UCL Workshop Dr Mary Moran Policy Cures December 2014
Dec 13, 2015
UCL Workshop
Dr Mary MoranPolicy CuresDecember 2014
Outline
• Policy Cures
• The G-FINDER report on neglected disease R&D funding
• A troubling confusion (the Nature article)
POLICY CURES
• An independent non-profit research and analysis group
• Founded in 2004 at LSE
• Innovative ideas and rigorous analysis
• Focussed on R&D for neglected diseases of the developing world
• Annual survey of global neglected disease R&D funding
• Neutral, comparable, comprehensive analysis
• Commissioned by the Bill & Melinda Gates Foundation
G-FINDEROVERVIEW
• 34 neglected diseases • 138 product areas • All R&D stages• Data from 197 organisations• Over 8,900 entries
G-FINDERSCOPE & METHODOLOGY
$193m
FindingsOVERALL
$3.2 bn in 2013
FindingsDISEASES
2013 funding
FindingsTOP FUNDERS
50%
FindingsFUNDERS
2013 funding
DiscussionPUBLIC FUNDING
The US budget sequester had a big impact on neglected disease R&D funding
of total investment: low and declining
12%
DiscussionINDUSTRY FUNDING
The first increase in PDP funding in five years
DiscussionPDP FUNDING
First increase in Gates Foundation funding in five years, largely due to greater investment in industry and other mechanisms
DiscussionGATES FOUNDATION
A troubling confusion
• Nature article – Where patents and profits are/ are
not the problem– The role of the WHO
• The purpose/ hope for today
Two main R&D areasCommercial
Type INeglected
Type II/III
• Chronic (cancer, diabetes, heart)
• Limited public control over R&D and price
• … but no funding needed
• Patients fund R&D (linkage)• IP/patent monopolies allow
profit mark-ups to patients• Profits fund R&D• But mark-ups put products
out of reach of the poor
• Infectious (malaria, TB, worms ..)
• Full public has control over R&D and price
• …. but has to fund the R&D itself
• Already delinked from profits (since no profits by definition)
• Funded by from public & philanthropy, not from sales
• Low-or-no profit prices to DCs• Non-profit IP use, open-source,
collaborations common
CommercialType I
• It’s about IP/ patents / access (industry has control)
• R&D funding is not a problem
• Cancer drugs (Glivec) - $22,000• Ambisome for HIV
(leishmaniasis) - $350• AIDS drugs …• Xpert anthrax test (DR-TB) -
$10/test• Hep C drug (Sovaldi) - $9,000
NeglectedType II/III
• Few/ no IP issues (public has control over access provisions)
• It’s about securing R&D funding and coordination
• Polio vaccine • Human genome• Ivermectin for river blindness
(free)• Meningitis A vaccine ($0.50c)• Coartem kids anti-malarial
($0.38c)• GSK Tres Cantos/ academic hub
$3.2 billion annual public/nfp funding
Pipeline 350+ candidates
44 new ND products
registered
History: The key to the confusion
AIDS drug crisis
Proposed R&D Treaty & pooled fund
TDR/ PDPs/ public research institutes/ academia/ nfp
industry
NDs
CommercialType I
NeglectedType II/III
WHO process Outside WHO process
Proposed Treaty Fund (~2003)TDR Pilot Fund (2014-16) TDR Pooled Fund (2016 - )
• Public & nfp funding• Focus on delinkage (non-IP)• Medicines non-profit to all (HIC,
MIC, LIC)• Type I diseases as well as NDs
• Focus on IP, not on funding and R&D hurdles
ND R&D(PDPs; public research institutes;
academics; NFP industry)
• Public and nfp funding • IP-agnostic • Medicines non-profit to DCs (not
HICs)• Only NDs
• Focus is on the funding and R&D hurdles, not on IP
A policy confusion
• The WHO Fund and the Treaty are designed to target access to commercial medicines (the IP system)
• BUT lack of political support for an overhaul of the commercial IP system meant that the WHO process instead focussed on NDs (four ND pilots)
• Doesn’t make sense …..– Focussing on NDs where we already have most of the things we’re asking for
• R&D is already delinked (funded by gov’ts/ phil, not from sales to patients)• Open source and collaborations already used, and allowed• Products made under nfp model – often generic producers• IP usually controlled by public/ nfp groups for DC use (part of standard agreements)
Does it matter for access to commercial medicines?
• Neglected in the debate• Delinkage and the WHO
Pool are now all about NDs
Does it matter for NDs?
– Focus on IP means we’re not focussing on the real problems – funding and coordination
– No new R&D funding proposals (just more public funding)
– Coordination via a central fund would be helpful but ….
– Can do unintended harm …
Delink the debates
• Commercial medicines– Need to focus on IP and access in a
serious way; the WHO focus has let it drop down the agenda
• Non-profit medicines – Need to focus on funding and
collaboration, and stop sidetracking off into for-profit IP issues
Thank you