1. R&D Financing by the Bill & Melinda Gates Foundation
PRESENTED BY
Neil McDonnell, Pharm.D. January 12, 2009
WHO Expert Working Group on R&D Financing

2. Gates Foundation Mission
To ensure that life-saving advances in health are developed & shared with those who need them the most.
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© 2009 Bill & Melinda Gates Foundation | ‹2›

3. How We Prioritize Our Work
Greatest burden
The areas that cause widespread illness and death: infectious diseases, undernutrition, and reproductive maternal, neonatal, and child health
Widest imbalance
Problems that disproportionately affect poor countries
Gaps in attention
Fill in areas receiving inadequate attention and resources
Benefit the most people
Prevention has the greatest impact – focus on vaccines and other prevention strategies, micronutrient deficiencies
Be willing to take risks
Innovation requires accepting risks
© 2009 Bill & Melinda Gates Foundation | ‹3›

4. DALYs by Cause, Low Income Countries
Non-Foundation
Priorities: 43%
Foundation
Priorities: 57%
© 2009 Bill & Melinda Gates Foundation | ‹4›

5. How We Prioritize Our Work
Greatest burden
The areas that cause widespread illness and death: infectious diseases, undernutrition, and reproductive maternal, neonatal, and child health
Widest imbalance
Problems that disproportionately affect poor countries
Gaps in attention
Fill in areas receiving inadequate attention and resources
Benefit the most people
Prevention has the greatest impact – focus on vaccines and other prevention strategies, micronutrient deficiencies
Be willing to take risks
Innovation requires accepting risks
© 2009 Bill & Melinda Gates Foundation | ‹5›

6. Foundation Support for Discovery, Development, and Delivery
Global
Health
Impact
Appropriate Uptake and Use
© 2009 Bill & Melinda Gates Foundation | ‹6›

7. Gates Foundation Support for Drugs and Vaccines in Late-Stage Preclinical or Clinical Development
Product Class
Candidates
HIV (Vaccines) 13
HIV (Non-Vaccine Prevention) 9
TB (Vaccines) 6
TB (drugs) 2
Malaria (vaccines) 10
Malaria (drugs)
Pneumonia (vaccines) 5
Diarrhea (vaccines) 11
Diarrhea (drugs) 1
Dengue Fever
Visceral Leishmaniasis 3
Human African Trypanosomiasis
Hookworm
Japanese Encephalitis
Human Papillomavirus
Product/Platform Candidates 4
Total 77
© 2009 Bill & Melinda Gates Foundation | ‹7›

8. Product Development Partnerships Supported by the Gates Foundation
Diarrhea
International Vaccine Institute
Enteric Vaccine Initiative
Advancing Rotavirus Vaccine Development
HIV/AIDS
International AIDS Vaccine Initiative
International Partnership for Microbicides
Malaria
Medicines for Malaria Venture
Malaria Vaccine Initiative
NTD
Dengue: Pediatric Dengue Vaccine Initiative
Hookworm: Human Hookworm Vaccine Initiative
Leishmaniasis: Infectious Disease Research Institute
Trypanosomiasis: UNC Consortium for Parasitic Drug Development
Multiple: Drugs for Neglected Diseases Initiative
Respiratory Infection
Influenza Vaccine Development Program
Meningitis Vaccine Project
Pneumococcal Vaccine Development Program TB
Aeras Global TB Vaccine Foundation
Global Alliance for TB Drug Development
Cross-Cutting
Foundation for Innovative New Diagnostics
Innovative Vector Control Consortium
Institute for One World Health
© 2009 Bill & Melinda Gates Foundation | ‹8›

9. Global Health Program Payout
© 2008 Bill & Melinda Gates Foundation

10. The Need for R&D in Global Health
Guaranteed obsolescence in infectious diseases
We need for newer, better methods of prevention
Many disease for which no effective treatment or prevention is available
Innovation is required to meet these challenges
Financing innovation requires a willingness to make extremely risky investments
© 2008 Bill & Melinda Gates Foundation

11. Providing Access to Medicines and Vaccines for the Poor – Focus on R & D
Governments
Support for basic research
Support innovative finance mechanisms designed to stimulate R&D
Support for funds such as the Global Fund, GAVI, UNITAID, etc.
Industry
Research, development, and manufacturing to addresses global disease burden and neglected diseases
Access Plans
© 2008 Bill & Melinda Gates Foundation

12. Providing Access to Medicines and Vaccines for the Poor – Focus on R & D
Foundations
Work in defined niches
Support innovation and development of new health solutions
Operating at the interface between governments, the private sector, and other interested parties
De-risking subsequent investments by the public and private sectors
© 2008 Bill & Melinda Gates Foundation

13. Many players to incentivize in R&D, final common pathway through industry
Pharma
Biotech
Govern-ment Lab
Academic Lab
Academic Lab
ResearchInstitute
ResearchInstitute
Discovery
Development
Product Approval
Introduction
Govern-ment Lab
Pharma
Biotech
Govern-ment Lab
Biotech Company
Pharma
Biotech Company
Pharma
Pharma
Biotech
© 2008 Bill & Melinda Gates Foundation

14. Stimulating Global Health R&D
We need incentives for governments, foundations, and a broad cross section of industries to participate in the R&D effort
We need to identify novel mechanisms to fund global health R&D and new policies that encourage more R&D.
We have to be willing to take risks
© 2008 Bill & Melinda Gates Foundation