Can public-private partnerships in pharma work even better?

Now, more than ever, public-private partnerships in the pharmaceutical industry are needed.  Chronic and acute health problems are on the rise.  Global funding for health has stagnated.  And national governments have reduced health expenditures.  Across all sectors, development experts are asking for help.

Drug donations are not new to Big Pharma.  Since the late 1980s, Big Pharma has taken on tough challenges by partnering with NGOs and governments to eliminate diseases in the developing world.  At least eight different partnerships targeting drug donations have helped fight neglected tropical diseases (NTDs).  The most famous example, now regularly taught as a case study in ethics, is Merck’s donation of Mectizan, the river blindness drug, to African countries.

New public-private models have emerged beyond donations and NTDs.  Models like the Medicines for Malaria Venture (MMV) and ViiV healthcare target R&D through joint development of new drug pipelines.  Further down the value chain, the Clinton Health Access Initiative (CHAI) and the Global Alliance Vaccine Initiative (GAVI) focus on all aspects of access. 

However, there is a risk of partnership fatigue.  As diseases are painstakingly eliminated and children increasingly vaccinated, it is easy to think that global health problems have been solved.  On the contrary, non-communicable diseases are on the rise, and infectious diseases still threaten millions of lives.  Pharma companies continue to have a moral obligation to ensure access to a portfolio of life-saving medicines even as single disease burdens vanish.

Pharma companies should publish results from public-private partnership programs.  Similar to clinical trial results, partnership results should be documented and released, whether positive or negative.  Results – dollars spent, lives saved, and lessons learned – must be shared more broadly across the global health community to offer solutions and avoid costly lessons.  Economists need access to this data to assess effectiveness.  Unlike projects funded entirely by funding agencies such as the Global Fund or the Gates Foundation, private sector partnership expenditures are often shrouded in secrecy.  Drug valuation alone inspires much controversy.

The pharma industry should take three steps to ensure greater transparency.  First, pharma must fairly value its donations using a standard set of accounting rules.  Second, expenditures and program focus areas should be published to identify potential overlaps and gaps as well as draw attention to local NGOs already serving the communities.  Finally, the pharma industry should work with economists to help identify the most cost-effective interventions to deliver the biggest bank for their buck.  These steps would help eliminate waste in an industry where each inefficiency costs not only dollars but also lives. 

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