be confined to being users of the local
  innovation or are they active contributors to the
  innovation as well?

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Common belief

• Developing countries researchers and firms do
  not focus on their local health problems but are
  rather focused on the health problems of people
  in industrially advanced countries.
• It carries more prestige to study health topics
  that the leading scientists in the world are
  researching
• There are better chances for the research to be
  accepted for publication in the most
  influential journals.
• For firms in developing countries it is most
  lucrative to focus on health problems in
  industrially advanced countries, where the
  largest profit margins lie.

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Health Biotechnology Innovation in Developing
Countries
How have developing countries that have developed
successes in health biotechnology been able to do
it?
Countries Brazil, China, Cuba, Egypt, India,
South Africa, and South Korea
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PROJECT TEAM
CANADA Abdallah Daar Uyen Quach Peter
Singer Halla Thorsteinsdóttir
SOUTH KOREA Joseph Wong
CHINA Li Zhenzhen Zhang Jiuchun Wen Ke
EGYPT Basma Abdelgafar
CUBA Tirso Saénz
INDIA Nandini Kumar Hemlatha Somsekar
BRAZIL Marcela Ferrer
SOUTH AFRICA Marion Motari
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Case Studies

• Semi-structured interviews with key informants -
  private sector enterprises, governmental
  departments, public and private research
  institutes, educational institutions, regulatory
  agencies, relevant associations, major interest
  groups, relevant NGOs etc.
• Interviewed 207 experts from developing
  countries
• Background documents - relevant published
  information, governmental reports , policy
  briefs, legal and regulatory arrangements,
  official statistics
• Data on publication and patents in health
  biotechnology

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• Specialisation indices
• Express the intensity of research in a specific
  field that a country publishes in, relative to
  the intensity of publications in that field by
  the rest of the world.
• Indices of larger than 1 means a country is
  relatively specialised in a field/subfield

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Specialisation indices in subfields of health
biotechnology
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DALYs (Disability Adjusted Life years) due
to Communicable Diseases
Source WHO 2004
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Estimated proportion of total deaths by cause in
India (all ages, 2005).
Source Reddy et al, 2005
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Interviews on health biotechnology innovation in
developing countries

• How do you see the role of health biotechnology
  in your country in the context of health delivery
  and public health?

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CUBA
Main driving force for the health biotechnology
sector was solving local problems
Purified Meningococci Meningitis B and C
Vaccine Produced by
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Cuban health biotechnology

• Cuban procurement policies favour local health
  products to imported ones.
• Tight linkages, with clinicians in Cuba heavily
  involved in the innovation process, and are
  active in the biotechnology cluster, West Havana
  Scientific Pole.
• A researcher in a public research institute said,
  for example We have feedback from the clinical
  trials to the lab. This is not a linear process.
  The cycle is a good ground for innovative
  thinking. It has definitely improved our
  products.

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INDIA
Governmental support to biotechnology since early
1980s but not instrumental policies towards
solving particular health problems
India has a great market. I mean we have so many
diseases. So there is no, I think, there is no
better place , no better market for you, we have
a billion people here and everybody needs three
things in life, I think. You need roti, kapda
and makaan food, clothing, shelter so and you
need davai medicine. So, you have, I mean,
that is definitely there is a market. In a
country, if you have more people, you have more
health problems
Shanvac-B Recombinant hepatitis B vaccine
surface antigen Produced by
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Indian health biotechnology

• To go global was a theme in the interviews
• Extensive exporting through supplying vaccines to
  UN agencies, e.g. UNICEF and WHO
• Health sector is important for clinical trials
  but not much emphasis on close linkages and
  knowledge flow between researchers/entrepreneurs
  in health biotechnology and health system

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BRAZIL

• Active in scientific publishing in health
  biotechnology
• Concerns that Brazilians were relatively weak in
  developing health biotechnology products
  services

We have certain competitive advantages. What are
these competitive advantages? Our needs. For
example, the problem of public health. Now,
besides the need, we have capacity. We have a way
to generate our industry. We also have specific
health problems that carry us to develop certain
things. Another advantage we have is that it is
cheaper making some things in Brazil than making
them outside of the country. We have human
resources
Biobrás and Federal University of Minas Gerais
developed recombinant human insulin
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Brazilian health biotechnology

• Lack of linkages and knowledge flow have been
  between the major actors in health biotechnology
  innovation system
• Procurement policies have been detrimental to
  local innovation

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Main answers

• Are the health biotechnology sectors in
  developing countries aimed at local health needs?
  Yes
• Both quantitative and qualitative data has
  supported that health biotechnology sectors in
  the countries discussed have attempted to meet
  local health needs
• Are the roles of the health systems likely to be
  confined to being users of the local innovation
  or are they active contributors to the innovation
  as well? Yes and No
• In most of the countries the linkages between
  researchers and entrepreneurs in health
  biotechnology and the health systems could be
  closer

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Additional statistics in demand

• How many of the health biotechnology products
  reach local markets versus exporting markets?
• What are the earnings the producers have in the
  different markets?
• To which countries do developing countries
  export their health biotechnology products?
• What proportion of their exports are through
  purchasing by UN agencies?
• What are the health effects of the health
  biotechnology products?

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Funding support
Bill and Melinda Gates Foundation McLaughlin
Centre for Molecular Medicine The Rockefeller
Foundation
Funding partners for the Canadian Program on
Genomics and Global Health listed at
www.geneticsethics.net