Schwab Charitable Philanthropy Speaker Series Profiling Global Change Makers   Dr. Klaus Leisinger President and Managing ...
Corporate Responsibilities for Access to Medicines Klaus M. Leisinger Novartis Foundation for Sustainable Development UC B...
The social and economic context <ul><li>Despite significant progress made in poverty alleviation and health-related Millen...
Poverty and health: a vicious circle Source: Novartis Foundation  for Sustainable Development | UC Berkeley | Klaus M. Lei...
Good health has a lot of influencing factors... ...and many stakeholders contributing to healthcare and prevention Source:...
The societal context <ul><li>People all over the world rate “health” as one of their top personal concerns; </li></ul><ul>...
Causes of death among children aged <5 years and influence of medicines (%) Source: WHO World Health Statistics 2009 | UC ...
“ Health” as an international political subject-matter: UN Millennium Development Goals <ul><li>The Millennium Development...
The Right to Health debate:  Article 25 <ul><li>Universal Declaration of Human Rights </li></ul><ul><li>Article 25. </li><...
The Right to Health debate: The International Covenant on Economic, Social and Cultural Rights <ul><ul><ul><ul><ul><li>Art...
The Preamble of the Universal Declaration of Human Rights <ul><li>THIS UNIVERSAL DECLARATION OF HUMAN RIGHTS (has been pro...
What are companies competing with integrity responsible for?   Be successful  in the core competence with integrity and co...
Success in the core competence serves  people and the common good Sources: OECD Health Data 2004; Health, United States, 2...
Corporate responsibility challenges  Market failures and failing states <ul><li>Who is in charge if markets fail due to th...
There  is  an access-to-medicines problem | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities...
But price is only one of several reasons: e.g. poor people use available health services less often  Source: Lancet 2008, ...
Corporate responsibility tools for „Access to Medicine“ <ul><ul><li>Differential (preferential) pricing; </li></ul></ul><u...
Political and economic preconditions for differential pricing <ul><li>Preferential prices (and donations!) can only benefi...
Differential pricing controversial issues Differential pricing <ul><ul><li>For what products?  </li></ul></ul><ul><ul><li>...
In 2010 Novartis supported more than 85 million patients with access-to-medicine programs  1 Novartis Institute for Tropic...
Current strategy to fight malaria Today’s efforts focus on prevention and cure  <ul><li>Treatment </li></ul><ul><ul><li>Ar...
The Novartis Malaria Initiative  A holistic approach to best serve patients needs <ul><li>Capacity building –  patient-foc...
We are helping to make a difference Key indicators are showing progress 2004 * Estimate ** 2009 ***2008 Every 30 seconds C...
Healthcare projects of the Novartis Foundation for Sustainable Development | UC Berkeley | Klaus M. Leisinger | 4 October ...
Foundation research on access-to-healthcare obstacles: A complex and multi-dimensional issue  Source: Obrist B.  et al. (2...
Foundation research on “Community effectiveness of malaria treatment” | Access to Medicines UC Berkeley| Klaus M. Leisinge...
Video on the ACCESS project in Tanzania Improving access to effective malaria treatment <ul><li>www.youtube.com/watch?v=kd...
ICATT: Innovative e-learning tool to scale up training in childhood diseases (1/2) <ul><li>9 million  children under five ...
ICATT: Innovative e-learning tool to scale up training in childhood diseases (2/2) <ul><li>ICATT was successfully piloted ...
Overall results of the Novartis Foundation healthcare projects and programs <ul><li>Saved 10’000s of lives, particularly o...
NIBR efforts to address medical needs in the  developing world: infectious disease examples (1/2)  Tuberculosis (Prevalenc...
NIBR efforts to address medical needs in the  developing world: infectious disease examples (2/2)  | UC Berkeley | Klaus M...
Why become involved in health and access issues beyond the conventional business model? <ul><li>Because it is the right th...
Plausible arguments for a “Business Case”  <ul><li>Engagement in corporate responsibility for the achievement of the healt...
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Klaus Leisinger Novartis Foundation 10 04 2011

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Dr. Leisinger leads one of the world's largest corporate social-impact initiatives. His presentation will underscore the obligation of ethical companies as partners to address far-reaching health and socio-economic problems. Dr. Leisinger has extensive experience collaborating across the corporate world and public institutions, such as the United Nations and international NGOs. His successes argue for cross-sector partnerships as a proven model for addressing tough problems. The Novartis Foundation's extensive efforts toward achieving the U.N. Millennium Development Goals serves as a tangible case study in how such partnerships can work to achieve global social impact.

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Klaus Leisinger Novartis Foundation 10 04 2011

  1. 1. Schwab Charitable Philanthropy Speaker Series Profiling Global Change Makers   Dr. Klaus Leisinger President and Managing Director Novartis Foundation for Sustainable Development October 4, 2011 The Partnership Puzzle: How global organizations work to solve social issues  
  2. 2. Corporate Responsibilities for Access to Medicines Klaus M. Leisinger Novartis Foundation for Sustainable Development UC Berkeley, 4 th October 2011
  3. 3. The social and economic context <ul><li>Despite significant progress made in poverty alleviation and health-related Millennium Development Goals achievements, </li></ul><ul><li>2.5 billion people continue to live in poverty (USD 2.50 per day), thereof about 1.4 billion in extreme poverty (USD 1.25 per day); </li></ul><ul><li>These people’s living conditions are characterized by nutritional deficiencies, lack of access to safe water and sanitation, squalid housing, insufficient knowledge about health, lack of access to preventive and curative medical services and lack of access to safe medicines, lack of voice and visibility – therefore lack of political power; </li></ul><ul><li>Due to neglected tropical diseases alone , </li></ul><ul><ul><li>millions of children, women and men die prematurely, </li></ul></ul><ul><ul><li>the number of disability-adjusted life years is in the dozens of millions, and </li></ul></ul><ul><ul><li>the economic burden adds up to an amount beyond USD 15 billion per year. </li></ul></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  4. 4. Poverty and health: a vicious circle Source: Novartis Foundation for Sustainable Development | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines Basic education for health awareness and appropriate health seeking behavior Freedom from discrimination, violence and harmful traditional practices Good governance incl. appropriate allocation and funds for health and good health policy Sufficient health infrastructure for preventive and curative care Access to diagnosis and medical care (treatment and prevention) Life style choices and risk taking (e.g. food) habits, sexual behavior, smoking Save and adequate food Appropriate habitat incl. good sanitation Save drinking water and good personal and food hygiene Individual and collective poverty State of health
  5. 5. Good health has a lot of influencing factors... ...and many stakeholders contributing to healthcare and prevention Source: Dahlgren G. / Whitehead M. (1991): Policies and strategies to promote social equity in health, Stockholm | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  6. 6. The societal context <ul><li>People all over the world rate “health” as one of their top personal concerns; </li></ul><ul><li>For people living in low-income countries HIV/AIDS, tuberculosis, malaria and other infectious diseases rates are most important (> 5 mio deaths p.a.), along with malnutrition, access to clean water, access to medical care, above all ante-natal, peri-natal and postnatal care; </li></ul><ul><li>Pharmaceutical products (medicines and vaccines) play an important role – along with well-trained and motivated staff medicines are the most important means available to prevent, alleviate and cure illnesses; </li></ul><ul><li>Lack of access to essential medicines and vaccines is seen to result in more than 10 million premature deaths; </li></ul><ul><li>Many NGOs and civil society media see patents and prices to be the most important obstacles for the access to medicines; </li></ul><ul><li>The access-to-medicines debate is a political debate, using methods and techniques of the political communication, including agitation. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  7. 7. Causes of death among children aged <5 years and influence of medicines (%) Source: WHO World Health Statistics 2009 | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines WHO region Neonatal HIV/AIDS Diarrhea Measles Malaria Pneumonia Injuries Other African Region 21.0 5.0 16.3 3.9 15.6 20.4 2.4 15.4 Region of the Americas 37.7 0.7 12.7 0.0 0.2 12.7 5.9 30.0 South-East Asia Region 39.0 0.4 19.5 5.5 0.4 13.7 5.3 16.2 European Region 37.8 0.7 14.0 0.1 0.0 14.9 5.7 26.7 Eastern Mediterranean Region 32.6 0.3 16.7 3.0 2.3 19.6 3.5 21.9 Western Pacific Region 46.2 0.3 12.0 0.8 0.3 9.8 7.5 23.1
  8. 8. “ Health” as an international political subject-matter: UN Millennium Development Goals <ul><li>The Millennium Development Goals (MDGs) were adopted by 189 nations-and signed by 147 heads of state and governments during the UN Millennium Summit in September 2000. </li></ul><ul><li>Eradicate extreme poverty and hunger </li></ul><ul><li>Achieve universal primary education </li></ul><ul><li>Promote gender equality and empower women </li></ul><ul><li>Reduce child mortality </li></ul><ul><li>Improve maternal health </li></ul><ul><li>Combat HIV/AIDS, malaria and other diseases </li></ul><ul><li>Ensure environmental sustainability </li></ul><ul><li>Develop a global partnership for development </li></ul><ul><li>... to be achieved by 2015. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  9. 9. The Right to Health debate: Article 25 <ul><li>Universal Declaration of Human Rights </li></ul><ul><li>Article 25. </li></ul><ul><li>Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. </li></ul><ul><li>(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  10. 10. The Right to Health debate: The International Covenant on Economic, Social and Cultural Rights <ul><ul><ul><ul><ul><li>Article 12 </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>1. The States Parties to the present covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for: </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child; </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>(b) The improvement of all aspects of environmental and industrial hygiene; </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases; </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness. </li></ul></ul></ul></ul></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  11. 11. The Preamble of the Universal Declaration of Human Rights <ul><li>THIS UNIVERSAL DECLARATION OF HUMAN RIGHTS (has been proclaimed) as a </li></ul><ul><li>“ common standard of achievement for all peoples and all nations, to the end that every individual and every organ of society , keeping this Declaration constantly in mind, shall strive by teaching and education to promote respect for these rights and freedoms and by progressive measures, national and international, to secure their universal and effective recognition and observance , both among the peoples of Member States themselves and among the peoples of territories under their jurisdiction.” (excerpt) </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  12. 12. What are companies competing with integrity responsible for? Be successful in the core competence with integrity and comply with applicable laws and regulations Corporate Responsibility beyond legality: Legitimacy in the spirit of international norms Corporate philanthropy and pro bono work Desirable (can) Expected (ought to) Essentials (must) | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines Corporate responsibility excellence Good management practices
  13. 13. Success in the core competence serves people and the common good Sources: OECD Health Data 2004; Health, United States, 2003: Chartbook on Trends in the Health of Americans; Manton KG, Gu X., Proc Natl Acad Sci USA 2001 May 22; 98(11):6354-9. | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines Drop in death rates 1990-2000 among US pop. 45-64 US life expectancy Years at birth Females Males Average length of stay in patient days US pop. > 65 with disability Heart Disease Cancer Stroke All causes
  14. 14. Corporate responsibility challenges Market failures and failing states <ul><li>Who is in charge if markets fail due to the lack of purchasing power of patients and / or the state authorities not able or willing to deliver a basic package of primary health care goods and services? </li></ul><ul><li>Under which conditions can a pharmaceutical company be expected to do what for whom until when? </li></ul><ul><li>What is “appropriate” in a world with 2.5 billion people living in absolute poverty? How much is enough? Who has the legitimacy to determine this? </li></ul><ul><li>What medicines and vaccines should be offered with differential pricing? </li></ul><ul><li>What is a “fair” proportion of research dedicated to neglected diseases? </li></ul><ul><li>What would a “stakeholder-solution-team” consist of, given the dimension and complexity of the global health problems? </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  15. 15. There is an access-to-medicines problem | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  16. 16. But price is only one of several reasons: e.g. poor people use available health services less often Source: Lancet 2008, 372, 1661-69 | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  17. 17. Corporate responsibility tools for „Access to Medicine“ <ul><ul><li>Differential (preferential) pricing; </li></ul></ul><ul><ul><li>Licensing for market failure; </li></ul></ul><ul><ul><li>Corporate philanthropy incl. donations; </li></ul></ul><ul><ul><li>Pro Bono research; </li></ul></ul><ul><ul><li>Screening of patent library; </li></ul></ul><ul><ul><li>Project and program co-operation with development institutions; </li></ul></ul><ul><ul><li>Management support (Human Resources, logistics, etc.); </li></ul></ul><ul><ul><li>Other innovative and creative private sector skills and methods as well as innovative business models. </li></ul></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  18. 18. Political and economic preconditions for differential pricing <ul><li>Preferential prices (and donations!) can only benefit poor patients in the context of a functioning health care and supply system; </li></ul><ul><li>Market segmentation and separation must be possible to prevent leakage of products that are offered at low prices to the poor into the “normal” market of insurance covered and well-to-do patients; </li></ul><ul><li>Differential prices must not be used as benchmark for reference price regulation schemes in industrialized countries; </li></ul><ul><li>Acceptance of governments, health insurances and patients in high-income counties for preferential pricing in low-income countries; </li></ul><ul><li>More (international) resources are needed even if all medicines would be given away at preferential prices. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  19. 19. Differential pricing controversial issues Differential pricing <ul><ul><li>For what products? </li></ul></ul><ul><ul><li>For countries or for patients? </li></ul></ul><ul><ul><li>Who controls proper access? </li></ul></ul>Donations Pro bono research Constructive use of patents <ul><ul><li>What products? </li></ul></ul><ul><ul><li>For whom? </li></ul></ul><ul><ul><li>How long? </li></ul></ul><ul><ul><li>What diseases? </li></ul></ul><ul><ul><li>Also improved efficacy / side effect profiles? </li></ul></ul><ul><ul><li>Access to patent library? </li></ul></ul><ul><ul><li>What products? </li></ul></ul><ul><ul><li>Who develops the medicines? </li></ul></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  20. 20. In 2010 Novartis supported more than 85 million patients with access-to-medicine programs 1 Novartis Institute for Tropical Diseases; 2 Novartis Vaccines Institute for Global Health; 3 Based on approximate market value 2010 Programs and research valued at USD 1.5 bn Coartem ® subsidized > 82 million treatments shipped – cumulatively delivered > 380 million treatments, helping to save about 950,000 lives of mostly children under 5 years Leprosy medication free of charge > 5 million patients cured since 2000 Tuberculosis medicine donations 500,000 treatments committed, 50% delivered Glivec ® patient assistance Free to >37,000 patients in about 80 countries NITD 1 in Singapore Focus on tuberculosis, dengue fever and malaria NVGH 2 in Siena, Italy Vaccines research institute for neglected diseases | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  21. 21. Current strategy to fight malaria Today’s efforts focus on prevention and cure <ul><li>Treatment </li></ul><ul><ul><li>Artemisinin-based Combination Therapies (ACTs) </li></ul></ul><ul><li>Insecticide spraying </li></ul><ul><ul><li>Indoor residual insecticide spraying (IRS) </li></ul></ul><ul><li>Bed nets </li></ul><ul><ul><li>Long Lasting Insecticide-Treated Nets (LLITN) </li></ul></ul><ul><li>Diagnosis </li></ul><ul><ul><li>Rapid diagnostic tests (RDTs) to diagnose malaria </li></ul></ul>Prevention Cure | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  22. 22. The Novartis Malaria Initiative A holistic approach to best serve patients needs <ul><li>Capacity building – patient-focused education and information </li></ul><ul><li>Best practice sharing workshops for public health officials responsible for malaria control </li></ul><ul><li>State-of-the-art packaging and patient information developed specifically for not yet literate populations </li></ul><ul><li>Training material made available free of charge in several local languages </li></ul><ul><li>Access – affordability and availability are key </li></ul><ul><li>Treatment provided without profit to governments and NGOs </li></ul><ul><li>Over 50% price reduction and a 21-fold production increase since 2004 </li></ul><ul><li>SMS for life: using mobile technology to help avoid stock-outs at health facility level </li></ul><ul><li>R&D – leading the path to malaria elimination </li></ul><ul><li>Mass screening and targeted treatment of asymptomatic carriers </li></ul><ul><li>Next generation of malaria treatments </li></ul><ul><li>Treatment – Coartem®, a story of firsts </li></ul><ul><li>First fixed-dose ACT brought to market in 1999 and > 95% cure rate* with demonstrated safety profile </li></ul><ul><li>First ACT pre-qualified by the WHO for its efficacy, safety and quality </li></ul><ul><li>First dispersible sweet- tasting ACT specifically developed for infants and children </li></ul>* 28-day PCR-corrected in evaluable population | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  23. 23. We are helping to make a difference Key indicators are showing progress 2004 * Estimate ** 2009 ***2008 Every 30 seconds Child mortality Every 45 seconds*** Malaria Cases 225 million** 243 million 12 countries served Coartem® deliveries Patient share of ACT market Countries served 30% ACT market share 50% ACT market share* 60+ countries served Average price per treatment USD 1 .57 per treatment Price for public-sector buyers has dropped by over 50% 82 million treatments 4 million treatments 2010 | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  24. 24. Healthcare projects of the Novartis Foundation for Sustainable Development | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  25. 25. Foundation research on access-to-healthcare obstacles: A complex and multi-dimensional issue Source: Obrist B. et al. (2007): Access to health care in contexts of livelihood insecurity: A framework for analysis and action. In: PLoS Med 4( 0): e308.doi: 0. 37 /journal.pmed.0040308 Are there enough points of care to serve the population? Do drug supplies suffice? What is the geographical distance between points of care and the homes of intended users? Do the prices of services match patients‘ ability to pay? Does the organisational set up meet patients‘ needs and expectations? Does the information and treatment provided take local values into account? | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  26. 26. Foundation research on “Community effectiveness of malaria treatment” | Access to Medicines UC Berkeley| Klaus M. Leisinger | October 2011 Provider compliance with official guidelines Patient adherence Source: Alba et al. 2010: Improvements in access to malaria treatment in Tanzania following community, retail sector and health facility interventions - a user perspective. In: Malaria Journal 2010, 9:163. | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  27. 27. Video on the ACCESS project in Tanzania Improving access to effective malaria treatment <ul><li>www.youtube.com/watch?v=kdW07TNe6pI </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  28. 28. ICATT: Innovative e-learning tool to scale up training in childhood diseases (1/2) <ul><li>9 million children under five die every year, mostly due to preventable and treatable diseases. </li></ul><ul><li>IMCI (Integrated Management of Childhood Illness) is a WHO/UNICEF strategy reduce child mortality by improving diagnosis and treatment at primary healthcare level. </li></ul><ul><li>IMCI implementation faces two major challenges: </li></ul><ul><ul><li>Ensuring periodical updates of national IMCI clinical guidelines, and </li></ul></ul><ul><ul><li>Scaling up training of a very large number of health workers globally. </li></ul></ul><ul><li>Decision by WHO and NFSD to develop ICATT (IMCI Computerized Adaptation and Training Tool) </li></ul><ul><li>ICATT is a flexible and easy-to-use software program which </li></ul><ul><ul><li>Facilitates adaptation of global IMCI guidelines to local circumstances (languages etc.) </li></ul></ul><ul><ul><li>Helps scale up training through interactive e-learning program </li></ul></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  29. 29. ICATT: Innovative e-learning tool to scale up training in childhood diseases (2/2) <ul><li>ICATT was successfully piloted in Tanzania, Peru and Indonesia. </li></ul><ul><li>To date 12 countries have implemented adaptation; global roll-out is ongoing. </li></ul><ul><ul><li>Other major challenge is maternal and newborn health : Every day, up to 1,500 women and 10,000 newborn babies die due to complications in pregnancy and childbirth. </li></ul></ul><ul><li>WHO and NFSD decided to continue collaboration to develop a similar tool for maternal and newborn health. </li></ul><ul><li>IMPACTT (Integrated Management of Pregnancy and Childbirth Training Tool) will include modules on: </li></ul><ul><ul><li>Pregnancy care, childbirth care, postnatal maternal care, newborn care, and postnatal newborn care. </li></ul></ul><ul><ul><li>Module on newborn care is under development and will be tested by end of 2011. </li></ul></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  30. 30. Overall results of the Novartis Foundation healthcare projects and programs <ul><li>Saved 10’000s of lives, particularly of children under 5, and improved livelihood of millions of people in low-income countries; </li></ul><ul><li>Contributed with new concepts towards bringing leprosy down from about 13 million patients in 1985 to less than 220’000 (2010) and helped to cure more than 5 million leprosy patients, preventing more than 4 million disabilities; </li></ul><ul><li>Developed innovative “access-to-medicines” systems (e.g. patient-based TB therapy) and did innovative research on obstacles to access (e.g. Malaria); </li></ul><ul><li>Developed and field-tested innovative “bare foot health insurance” as well as computer-based learning and diagnosis program for IMCI; </li></ul><ul><li>Developed and scaled up psychosocial support programs for vulnerable children; </li></ul><ul><li>Developed and field-tested performance-based funding system, measuring outcome rather than input; </li></ul><ul><li>Are in the process of setting new benchmark for telemedicine in Africa. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  31. 31. NIBR efforts to address medical needs in the developing world: infectious disease examples (1/2) Tuberculosis (Prevalence/100,000 – WHO 2004) Dengue Fever (Incidence/100,000 – WHO 2005) Malaria (Prevalence/100,000 – WHO 2004) Infectious Diarrhea (Mortality rate/100,000- WHO 2002) Chagas (Prevalence/100,000 – WHO 2002) Typhoid Fever (Incidence/100,000 – WHO 2004) | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines <1 >250 Known risk <25 >25000 <50 >1000 1-5 >100 <1000 >6000 >100 10-100 <10
  32. 32. NIBR efforts to address medical needs in the developing world: infectious disease examples (2/2) | UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines Malaria TB Infectious Diarrhea Dengue Fever Typhoid Fever Chagas Disease Incidence 250 million (Tropics, mostly Africa) 9 million (Developing World) 2.5 billion children (Dev World) 50 million (Tropics & Subtropics) 16-33 million (Developing World) 10 million (mostly Latin America) Mortality (per year) 1 million (mostly children) 1.3 million (often AIDS patients) 1.6 million children (3-5 million total) >100,000 (mostly children) >200,000 (mostly children) >10,000 Organism Plasmodium Myco- bacterium GI bacteria (incl. cholera) Flavivirus Salmonella Trypano-soma Medical need/issue Drug resistance (incl. Coartem) Multi /extensive drug resistance; treatment length; HIV co-infection Drug resistance; rapid dehydration No effective treatment for hemorrhagic fever Drug resistance; no pediatric vaccine (<2yrs) No available treatment for chronic disease Collaboration NITD, GNF & two European Research Centers NITD, GNF & TB Alliance, NIAID Grand Challenges in Global Health (GC11) grantees NIBR (RESP) & OneWorld Health Singapore Dengue Consortium (incl. NITD) NVGH NIBR (ID), NITD and GNF Outside Funding MMV, Wellcome Trust & Singapore Gov Gates Foundation & GC11 Grant Gates Foundation <ul><ul><li>Singapore Government & Novartis Foundation </li></ul></ul><ul><ul><li>Wellcome Trust, Gates Foundation, Local Gov & Siena Foundation </li></ul></ul>NIH & Drugs for Neglected Disease initiative Research Status Drug candidate NITD609 entering clinic Compound discovery Lead optimization Compound discovery Vaccine vi-CRM197 in Phase II trials Screening & biomarker discovery
  33. 33. Why become involved in health and access issues beyond the conventional business model? <ul><li>Because it is the right thing to do! </li></ul><ul><li>You cannot have a first class economic performance and be perceived not to care about preventable mortality and morbidity, predominantly in children under 5 years of age. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines
  34. 34. Plausible arguments for a “Business Case” <ul><li>Engagement in corporate responsibility for the achievement of the health-related UN Millennium Development Goals mainly depends on top-management’s normative thinking. But </li></ul><ul><li>Saving lives, curing patients and preventing illness by providing innovative solutions is also likely to </li></ul><ul><li>Engender employees’ motivation and identification; </li></ul><ul><li>Enhance the attraction of the corporation as a partner for cooperation, ethical investment, excellent people, and critical customers); </li></ul><ul><li>Be positive from a political point of view as being “part of the solution” of one of the most difficult social issues ought to trigger good will and overcome negative stereotypical thinking. </li></ul>| UC Berkeley | Klaus M. Leisinger | 4 October 2011 | Corporate Responsibilities for Access to Medicines

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