The Medicines Patent Pool (MPP) has announced a ground-breaking collaboration with a private sector joint venture that will facilitate greater availability of critical generic medicines for children with HIV. The deal allows the royalty-free licensing of a key HIV medicine, abacavir, in 118 countries where 98.7% of children with HIV live, as well as future commitments for licensing of pipeline drugs. The Memorandum of Understanding goes further than previous deals struck by the Pool, which came under some criticism for possibly not being ambitious enough in getting commitments from partner companies. The agreement is expected to include future drugs developed by the industry venture. The MPP has a priority list of antiretrovirals (ARVs) to fight HIV and AIDS, based on the most needed and those that are patented (and therefore not readily available at affordable prices). The company with which the MPP struck the deal, ViiV, has a number of desirable ARVs in the pipeline, and has committed to allow the MPP to licence them for paediatric use for the same geographic territory, once the drugs receive approval.
Public-Private Mix
To improve the quality of care received for presumptive malaria from the highly accessed private retail sector in western Kenya, subsidised pre-packaged artemether-lumefantrine (AL) was provided to private retailers, together with a one-day training course for retail staff on malaria diagnosis and treatment, job aids and community engagement activities. This study assessed the intervention through provider and mystery-shopper cross-sectional surveys, which were conducted at baseline and eight months post-intervention to assess provider practices. On average, 564 retail outlets were interviewed per year. At follow-up, 43% of respondents reported that at least one staff member had attended the training in the intervention arm. The intervention significantly increased the percentage of providers knowing the first line treatment for uncomplicated malaria by 24.2%; the percentage of outlets stocking AL by 31.7%; and the percentage of providers prescribing AL for presumptive malaria by 23.6%. Generally, outlets that received training and job aids performed better than those receiving one or none of these intervention components.
In this paper, the authors argue that global health partnerships created to encourage funding efficiencies need to be approached with some caution, especially when claims for innovation and responsiveness to development needs are based on untested assumptions around the potential of some partners to adapt their application, funding and evaluation procedures within these new structures. The authors examine this in the case of the Health Systems Funding Platform, which despite being set up some three years earlier, has stalled at the point of implementation of its key elements of collaboration. While much of the attention has been centred on the suspension of the Global Fund’s Round 11, and what this might mean for health systems strengthening and the Platform more broadly, they argue that inadequate scrutiny has been made of the World Bank’s contribution to this partnership, which might have been reasonably anticipated based on an historical analysis of development perspectives. Given the tensions being created by the apparent vulnerability of the health systems strengthening agenda, and the increasing rhetoric around the need for greater harmonisation in development assistance, an examination of the positioning of the World Bank in this context is vital, the authors conclude.
AIDS activists in Uganda have drawn attention to overpricing of medicines at a local pharmaceutical plant, Quality Chemicals Industries Limited (QCIL). The plant was started in 2007 to improve treatment access by providing cheaper ARVs locally. The authors argue that between December 2009 and October 2010, the government's National Medical Stores (NMS) paid $17.8 million more than it should have to QCIL, with a 15% mark-up on imported drugs that had been intended only for locally produced drugs. QCIL is reported in the article to be selling imported drugs manufactured by Cipla at high prices even after it started producing its own drugs. The government inspector general and civil society activists have demanded the government investigate and recover the funds.
This chapter from Global Health Watch 3 explores the origins of philanthrocapitalism and addresses its increasing influence on global health governance and decision-making. It examines the functioning and priorities of the Bill and Melinda Gates Foundation in order to explore how the alignment of corporate interests and philanthropic investment may be having adverse effects on health policy. It looks at the efforts of the proponents of philanthrocapitalism to challenge progressive tax measures that could generate government revenues earmarked for global health. Finally, the chapter suggests that a focus on conflicts of interest could be a useful starting point for the mobilisation of health specialists who are concerned about the influence of the Gates Foundation on health policy, but who have thus far had difficulty, as a result of the immense scale of the Foundation’s influence, in highlighting some of its controversial policies. Global Health Watch cautions against the new philanthropy’s core idea that private-sector investment fills the void left by cash-strapped governments. A key objective for health activists could be highlighting the ways in which government revenues are strapped through private-sector support and through a reluctance to embrace tax measures that are disparaged by philanthropists who purport to be operating outside the realm of politics.
In recent years, tax-exempt private foundations and for-profit corporations have increasingly engaged in relationships that can influence global health. Using a case study of five of the largest private global health foundations, the authors of this study identified the scope of relationships between tax-exempt foundations and for-profit corporations. They found that many public health foundations have associations with private food and pharmaceutical corporations. In some instances, these corporations directly benefit from foundation grants, and foundations in turn are invested in the corporations to which they award these grants. Personnel move between food and drug industries and public health foundations. Foundation board members and decision-makers also sit on the boards of some for-profit corporations benefitting from their grants. While private foundations adopt standard disclosure protocols for employees to mitigate potential conflicts of interests, these do not always apply to the overall endowment investments of the foundations or to board membership appointments. Transparency or grant-making recusal of employees alone may not be preventing potential conflicts of interests between global health programmes and their financing, the authors conclude.
This article addresses recent calls for the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) to develop a Code of Practice on the Marketing of Unhealthy Food and Beverages to Children. The author argues that such suggestions ignore the development of WHO’s Set of Recommendations on the Marketing of Food and Non-Alcoholic Beverages to Children and misrepresent its scope. The recommendations, adopted by the World Health Assembly in 2010, aim ‘to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.’ In light of the current WHO reform process and financial constraints, the fact that WHO member states explicitly chose to develop a Set of Recommendations instead of a Code, the author questions the feasibility and value of re-opening the issue. Instead he recommends that the Secretariat be supported in their mandate to provide assistance to member states in implementing the existing WHO Set of Recommendations.
This paper argues that the Affordable Medicine Facility–malaria, a global subsidy for malaria could skew investment away from more effective solutions to the disease. The AMFm advocates selling artemisinin-based combination therapy (ACT) medicines through the private sector, such as small shops. But selling ACT drugs, even at a small cost, is argued to exclude poor people who cannot afford to pay for a full course of treatment. Furthermore, the informal private sector does not have the ability or incentive to provide correct diagnosis and treatment, which may contribute to worsening drug resistance. The authors raise that getting malaria medicines from informal private providers is not a sound public health approach and not a substitute for investment in public service provision.
In this article, the author argues that there is a conflict of interest regarding public and nonprofit leaders who sit on the corporate boards of major commercial softdrink companies and their role on non profit foundations. The author reports in the paper that 7% of the Gates Foundation’s corporate stock endowment (more than 15 million shares) is in the form of shares of Coca-Cola, and questions whether Gates should be invested so heavily in sweetened soft-drinks given its health focus.
In September 2009, the Constitutional Court of South Africa heard the final appeal in a case brought by five Soweto residents challenging prepaid water meters and insufficient free basic water. The Bill of Rights of the South African Constitution guarantees right of access to sufficient water. However, poor communities in Johannesburg's townships do not have sufficient water and do not receive the same water service as the richer suburbs. Amanzi Ngawethu (The Water is Ours) is a short documentary representing the six-year legal battle against water privatisation. It brings together protest songs, photos and video from people and organisations involved in the struggle and working in solidarity.