Evan Lee, MD, MBA Executive Director Global Health Partnership (USA) September 2012

3,4 min Diabetic patients - diagnosed* 3,1 mln. patients T2D patient T1D patient in insulin Adult Children and adolescents 2,2 mln. patients on OHA patient in insulin+OHA In Russia estimated number of undiagnosed pts with Diabetes is 6 mln 72% pts don’t reach HbA1c target level First medicine for Diabetes Pts is MET Commonly prescribed OHAs are Met+CM IDPP-4 is the most growing class of OHA Basal insulin 52% 17 % Mix insulin BBT 27 % Short 4 % *Register of Diabetes 2011, Russian Association of Diabetes Diabetes Monitor 2011, GFK Diabetes is a growing challenge in Russia

Diabetes: Better outcomes require multiple interventions High-risk population Pre-diabetes Early Diabetes Complex Diabetes Lifestyle Monotherapy Dual therapy Insulin  oral drugs Reinforcing prevention: Community awareness Strengthening locally-led research capacity (research grants program) Measuring patient outcomes Establishing most cost-effective pathways to manage patients Environment & Community Patients and family Healthcare Providers Healthcare System Ensuring early diagnosis: Screening by HCP Screening at community level Updated national/regional guidelines available and appropriate for local conditions Healthy lifestyles: prevention Schools – awareness of disease Workplace – supportive (food choices, needle safe-boxes, exercise) Coordination of care & referrals: defining role of nurses, educators, specialists for quality Information management: Diabetes registry, patient records HCP capacity: Evidence-based management of DM(stepped care, esp. insulin mgmt) Motivation, attention, time Cultural competency Improve recognition and management of co-morbidities: Depression, Etoh, TB Special populations (e.g. mgmt during Ramadan) Tools/support for patient and family education: living with disease, lifestyle management, motivation, understanding

Public Private Partnerships 1. Opportunity to work together towards shared goals PPPs can provide an opportunity for the private sector and the public sector to work together to: Meet challenges that are beyond the ability of either the public or private sector to tackle alone, such as: Health - especially non-communicable diseases which require interventions to address prevention, early diagnosis, and adherence to treatment Example of diabetes: food/nutrition, lifestyle/exercise, patient and family support Provide a way for organizations, government ministries, non-profit institutions to collaborate and share resources and expertise, and to avoid duplication. Extend reach beyond the “usual stakeholders”

Public Private Partnerships 2. Ensuring effective collaboration PPP is a form of collaboration where all partners involved: share mutually agreed vision and goals are committed and invested, in terms of resources, assets, money and/or people have a formalized collaboration with shared decision making. Many forms of public-private collaboration are possible: Ad hoc associations, with each party’s activities remaining independent, focused on information-sharing Defined contractual arrangements in which one party provides the other with services in return for payment. Can involve just two parties or multiple stakeholders PPPs build on the individual partner’s needs and draw on their respective capabilities.