The Partnership for Access and Delivery of New Health Technologies is led by UNDP, in collaboration with WHO and PATH. Recognizing the gap between the development of new global health technologies for TB, malaria and neglected tropical diseases (NTDs), and the capacity gap for access and delivery of these new technologies in low and middle-income countries (LMICs), the partnership seeks to work with LMICs to strengthen their capacities to improve the access and delivery of new health technologies for these diseases.
The global burden of TB, malaria and NTDs In 2011, 8.7 million people fell ill with TB, including 1.1 million 1 cases among people with HIV . Ongoing malaria transmission continues to affect 99 countries and territories around the world. In 2010, an estimated 3.3 billion people were at risk of 2 malaria globally . NTDs represent some of the most common infections among people living in extreme poverty in subSaharan Africa, Asia, and Latin America and the Caribbean, disproportionately affecting the so-called “bottom billion” (the 1.4 billion people who live below the World Bank’s 3 poverty figure of US$1.25 per day) . The high degree of geographic overlap of these diseases – whereby a large proportion of people are infected with more than one disease – is a significant factor of the disease burden. NTDs often augment the deleterious effects of one another, especially in sub-Saharan Africa where NTDs geographically overlap with HIV and malaria. Infection with a NTD may increase susceptibility to HIV and worsen outcomes in those with HIV, TB, or malaria. Eliminating or controlling NTDs with the help of safe, effective and relevant health technologies thus represents an opportunity for development; as generations are given the chance to emerge from a cycle of poverty and disease caused by endemic NTDs. Linkages with African Union (AU) initiatives Against the background of an especially high burden of NTDs in Africa, and consistent with a renewed global focus on accelerating work to overcome NTDs at WHO, AU Ministers of Health committed, in April 2013, to increasing support for the fight against NTDs. The AU is working towards a Regional Action Plan on NTDs for 2014-2020, which is expected to include strong commitments to scale up investments in and access to, health technologies to address NTDs.
MATTERS OF FACT: • More than 1 billion of the world’s poorest 2.7 billion people are affected by one or more NTD. • 17 NTDs are listed by WHO as sharing common features, including their prevalence in poor and disadvantaged populations with little political voice, their relative neglect by research and their significant impact on morbidity and mortality • NTDs are endemic in 149 countries and territories. • 3,215 new cases of Buruli ulcer were reported globally; 3,104 of them in the African region. • There has been a 30 fold increase in the global incidence of dengue fever during the past 50 years. • Less than 1% of the 1,393 new chemical entities marketed globally between 1975 and 1999, were for neglected diseases and TB.
Challenges for access and delivery of new health technologies A renewed focus on NTDs since the 2000s has raised expectations for development of promising treatments, however their impact is likely to be small given the magnitude of the need. Even as the number of new health technologies coming to market for TB, malaria, and NTDs increases slowly, evidence suggests that capacity in LMICs to absorb such technologies – or to ensure access and delivery of these technologies – remains weak. Three key determinants can affect how well LMICs are equipped to absorb new technologies: Innovation: Health technologies should be developed to meet the specific needs of the populations in developing countries. There is also a need for ongoing adaptive research to make new or improved products better suited to developing country settings, and for developing country stakeholders to be able to have a voice in deciding priorities. Affordability: The costs and pricing of health technologies, as well as the funds available for procurement of health technologies vitally influence their affordability. It is also important to examine the implications of intellectual property rights and competition on affordability of health technologies.
National capacity: Access and delivery are dependent on the adequacy of the healthcare infrastructure and resources at the national level. The policy and regulatory environments, basic infrastructure, adequate human resources with the requisite skills, functioning primary and secondary health-care delivery systems, among many others – are central to making existing treatments available. The Partnership for Access and Delivery Partnership of New Health Technologies UNDP, together with WHO and PATH, seeks to work with stakeholders at the national and regional levels to bridge the gap between new drug development and access and delivery in developing countries. The Access and Delivery Partnership will focus on the following:
strengthening legal and policy frameworks, to expedite access and delivery of new global health technologies for TB, malaria, and NTDs; building capacity for evaluation of epidemiological studies to understand country specific needs for new global health technologies, potential market size, and user perspectives; strengthening health sector capacity in monitoring of Phase IV (final stage trials to confirm safety and efficacy)trials; strengthening capacity within LMICs to around sustainable financing of and budgeting for new global health technologies; building capacity on the various steps from discovery of new technologies to consumerization, to ensure that new global health technologies are priced appropriately, and supply meets population demand; and strengthening capacity of delivery systems including supply chain of new global health technologies for TB, malaria, and NTDs.
The objective is to address factors that can expedite or impede the access and delivery of new health technologies, so as to facilitate the greatest and speediest coverage. In developing and implementing the menu of appropriate interventions in LMICs, the Access and Delivery Partnership will be guided by the following strategic thrusts:
Relationship between the Access and Delivery Partnership and GHIT Fund The Global Healthcare Innovation Technology (GHIT) Fund is a public-private partnership established by the Government of Japan and the Bill and Melinda Gates Foundation, with a consortium of Japanese pharmaceutical companies, to promote the discovery and development of new health technologies for TB, malaria, and NTDs. The GHIT Fund and the Access and Delivery Partnership are separate but complementary; they are linked by their funding from the Government of Japan and in their common goals aimed at responding to MDG 8 by supporting the development of new global health technologies for TB, malaria, and NTDs, and strengthening access and delivery for new health technologies by building capacity within LMICs. The diagram below illustrates an overview of the relationship between the two projects.
Notes: 1. Factsheet on WHO Global Tuberculosis Report 2012. Available from: http://www.who.int/tb/publications/factsheet_global.pdf 2. Report by the Director General of the World Health Organization, 5 April 2013, Implementation of General Assembly resolution 66/289 on consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2015. Available from: http://www.who.int/malaria/publications/atoz/UNGA_malaria_report_20 13_English.pdf 3. WHO (2010) Working to overcome the global impact of neglected tropical diseases: First WHO Report on neglected tropical diseases, WHO Geneva.
For more information contact:
Ensuring the appropriate linkages between innovation and access Promoting an enabling environment for innovation in developing countries Ensuring sustainable and affordable access to health technologies Enabling strategic South-South collaboration
Tenu Avafia tenu.avafia@undp.org HIV, Health and Development Group United Nations Development Programme One United Nations Plaza New York, NY 10017 USA June 2013