Global Health Blog

As I prepared to go to the annual tuberculosis (TB) Union meeting in October, friends and colleagues mentioned that they had heard the good news about TB, that incidence is falling. And I would respond that only 0.5% of people who have multi drug resistant TB (MDR-TB) are being treated. I went to Lille, France with my colleagues to roll up our sleeves and do something about this.

Our work over the last six months with Eli Lilly and Company was announced last week: a five-year, $30M commitment to the third phase of the Lilly MDR-TB Partnership, focusing on second line drug supply and access, and health care provider training. With so many problems in MDR-TB, it was not easy to choose a focus. Lilly takes an approach throughout its programs to create long term impact through its activities under the framework of Research, Report and Advocate – you can read more about this work from our client, Tracy Sims in a recent blog post.

Imagine Siberia, swamps, snows and mosquitos, the dark heart of Russian history- prisons and camps and starving farmers. It might be surprising to you that I left Moscow on a midnight flight disheartened about the Russian health system and 24 hours later I am inspired by a Siberian prison doctor.

After years as an itinerant engineer bachelor my friend, whom we will call him Max, got married last year. He settled down into a little house in the San Francisco Bay Area and prepared for the arrival of his first child. Over a Baja-style fish taco, Max and his wife asked me whether I had an opinion about vaccines and potential risks.

The scarcity of R&D for the developing world is not a new problem. It has been 50 years since we had a new TB drug – because the issue has been addressed in the developed world. A decade ago the Global Forum for Health Research named the 90/10 problem, pointing out simply that 90% of health research addresses 10% of the world’s population. This may no longer be entirely true as my colleagues Sebastien Mazzuri and Matt Rehrig have noted in recent blogs that the epidemiological trends are actually bringing the needs of the developing and developed worlds closer together as chronic disease now accounts for 60% of global deaths with many more deaths occurring in the developing world. However even with this shift in disease distribution I see two significant gaps in our global investment in R&D: first, there is a lack of investment in new products for neglected diseases like Chagas Disease or African Sleeping Sickness. Second, there is a less recognized opportunity to develop new products for chronic diseases —not only delivering access to existing medicines, but developing new products like pacemakers for Africa. While some companies have started to address these issues, there is much to be done, I believe, especially in light of the article on the concept of shared value that FSG co-founders Mark Kramer and Michael Porter discuss in Harvard Business review this month.

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