Epidemiology and control of filariasis (Lymphatic Filariasis) in India
Murray Berlin.25.11.04 - Final presentation - vfa.de · partnership with WHO in the Global...
26
Insufficiencies in healthcare systems Actions by research-based pharmaceutical industry Christopher Murray Director, Pharma International, Roche Roche Principal to the Accelerating Access Initiative VFA Berlin 25/11/04
Transcript of Murray Berlin.25.11.04 - Final presentation - vfa.de · partnership with WHO in the Global...
Insu
ffici
enci
es in
hea
lthca
re s
yste
ms
Act
ions
by
rese
arch
-bas
ed p
harm
aceu
tical
in
dust
ry
Chr
isto
pher
Mur
ray
Dire
ctor
, Pha
rma
Inte
rnat
iona
l, R
oche
Roc
he P
rinci
pal t
o th
e A
ccel
erat
ing
Acc
ess
Initi
ativ
e
VFA
Ber
lin 2
5/11
/04
Ove
rvie
w
•H
ealth
care
cha
lleng
es a
cros
s lo
w in
com
e co
untri
es
•S
ocia
lly re
spon
sibl
e ac
tion
by th
e re
sear
ch-
base
d P
harm
aceu
tical
Indu
stry
–w
hy, h
ow?
•E
xam
ples
dem
onst
ratin
g P
rivat
e P
ublic
P
artn
ersh
ips
by th
e re
sear
ch-b
ased
P
harm
aceu
tical
Indu
stry
•Fu
ture
cha
lleng
es
WH
O u
rges
sci
ence
to k
eep
wor
ld
heal
thy
(10/
11/0
4)
•“H
alf t
he w
orld
's d
isea
ses
can
be p
reve
nted
by
sim
ple
mea
ns a
lread
y av
aila
ble,
…”
•“In
Afri
ca,…
it is
est
imat
ed th
at o
nly
betw
een
2-15
% o
f chi
ldre
n sl
ept u
nder
bed
-net
s in
200
1-a
sim
ple,
effe
ctiv
e an
d pr
oven
met
hod
to p
reve
nt
mal
aria
. “
Exam
ples
of h
ealth
care
cha
lleng
es
acro
ss lo
w in
com
e co
untr
ies
•P
over
ty /
Fund
ing
–3
billio
n pe
ople
live
on
< $2
/ da
y, h
ealth
care
is u
naffo
rdab
le–
heal
thca
re fu
ndin
g
•S
ocia
l and
cul
tura
l fac
tors
impa
ctin
g he
alth
–
stig
ma
of d
isea
ses
such
as
HIV
/AID
S p
reve
nt te
stin
g an
d tre
atm
ent
–un
equa
l sta
tus
of w
omen
•P
oliti
cal w
ill–
egta
xes
levi
ed o
n es
sent
ial H
IV m
edic
ines
by
som
e go
vern
men
ts
•Fa
iling
hea
lthca
re s
yste
ms
–ed
ucat
ion,
trai
ning
, doc
tors
, nur
ses,
labo
rato
ry te
stin
g fa
cilit
ies,
se
cure
dru
g su
pply
cha
in–
600,
000
heal
th w
orke
rs in
sub
-Sah
aran
Afri
ca s
ervi
ng 6
82 m
illio
n pe
ople
, > 2
.5 m
illio
n ne
eded
(WH
O)
“AID
S ra
vage
d A
fric
a hi
t by
mas
s ex
odus
”Th
e D
aily
Tel
egra
ph 2
/11/
04
•“In
Gha
na a
nd Z
imba
bwe,
mor
e th
an 7
0% o
f do
ctor
s em
igra
te…
.”
•M
alaw
i –60
% n
ursi
ng p
ositi
ons
unfil
led
due
to
exod
us to
the
Wes
t
•“A
frica
's c
reak
ing
heal
th s
ervi
ces
are
clos
e to
co
llaps
e.”
Varia
tions
in H
ealth
Ex
pend
iture
s
•W
ide
varia
tions
in in
com
e le
vels
with
in a
nd
amon
g co
untri
es•
Gov
ernm
enta
l pol
icie
s an
d pr
iorit
ies
(US
$ pe
r cap
ita):
–B
otsw
ana
120,
Rus
sia
78–
Pak
ista
n 4,
Thai
land
39
–Li
beria
, 1V
ietn
am 6
–U
krai
ne 2
2,In
done
sia
4
•To
tal e
xpen
ditu
re o
n he
alth
as
% o
f GD
P
varie
s–
Sou
th A
frica
8%
–
Sen
egal
4.8
%
–M
adag
asca
r 2%
•H
ealth
exp
endi
ture
in lo
w in
com
e co
untri
es
deem
ed a
s fa
r fro
m s
uffic
ient
6
6. W
HO
. Com
mis
sion
on
Mac
roec
onom
ics
and
heat
h, 2
001
Soci
ally
resp
onsi
ble
actio
n by
the
Phar
mac
eutic
al In
dust
ry -
Why
?
•O
ur p
rimar
y ro
le:
–Th
e re
sear
ch-b
ased
pha
rmac
eutic
al in
dust
ry is
a u
niqu
e so
urce
of n
ew m
edic
ines
whi
ch h
ave
cont
inuo
usly
offe
red
clea
r be
nefit
s to
pat
ient
s, s
ocie
ties
and
heal
thca
re s
yste
ms
wor
ldw
ide
–R
esea
rch-
base
dph
arm
aceu
tical
com
pani
esha
vedi
scov
ered
and
deve
lope
dth
egr
eatm
ajor
ityof
exi
stin
gm
edic
ines
(ww
w.if
pma.
org)
•W
ith s
o m
any
broa
d ba
rrie
rs to
hea
lthca
re, c
lear
nee
d to
impr
ove
heal
th in
a s
usta
inab
le m
anne
r -ec
onom
ical
ly, s
ocia
lly a
nd e
nviro
nmen
tally
Soci
ally
resp
onsi
ble
actio
n by
the
Phar
mac
eutic
al In
dust
ry -
How
?
•C
orpo
rate
Gov
erna
nce
-act
ing
trans
pare
ntly
and
re
spon
sibl
y
•E
cono
mic
per
form
ance
-in
eve
ryon
e's
inte
rest
•S
afet
y an
d en
viro
nmen
tal p
rote
ctio
n
•E
ngag
emen
t and
dia
logu
e w
ith re
leva
nt s
take
hold
ers
•P
rivat
e P
ublic
Par
tner
ship
s
•In
divi
dual
and
col
lect
ive
com
pany
initi
ativ
es to
incr
ease
ac
cess
to h
ealth
care
and
med
icin
es
•H
IV/A
IDS
is n
ot “b
usin
ess
as u
sual
”
HIV
/AID
S is
not
“bu
sine
ss a
s us
ual”
•“T
o de
liver
ant
iretro
vira
l tre
atm
ent t
o th
e m
illio
ns w
ho
need
it, w
e m
ust c
hang
e th
e w
ay w
e th
ink
and
the
way
w
e ac
t.”
•“A
IDS
ther
apy
is a
long
-term
com
mitm
ent,
not a
one
sh
ot.
We
need
dra
mat
ic a
nd s
usta
ined
incr
ease
s in
re
sour
ce a
nd p
oliti
cal c
omm
itmen
t –in
clud
ing
from
the
hard
-hit
coun
tries
them
selv
es.”
Hea
d of
the
WH
O, D
r Jon
g-W
ook
Lee,
200
3
Kof
iAnn
anU
N S
ecre
tary
Gen
eral
Apr
il 20
01•
"The
pha
rmac
eutic
al in
dust
ry is
pla
ying
a c
ruci
al ro
le.
How
ever
, the
sol
utio
n do
es n
ot li
e w
ith th
e ph
arm
aceu
tical
com
pani
es a
lone
. I a
m c
allin
g fo
r a
maj
or m
obili
satio
n of
pol
itica
l will
and
sig
nific
ant
addi
tiona
l fun
ding
to e
nabl
e a
dram
atic
leap
forw
ard
in
prev
entio
n, e
duca
tion,
car
e an
d tre
atm
ent."
Wor
ld A
IDS
Day
mes
sage
, 200
3 •
“we
are
not o
n tra
ck to
beg
in re
duci
ng th
e sc
ale
and
impa
ct o
f the
epi
dem
ic b
y th
e ta
rget
yea
r of 2
005”
•“T
oday
, we
have
the
com
mitm
ent.
Our
reso
urce
s ar
e in
crea
sing
. But
the
actio
n is
stil
l far
sho
rt of
wha
t is
need
ed”
Priv
ate
Publ
ic P
artn
ersh
ips
Acc
eler
atin
g A
cces
s In
itiat
ive
(AA
I)
•A
nnou
nced
with
the
UN
May
200
0
•Th
e fir
st b
road
-bas
ed p
ublic
/priv
ate
partn
ersh
ip o
f its
ki
nd, e
stab
lishe
d to
:–
expa
nd th
e gl
obal
resp
onse
to H
IV/A
IDS
–fin
d su
stai
nabl
e ac
cess
to H
IV c
are
in re
sour
ce p
oor
coun
tries
dev
asta
ted
by H
IV/A
IDS
, par
ticul
arly
A
frica
•G
row
n to
incl
ude
7 ph
arm
aceu
tical
com
pani
es (A
bbot
t, B
MS
, BI,
GS
K, M
erck
, Gile
ad a
nd R
oche
) and
5 U
N
orga
nisa
tions
(UN
AID
S, W
HO
, UN
ICE
F, U
N P
opul
atio
n Fu
nd, a
nd th
e W
orld
Ban
k)
Acc
eler
atin
g A
cces
s In
itiat
ive
Prin
cipl
es
1.U
nequ
ivoc
al a
nd o
ngoi
ng p
oliti
cal c
omm
itmen
t by
natio
nal
gove
rnm
ents
2.S
treng
then
ed n
atio
nal c
apac
ity
3.E
ngag
emen
t of a
ll se
ctor
s of
nat
iona
l soc
iety
and
the
glob
al
com
mun
ity
4.E
ffici
ent,
relia
ble
and
secu
re d
istri
butio
n sy
stem
s
5.S
igni
fican
t add
ition
al fu
ndin
g fro
m n
ew s
ourc
es
6.C
ontin
ued
inve
stm
ent i
n re
sear
ch a
nd d
evel
opm
ent b
y th
e ph
arm
aceu
tical
indu
stry
–
HIV
can
rapi
dly
mut
ate
and
beco
me
resi
stan
t to
curr
ently
ava
ilabl
e m
edic
ines
Publ
ic p
artn
er v
iew
of A
AI p
rogr
ess
Mar
ch 0
4
“The
AA
I exp
erie
nce
show
s th
at w
ith p
oliti
cal w
ill,
com
mitm
ent a
nd p
artn
ersh
ip, i
t is
poss
ible
to
gene
rate
and
sus
tain
a la
rge
jum
p in
acc
ess
to
HIV
car
e an
d tre
atm
ent i
n re
sour
ce-c
onst
rain
ed
setti
ng”
Dr.
Jack
Cho
w, A
ssis
tant
Dire
ctor
-Gen
eral
of
the
Wor
ld H
ealth
Org
aniz
atio
n
How
are
rese
arch
-bas
ed p
harm
aceu
tical
co
mpa
nies
pla
ying
thei
r par
t in
the
solu
tion?
•C
ontin
ued
inve
stm
ent i
n re
sear
ch &
dev
elop
men
t for
to
mor
row
s A
IDS
dru
gs a
nd v
acci
nes
•In
200
3 -8
3 ne
w m
edic
ines
in d
evel
opm
ent f
or
HIV
/AID
S
•Th
ere
is n
o cu
re fo
r AID
S
•C
omm
ittin
g tim
e, e
nerg
y, m
illio
ns o
f dol
lars
and
hu
man
reso
urce
s to
sup
port
the
cons
truct
ion
of
func
tioni
ng h
ealth
care
sys
tem
s
•P
rovi
sion
of H
IV/A
IDS
trai
ning
and
edu
catio
n fo
r hu
ndre
ds o
f Afri
can
heal
thca
re p
rofe
ssio
nals
How
are
rese
arch
bas
ed p
harm
aceu
tical
co
mpa
nies
pla
ying
thei
r par
t in
the
solu
tion
? (2
)
•P
rice
and
pate
nt p
olic
ies
for A
RV
sac
ross
sub
-Sah
aran
A
frica
and
Lea
st D
evel
oped
Cou
ntrie
s -a
nnou
nced
by
indi
vidu
al c
ompa
nies
-m
ean
neith
er d
rug
pric
es n
or
pate
nts
can
be c
onsi
dere
d pr
imar
y ba
rrie
rs to
in
crea
sing
acc
ess
to H
IV th
erap
y
•R
esea
rch-
base
d co
mpa
nies
are
indi
vidu
ally
sup
plyi
ng
AR
Vs
to s
ub-S
ahar
an A
frica
at r
educ
ed p
rices
, som
e w
ithou
t pro
fit o
r fre
e of
cha
rge
•B
rand
ed A
RV
sca
n be
low
er c
ost t
han
gene
rics
(MS
F,
ww
w.a
cces
smed
-msf
.org
/pro
d/pu
blic
atio
ns)
Exam
ples
of p
harm
aceu
tical
com
pany
H
IV/A
IDS
part
ners
hips
and
initi
ativ
es
•M
erck
AC
HA
Ppa
rtner
ship
in B
otsw
ana
•B
MS
Sec
ure
the
futu
re p
rogr
amm
es
•A
bbot
t and
BI P
MTC
initi
ativ
e to
bot
h te
st a
nd
prev
ent H
IV tr
ansm
issi
on fr
om m
othe
r to
baby
•G
SK
Pos
itive
Act
ion
enco
mpa
sses
man
y in
itiat
ives
•G
ilead
acc
ess
prog
ram
me
invo
lvin
g go
vern
men
ts, N
GO
s, e
mpl
oyer
s an
d ho
spita
ls
Exam
ples
of p
harm
aceu
tical
co
mpa
ny in
itiat
ives
•Th
e M
erck
Mec
tizan
Don
atio
n P
rogr
am
–th
e si
ngle
larg
est,
long
est s
tand
ing
publ
ic/p
rivat
e pa
rtner
ship
of
its k
ind.
Mer
ck h
as p
rovi
ded
mor
e th
an 8
50 m
illion
tabl
ets
of
Mec
tizan
free,
goa
l is
to e
limin
ate
river
blin
dnes
s
•P
fizer
's D
ifluc
anP
artn
ersh
ip P
rogr
amm
e –
Pfiz
er d
onat
es D
ifluc
anto
org
anis
atio
ns in
sub
-Sah
aran
Afri
ca
and
leas
t dev
elop
ed c
ount
ries
•N
ovar
tis a
nd th
e N
ovar
tis F
ound
atio
n fo
r Sus
tain
able
D
evel
opm
ent,
in c
oope
ratio
n w
ith W
HO
,hav
e co
mm
itted
to
prov
ide
free
lepr
osy
treat
men
t for
all
lepr
osy
patie
nts
wor
ldw
ide
until
end
200
5
•G
SK
–H
ighl
ight
s in
clud
e do
natio
n of
94
mill
ion
treat
men
ts o
f al
bend
azol
eto
34
coun
tries
thro
ugh
partn
ersh
ip w
ith W
HO
in th
e G
loba
l Pro
gram
me
to e
limin
ate
Lym
phat
ic F
ilaria
sis
Exam
ples
of R
oche
Priv
ate
Publ
ic
Part
ners
hips
•
Don
ated
exp
ertis
e in
indu
stria
l dru
g de
velo
pmen
t and
m
alar
ia d
rug
deve
lopm
ent t
o M
MV
to s
uppo
rt O
Z277
–to
incr
ease
pac
e of
rese
arch
, dev
elop
men
t and
affo
rdab
ility
of
new
ant
imal
aria
lsan
d ne
w tr
eatm
ent s
trate
gies
•R
oche
don
ated
the
right
s an
d te
chno
logy
to
man
ufac
ture
Ben
zoni
dazo
le, f
or C
haga
sdi
seas
e, to
B
razi
lian
gove
rnm
ent i
n 20
03
•C
TAP
-col
labo
ratio
n to
incr
ease
acc
ess
to H
IV
treat
men
t in
Cam
bodi
a
•C
AR
E p
rogr
amm
e to
wid
en a
cces
s to
HIV
ther
apy
via
build
ing
up m
edic
al in
frast
ruct
ure
in 4
Afri
can
coun
tries
2004
-H
IV/A
IDS
trai
ning
for 1
40 A
fric
an h
ealth
care
pr
ofes
sion
als,
from
14
Afr
ican
cou
ntrie
s.
DVD
pro
duce
d to
ext
end
lear
ning
Dr.
Erne
st D
arko
h, o
pera
tiona
l man
ager
fo
r Bot
swan
a's
effo
rt to
exp
and
trea
tmen
t w
ith a
ntire
trov
iral d
rugs
Phel
ophe
pa “
The
Trai
n of
Hop
e” -
Clin
ic o
n tr
acks
Phel
ophe
pa –
A c
linic
on
trac
ks
•P
helo
phep
a w
as fo
unde
d in
199
3 by
Tra
nsne
tfol
low
ing
the
“Ear
th S
umm
it” in
Rio
in 1
992
•R
oche
has
bee
n a
spon
sor s
ince
199
4, to
geth
er w
ith
othe
r priv
ate
sect
or o
rgan
isat
ions
•Th
is tr
ain
prov
ides
bas
ic m
edic
al c
are
and
train
ing
to
mor
e th
an 1
80,0
00 in
divi
dual
s an
nual
ly in
rura
l are
as in
S
outh
Afri
ca
•P
eopl
e liv
ing
in th
ese
area
s do
not
hav
e ac
cess
to
med
ical
car
e ot
herw
ise
Cha
lleng
es a
head
•G
loba
l sca
le o
f HIV
/AID
S d
evas
tatio
n
•A
bilit
y to
pre
vent
/ re
duce
HIV
tran
smis
sion
•H
ow c
an “a
fford
abili
ty” o
f hea
lthca
re a
nd
med
icin
es b
e de
fined
?
•3
prio
rity
dise
ases
of t
he d
evel
opin
g w
orld
id
entif
ied
by W
HO
nee
d ev
er in
crea
sing
fund
ing:
H
IV/A
IDS
, TB
& M
alar
ia
•S
usta
ined
and
incr
ease
d –
polit
ical
will
–gl
obal
fund
ing
Sum
mar
y
•W
orld
wid
e th
ere
are
imm
ense
dis
parit
ies
of:
–In
com
e, fu
nctio
ning
hea
lthca
re s
yste
ms,
hea
lthca
re
fund
ing
and
polit
ical
will
•G
loba
l Fun
d, W
orld
Ban
k an
d P
EP
FAR
fund
ing
avai
labl
e
•S
igni
fican
t act
ions
by
phar
mac
eutic
al
com
pani
es d
esig
ned
to in
crea
se s
usta
inab
le
acce
ss to
hea
lthca
re a
nd m
edic
ines
•W
e ca
nnot
ach
ieve
this
alo
ne –
supp
ort n
eede
d fro
m a
ll ot
her s
take
hold
ers
to m
ove
forw
ard
Not
hing
mor
e w
ill re
ally
cha
nge
with
out:
•G
over
nmen
t lea
ders
hip
•Fu
ndin
g
•C
hang
ed b
ehav
iour
•A
dequ
ate
num
bers
of t
rain
ed h
ealth
care
pr
ofes
sion
als
