Dateline: Havana
Can product development partnerships (PDPs) deliver? This was the question tackled during a session at this week’s Global Forum for Health Research in Havana. The presentations actually spoke little to the topic—perhaps because PDPs are taking on some of the biggest scientific challenges of our time such as developing a HIV vaccine, a tuberculosis vaccine, and broad-spectrum anti-virals. But it is a question worth asking.
PDPs are a relatively new concept. The earliest were started just over 10 years ago and are either free standing nonprofit organizations or several different product programs housed together under one nonprofit. The basic concept when they began was that industry has expertise and capabilities that are needed to make new vaccines, drugs, and diagnostics for neglected diseases affecting poor countries but this expertise and capability is not being applied to diseases primarily affecting the developing world. PDPs were created to bridge the gap between global health need (public sector) and an innovation system that responds to market demand (private sector).
Given the timelines for developing novel drugs, vaccines, and diagnostics, it may be too early to say if PDPs have indeed delivered upon their promise. What is stunning is that no one has developed evaluation metrics to measure either effectiveness or efficiency, and no PDP has been evaluated by such metrics. Billions of dollars have been invested in these mechanisms by philanthropic organizations such as The Bill & Melinda Gates Foundation and bilateral donor governments such as the U.S. Agency for International Development and the U.K. Department for International Development.
The companies who make products are evaluated daily by their shareholders or at least quarterly by their venture capitalists or investment bankers. Companies also use internal metrics to improve their business processes and improve profits. One company was able to reduce their time to peak sales in half in a short period of time, greatly improving their profits. Should we not be taking the same approach in the public sector—greatly improving the speed of development and uptake of new products so that more lives can be saved?
My guess is that most PDPs would come out well in an evaluation — the pipelines are filling up with new drugs, vaccines, and diagnostics targeted toward neglected diseases. But for some diseases, a single PDP is virtually the only mechanism for funding research on that specific disease intervention. We should assure ourselves as a global health community that these investments are operating efficiently and effectively.
We as a community stand the strong chance of donor fatigue because the funding for PDPs often comes from agencies who measure outcomes in election cycles. It may take decades for new chemical entities, novel vaccines, and appropriate diagnostics to be developed because in addition to market barriers, many of the neglected diseases being tackled are scientifically very challenging. Adopting robust evaluation schemes now may help to show interim progress that points towards timelines for future products with health outcomes that can be counted in hundreds of millions of lives saved.
Melinda Moree is the interim CEO of BVGH