Annex 8.1.2.3
Partnership Summaries
Accelerating Access Initiative to HIV Care (AAI)
Background:
Announced in May 2000, the initiative involves a dialogue between the UN and the pharmaceutical industry with the intention of making HIV/AIDS medicines and diagnostic equipment more available and affordable in the hardest hit regions of the world. It is a cooperative endeavor involving five UN organisations (WHO, UNICEF, UNFPA, the World Bank, and UNAIDS Secretariat) and six pharmaceutical companies (Abbott Laboratories, Boehringer Ingelheim, Bristol-Myers Squibb, F. Hoffman-La Roche, GlaxoSmithKline and Merck and Co., Inc.). AAI is involved in negotiating deeply discounted drug prices for countries that can provide proof they have the health services to handle the complicated HIV/AIDS medicines.
Funding:
Major funding comes from the individual countries.
Achievements:
More than 70 countries from Africa, Latin America and the Caribbean, Europe and Asia, have indicated their interest in collaborating with UNAIDS on access to care and support. Indeed, more than 25 countries have completed and or are in the advanced stages of developing national care and treatment plans. Significant price reductions have been achieved on an expanded range of HIV/AIDS medicines. For some drugs, prices are higher outside sub-Saharan Africa, despite price levels much lower than those in industrialised countries.
Action TB Programme (ATBP)
Background:
Action TB is a multinational, interdisciplinary research initiative into TB, funded by GlaxoSmithKline (GSK). Scientists in the United Kingdom, South Africa, Canada and the United States of America are collaborating with scientists employed by GSK to study all aspects of tuberculosis. ATBP is aimed at identifying new drug targets and vaccine candidates for TB, and surrogate markers for use in clinical trials. Launched in 1993, Action TB is a ten-year programme funded by GSK. Twenty million pounds sterling (20 million) is being spent in academic laboratories in the UK, South Africa, The Gambia, and the USA. The academic groups work closely with GSK researchers to ensure that basic research findings are quickly translated into high throughput drug screens and into the vaccine development pipeline within the company. In addition to this industry-academia partnership, GSK has entered into partnership with a number of public bodies including the US National Institutes of Health.
The programme has come to the end of the period when GSK had committed funds to Action TB.
Funding
Funding was provided by GSK in the amount of $3 million per year for ten years for a total of $30 million.
Achievements
Action TB attained its objective of identifying new targets for TB drugs, which are now being exploited internally. The programme stirred as well as stimulated basic research into drug and vaccine development activities. In addition to identifying targets, new tools were developed that can now be used to identify and validate drug targets, and progress has been made towards identifying surrogate markers that will facilitate clinical trials.
African Comprehensive HIV/AIDS Partnerships (ACHAP)
Background:
The African Comprehensive HIV/AIDS Partnerships (ACHAP) is an initiative between the Government of Botswana (GOB), the Bill & Melinda Gates Foundation and The Merck Company Foundation/Merck & Co., Inc. to support the goals of the GOB to decrease HIV incidence by rapidly advancing HIV/AIDS prevention programs, healthcare access, patient management and treatment of HIV/AIDS in Botswana in a sustainable and comprehensive manner. The Bill & Melinda Gates Foundation and the Merck Company Foundation have each dedicated 50 million dollars over five years for a total ACHAP commitment of 100 million dollars. Overall, ACHAP aims to be a model for other public-private partnerships and in this regard, documentation work is being carried out so that lessons learned may be communicated globally and applied in other settings.
Funding:
For each year from and including 2000 – 2004, the Bill & Melinda Gates Foundation has contributed $10 million and Merck & Co. has contributed $10 million for a total contribution over five years of $100 million.
Achievements:
More than 12,000 have been enrolled into the national ARV program, making Botswana’s program the largest public ARV treatment program on the continent of Africa. ACHAP assisted with the national HIV/AIDS strategy, including the development of a national monitoring and evaluation system and a needs assessment toolkit that is guiding HIV/AIDS interventions at the district level. ACHAP has trained more than 500 Government, NGO and other key players on project development, monitoring and evaluation, leadership skills, proposal development, media training and computer skills. Health care worker training programs - both through classroom teaching and hands-on training and coaching at clinics and hospitals - have been provided to over 1200 health care workers. A number of other ACHAP programs focus on skill-building for HIV/AIDS education as a means to increase awareness and knowledge and to de-stigmatize the disease. For example, a distance-learning initiative conducted in collaboration with UNDP, Botswana TV and the Botswana Ministry of Education is reaching teachers and students in more than 400 educational institutions. Key interventions include: · alcohol abuse and HIV transmission; · development of behavior change communications through market segmentation; · routine and diagnostic HIV testing; · condom education and marketing program including installation of more than 10,500 dispensers providing free condoms throughout the country; · small grants to fund community-based initiatives; · support for the construction of health resource centers at hospitals; · daycare facilities for orphans; · support and counseling services, including faith-based services, pre-and post-test
counseling, leadership development, the establishment of district responses to mobility; · strengthen blood safety practices; · disease prevention programs for highly mobile populations · working with traditional healers; · mobilizing private firms in Botswana to provide HIV/AIDS services for their employees and families, as well as for the communities where they conduct business.
African Programme for Onchocerciasis Control (APOC)
Background
One of the best known and oldest public-private partnerships for health, OCP was launched in 1974 and closed its operations on 31 December 2002 having met its objective to eliminate onchocerciasis as a problem of public health importance and an impediment to socioeconomic development in West Africa. It was a co-sponsored program by WHO, World Bank, UNDP, and the Food and Agriculture Organization (FAO) with WHO as Executive Agency and World Bank in charge of the OCP Trust Fund and fundraising. The strategy of the program was to control river blindness in 11 countries in West Africa by breaking the cycle of transmission by eliminating the vector, the black fly. To complement the vector control activities OCP distributed the drug ivermectin (see Mectizan Donation Program) where needed through a community-directed approach. OCP was funded by a coalition of over 20 donor countries and agencies. APOC extends the control of river blindness into 19 other endemic countries in Africa based almost exclusively on community-directed treatment with ivermectin (CDTI).
Funding:
The programme is closed.
Achievements:
Eighteen million people had received annual treatment with ivermectin up through May 2000. Over 34,440 communities have begun to be actively involved in planning and managing the distribution of ivermectin. Eventual distribution of ivermectin to 60 million people per annum, thereby protecting them from the devastating consequences of onchocerciasis. By 2000, National Onchocerciasis Task Forces (NOTFs) and communities, assisted by other partners, had established CDTI systems in 91 % of its projects.
Alliance for Health Policy and Systems Research (AHPSR)
Background:
The Alliance is born from the initiative of the Global Forum for Health Research launched in March 2000 at WHO headquarters. The Alliance aims to promote the generation, dissemination and use of knowledge for enhancing health system performance. The Alliance is open to producers and users of HPSR, as well as to contributors, such as financiers and technical institutions helping to foster the development of HPSR. The Alliance is governed by an 14-member Board representative of developing countries, experts, networks and donors; its secretariat is based in WHO's Global Programme for Evidence.
Funding:
DONORS/YEARS / 1999 / 2000 / 2001 / 2002 / 2003 / TOTALNorway, Government of / 1,446,065 / 502,572 / 1,948,637
Global Forum for Health Research / 20,000 / 20,000
COHRED / 35,000 / 35,000
World Bank / 400,000 / 400,000 / 400,000 / 400,000 / 1,600,000
World Health Organization (WHO) / 25,400 / 25,400
Swedish International Development Agency (SIDA) / 300,000 / 300,000
Canadian International Development Agency (CIDA) / 202,995 / 50,750 / 253,745
All other donors* / 10,000 / 10,000
TOTAL / 2,049,060 / 400,000 / 425,400 / 1,318,322 / 4,192,782
Achievements:
The Alliance has so far made contact with some 600 institutions that are producing health policy and systems research (HPSR) in more than 70
developing countries, over 70 HPSR institutions in the developed world (including private research organizations), and national and international agencies supporting HPSR. The Alliance runs a grants programme to support research in HPSR fields, carries out analytical work and capacity assessment and undertakes strategic research in high priority areas.
Alliance for Microbicide Development (AMD)
Background:
A coalition of biopharmaceutical companies, scientists, and advocates started in 1998 as an agent for change to catalyse scientific progress, funding, and policy change in the field of topical microbicides to prevent sexually-transmitted infections. The Alliance works to achieve its mission through research, education, and advocacy; networking and convening across constituencies, disciplines, and sectors; and strategizing to identify gaps and obstacles and working toward their elimination. Over 500 individual participants and colleagues from all sectors and many disciplines are involved.
Funding:
Support for the work of the Alliance comes from the William and Flora Hewlett Foundation, International Partnership for Microbicides (IMP), Moriah Fund, Rockefeller Foundation, Bill and Melinda Gates Foundation through the Global Microbicide Project (GMP), as well as from private contributions. The Alliance funding mechanism consists predominantly of grants and 2 contracts for core and specific projects.
Achievements:
The Alliance has played a sole or significant role in: 1) Growing the funding base for microbicides. The US Department of Health and Human Services provided in FY1998, $23.2 million and in FY2004, $73.1 million. The US Agency for International Development provided in FY1998, $2.1 million and FY2003, $15.0 million. 2) Public policy and legislative activities: Policy briefings (average, 1 per month); Microbicide Development Act of 2000: introduced, US House of Representatives; Microbicide Development Act of 2001: introduced, US House of Representatives and Senate; Microbicide Development Act of 2003: introduced, US Senate, April 2003; to be introduced in House of Representatives December 2003; Inclusion of support for microbicide research and development in a series of global HIV/AIDS bills (S.1230 and S.2525, H.R.2405 and S.1752, H.R.2069); Successive years of report language. 3) Partnerships and Collaborations; AIDS Vaccine Advocacy Coalition, Gay Men’s Health Crisis, Internastional AIDS Vaccine Initiative, National Organizations Responding to AIDS: legislative and joint advocacy initiatives; Global Campaign for Microbicides: 50/50 support of Senior Legislative Advisor joint legislative and advocacy activities; Global Microbicide Project: Science Advisory Committee brokering research and development initiatives; International Family Health: European Advocacy and Networking Project; International Partnership for Microbicides: Microbicide Research and Development Database, The Microbicide Quarterly; World Health Organization: international and regional regulatory meetings, document authorship.
Artesunate Suppository for Emergency Treatment of Severe Malaria
Background:
A product development project by WHO/TDR which involved extensive collaboration with pharmaceutical manufacturers, chemical processors and formulators, and packagers to create an antimalarial artesunate rectal suppository for patients, particularly children, suffering from severe malaria who are unable to take drugs by mouth or are unable to access injectible treatment. WHO submitted an application for assessment to regulatory authorities in the US and Europe under the orphan drug designation for the fast track approval process. Collaborators are discussing how to best take the drug into demonstration projects, resolve the significant follow-up treatment issues, address education/information programmes, and procurement/distribution of the product (possible partnership with UNICEF).
Funding:
Funding comes from the European Commission, World Health Organization (WHO), Sall Family Foundation, UNDP/WB/WHO Special Programme for Research & Training in Tropical Diseases (TDR) and USAID. The funding mechanism is via WHO, and directly to countries and participating institutions.
Achievements:
On-going.
Children's Vaccine Initiative (CVI)
Background:
The goal of CVI was to maximize protection against infectious diseases through the development and utilization of safe, effective, easy-to-deliver and widely available vaccines. CVI's secretariat was housed in WHO and attempted an innovative collaboration between public, nonprofit, and private sector (vaccine and biotech industry). It operated from 1990 through 1999.
Funding:
Major funding for this project was in the form of a multi-year grant in the amount of $125 million from the Bill & Melinda Gates Foundation. Other major funders include: Fondation Mérieux, Government of Ireland, Government of Japan, Rockefeller Foundation, Swiss Agency for Development and Cooperation, United Nations Children's Fund (UNICEF), United Nations Development Program (UNDP), US Agency for International Development (USAID), William H. Gates Foundation, and the World Bank.
Achievements:
Children's Vaccine Programme at PATH (CVP at PATH)
Background:
CVP is a program run by the Program for Appropriate Technology and Health (PATH), a U.S. tax-exempt 501 (c )(3) not-for-profit organisation based in Seattle, Washington, USA. The goal of the program is to ensure that all children receive the full benefits of new, lifesaving vaccines without undue delay. CVP works to put immunization at the top of the global health agenda, develops new financing solutions for immunization, collaborates on research to provide reliable information for decision-makers, and supports new technologies to improve immunization delivery. Oversight is provided by the PATH board and a Strategic Advisory Council and Expert Review Group composed of international experts.
Funding:
Major funding for this project is in the form of a multi-year grant in the amount of $125 million from the Bill & Melinda Gates Foundation.
Achievements:
On-going.
Concept Foundation (CF)
Background:
The Concept Foundation, a non-profit foundation was established, through the initiative of UNDP/UNFPA/WHO/WB Special program in Reproductive Health (WHO/HRP), PATH, World Bank and other organizations in 1989 in Bangkok, Thailand, as a mechanism through which WHO’s rights associated with an injectable contraceptive, Cyclofem, could be licensed onwards to potential producers in developing countries. Under these licensing agreements the manufacturer was required to treat any government body, non-profit entities, or member of the United Nations system as the public sector and offer preferential pricing compared to private sector market pricing. Conditions of licensing also assess a reasonable rate of return for public sector sales, but prohibit the recovery of marketing, research, and development cost on public sector sales. Since that time the Concept Foundation has gone on to successfully introduce several new quality reproductive health technologies that address the needs of people living in developing countries, at affordable prices. The Foundation ensures that these health products are manufactured under international standards, properly registered and licensed, and distributed and marketed with appropriate training and counseling services.