MEDICINE AND HEALTH IN THE TROPICS Plenary Session 3

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MEDICINE AND HEALTH IN THE TROPICSPlenary
Session 3 The Pharmaceutical Industrys RD
Drive and the issue of Tropical diseases 13
of September 2005

• Dr Pierre Le Sourd
• Leem President

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The issue of Tropical Diseases

• Definition
•  Neglected infectious diseases that
  disproportionately affect poor and marginalized
  populations (TDR Special Program for Research
  and Training in Tropical Diseases)
• Current disease portfolio

TDR Disease Category 1  Emerging or
uncontrolled disease  2  Control strategy
available, but disease burden persists  3
 Control strategy effective / Elimination
planned 
 Source World Health Report, 2004 DALYs -
Disability Adjusted Life Years (the number of
healthy years of life lost due to premature death
and disability)
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What is the Pharmaceutical Industry doing about
it ??Drug Companies part of the solution
instead of the issue
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Medicines existbut dont reach the patients in
need

• Most essential medicines are off-patent and
  inexpensivehowever over 50 of populations in
  Least Developed Countries lack regular access to
  these products

Source IFPMA, Septembre 2004
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What are the real barriers ?

• Poverty
• Lack of public health infrastructure
• Lack of human resources
• Lack of manufacturing capability
• High tariffs on medicines
• Political denial

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Successful interventions supported by Drug
Companies (1)

• In last decade, global companies have become
  critical contributors to numerous programs and
  initiatives targeting health needs of the poor
• In 2003, the value of donations by major
  companies matched the US AID Global Budget for
  Health
• 3,7 billion over last 5 years

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Successful interventions supported by Drug
Companies (2)

• Examples of concrete actions
• Malaria
• In 2001, Novartis formed a partnership with WHO
  to provide Coartem at no profit in developing
  countries
• Sanofi-Aventis launched a Specific Program
   Impact Malaria  to develop new treatments, new
  therapeutic strategies, educational campaign and
  to provide drugs at price,  not loss, not
  profit 
• Achievements Pilot projects in South Africa
  resulted with outstanding health outcomes
• Malaria cases reduced by 86
• Hospital admissions for malaria reduced by 82
• Malaria deaths decreased by 87
• Tuberculosis
• In South Africa, a huge involvement of
  Sanofi-Aventis
• Rifafour a combination of 4 medicines
  commercialized to enable better compliance
• A specific training program of 15 million
  developed DOT Supporters (DOT Directly
  Observed Treatment) for Health agents
• Ambitions
• Building of 9 Training centers
• 100,000 Health agents trained

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Successful interventions supported by Drug
Companies (3)

• Examples of concrete actions
• Leishmaniasis
• Ampules of Glucantime (Sanofi-Aventis) provided
  at no profit
• Onchocerciasis
• 40 million doses of Mectizan (Merck) donated
  annually in 34 countries
• Trachoma
• 16 million treatments donated in 11 countries
• More than 80 million of Zithromax (Pfizer)
  donated
• Leprosy
• 35 million donated in multi-drug treatment
  (Novartis)
• Achievements
• About 13 million people cured over the past 15
  years, while some 2-3 million people have been
  protected from developing deformities
• Lymphatic Filariasis
• 6 billion treatments of albendazole (GSK) planned
  to be donated
• 20 million treatments of Mectizan (Merck) donated
• Achievements
• 80 million people have received treatment

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Successful interventions supported by Drug
Companies (4)

• HIV/AIDS reference
• To increase access to ARVs in developing
  countries, a huge involvement of the
  Pharmaceutical Industry
• 564 million in 2002
• Involvement in International Programs
• ONUSIDA
• ACCESS thanks to significant price discounts,
  more than 330,000 patients in developing
  countries received ARVs by the end of September
  2004
• Pharmaceutical Initiatives
• Determine Donation Program (Abott), Secure the
  Future (BMS), African Comprehensive HIV/Aids
  Partnership (MerckCo), International HIV/Aids
  Health Literacy Grants Program (Pfizer)
• Health agents Training, equipments supply,
  prevention technical aids, health education

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New or improved treatments needed
Source IFPMA, Septembre 2004
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Drug resistance is widespreadthe example of
Malaria
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What about new drugs and vaccines ? (1)

• Quantum leap in Research is coming
• RD is at a crossroad
• Development of Biotech Products
• 2003 40 of New Molecular Entities
• 2010 around 100 New Molecular Entities expected
• could deliver major breakthroughs
• leading to new hope for Tropical Diseases

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What about new drugs and vaccines ? (2)

• New dynamics in RD for Neglected Diseases
• Establishment of dedicated research centers by
  major companies and increasing not-for-profit
  approach to RD for neglected diseases
• Creation of a RD efforts database of IFPMA
  members
• Growing number of product development public
  private partnerships (PPPs)
• Proliferation of RD players, including public
  research institutes, academia, major pharma
  companies, small specialized biopharmaceutical
  companies from developed and developing
  countries, etc.

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Establishment ofDedicated Research Centers
Source IFPMA, Septembre 2004
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Creation of a RD efforts database

• In September 2005, launch of a database
  collecting all the health initiatives involving
  the pharmaceutical industry to benefit the
  Developing countries
• A comprehensive list of both RD and Access
  Initiatives
• Accessible on the Internet (via the IFPMA
  website) by the general public
• Create an overall vision for industry activities
  in addressing developing countries needs
• Build a central depositary used to create new
  collaborations and partnerships

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Public-Private Partnerships development (1)

• TDR The Special Program for Research and
  Training in Tropical Diseases - and its Industry
  Partner a long and fruitful collaboration

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Public-Private Partnerships development (2)

• Examples of Product Development PPPs for
  Neglected diseases

Source IFPMA, Septembre 2004
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FAC Project an innovative partnership against
Malaria

• For Malaria, new medicine needed to adress drug
  resistance
• WHO recommands the development of 4 Artemisine
  Combination Therapies (ACT)
• But, 2 combinations needed a new fixed-dose
  combination
• FAC Project
• A scientific partnership, coordinated by DNDi, to
  develop fixed-dose combination of
  Artesunate/Amodiaquine (AS/AQ) and
  Artesunate/Mefloquine (AS/MQ)
• A public-private Innovative partnership
  Sanofi-Aventis DNDi
• In 2006, a new medicine available
• Easy to use for adults and children
• Less expensive Target price 1
• Off patent
• WHO estimations 50 to 100 million of people
  could received this treatement

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Results a growing RD pipeline
Source IFPMA, Septembre 2004
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Conclusions

• Public-private partnerships prove to offer the
  most effective solution
• Pharmaceutical companies increasing its
  commitment in
• Developing dedicated RD projects
• Establishing many health partnerships
• Bringing critical resources (products, money,
  people)
• Contributing in valuable cross-country experience
  and expertise in health care delivery
• Introducing a private sector management
  philosophy that helps achieve needed results
• Significant and promising global awareness

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Conclusions

• Therefore, any successful initiatives must
  include
• Political will
• Partners
• Infrastructure to get the medicines to patients
• Physicians training and patient education
• Proper diagnosis dispensing
• Quality control
• Proper dispensing
• Monitoring of outcomes