1. Public-Private Partnerships Washington DC: Global Health Council, June 1 2006 Charles A. Gardner The Rockefeller Foundation

2. BVGH: Bioventures for Global Health GFHR: Global Forum for Health Research LaunchMaturity IAVI: International AIDS Vaccine Initiative 19971998199920002001200220032004200520062007200820092010... MMV: Medicines for Malaria Venture TB Alliance: Global Alliance for TB Drug Development IPM: International Partnership for Microbicides PDVI: Pediatric Dengue Vaccine Initiative Goal: Product Availability for the Poor GDF: Global TB Drug Facility MIHR: Ctr for Management of IP in Health R&D R&D Local PPPs ManufactureProcurement PDPs

3. Perinatal conditions Lower respiratory infectionsHIV/AIDS Diarrhoeal diseases Unipolar depressive disorders Ischaemic heart diseaseMalaria Cerebrovascular diseaseTuberculosis Road traffic accidents Source: 1990 data from: Global Burden of Disease, Murray and Lopez, 1996, WHO, p. 180, 262; 2001 data from World Health Report 2002 Annex Prepared by The Boston Consulting Group Leading Causes of Death 6.2 5.6 11.1 20.9 0.5 >100 0.7 26.3 1.0 Percent of DALYs in Developing / Developed Regions Priorities: Based on Health Inequities IAVI & IPM MMV & MVI TB Alliance & Aeras

4. TB Alliance FIND SocialDemand Scientific Maturity IPM Aeras PDVI IAVI MVIMMV Filling the Ecological Niches They Have Collectively Raised over $1.5 Billion USD Priorities: Based on Demand & Science

5. It wasn’t just about products  Product Development  Advocacy and Awareness  “Culture Change” These were the original goals of The Rockefeller Foundation in this field

6. Core Budgets (1) Expertise (2) Model/Process (2) Advisory Board (3) & Management (4) Public Sector Private Sector 100% Public 50-50 Joint Venture 100% Private (1) Less than 1% private capital based on MMV and IAVI in 2003 (2) BCG subjective rating including development of sound business plans, conduct of pharmaco-economic analyses (3) Approximately a third of Boards have private sector experience based on IAVI (8/19), MMV (4/9), & GAVI (2/18) (4) Approximately 42% of management with private experience: IAVI (1/2); MMV (5/5); IPM (1/4); GATB (1/4); GAVI (1/11) IP Rights for Disease Endemic Countries (2) Resources Invested in Projects R&D Work Being Carried Out PDPs: Public and Private Contributions

7. A business plan; market analyses A business plan; market analyses CEO, CSO, CFO, Board of Directors (Public and Private Representatives) CEO, CSO, CFO, Board of Directors (Public and Private Representatives) Stakeholders’ Meetings Stakeholders’ Meetings Portfolio Management Strategy Portfolio Management Strategy Access and Advocacy Strategy Access and Advocacy Strategy Non-Profit Business Models Portfolio Management Strategy Portfolio Management Strategy

8. PDP Portfolio Approach new to public-sector product development  Better than Old Linear Model  Allows Modeling for Success  Insulates Donors from Risks

9. PDPs Expand Development Pipelines 2000 * Some with TDR collaboration ** Further SME in-house activity yet to be included Data from Mary Moran, LSE, Whitehall Presentation, funded by The Wellcome Trust Products in the pipelines of PDPs

11. Level of Complexity MarginalIncreaseinAccess Health Expenditures 6-9 Months DOTS Rx (TB) OVERCOME DECLINING MARGINAL RETURNS ON ADDED INVESTMENTS IN ACCESS Vaccines & Shorter Rx AIDS Care & HIV Prevention Iron Lung (Polio) Priorities: Breakthroughs to increase access

12. Product Development Partnerships  Northern headquarters, but global focus  A mix of public and private contributions  Follow non-profit business models  Portfolio approach; expanding pipelines  “Products, Advocacy and Culture Change”  Priorities are based on health inequities, social demand, and maturity of the science social demand, and maturity of the science  Technological goal would increase access

13. PushPullGoal Fast-track regulatory approval vouchersFast-track regulatory approval vouchers Transferable patent extensionsTransferable patent extensions Market analyses & partnering assistanceMarket analyses & partnering assistance Global procurement / distribution fundsGlobal procurement / distribution funds Advance Market Commitments (AMCs)Advance Market Commitments (AMCs) Airfare Solidarity ContributionAirfare Solidarity Contribution R&D funding from governmentsR&D funding from governments Tax breaks for private sector R&DTax breaks for private sector R&D Double-bottom-line venture capitalDouble-bottom-line venture capital Liability protection for manufacturersLiability protection for manufacturers Patent pooling; open source innovationPatent pooling; open source innovation Univ. humanitarian licensing practicesUniv. humanitarian licensing practices Tilting health product innovation systems toward the poor and vulnerable Public-private product development partnerships (PDPs)Public-private product development partnerships (PDPs) R&D Intellectual Property Manufactur e Regulatory Approvals Regulatory Approvals Procureme nt and Sales Procureme nt and Sales Distribution of Essential New Products Distribution of Essential New Products

14. Earmarked consumption tax revenuesEarmarked consumption tax revenues Conditional cash transfersConditional cash transfers ICT for remote expert adviceICT for remote expert advice Software to assist in diagnosis and referralsSoftware to assist in diagnosis and referrals Health system management changesHealth system management changes Tilting innovation in health systems toward the poor and vulnerable Distribution of Essential New Products Distribution of Essential New Products Micro-insuranceMicro-insurance Pooled procurementPooled procurement Social marketingSocial marketing Social franchisingSocial franchising Conditional cash transfersConditional cash transfers Resource Generation Service Provision Health Information Stewardshi p

15. Earmarked consumption tax revenuesEarmarked consumption tax revenues Conditional cash transfersConditional cash transfers ICT for remote expert adviceICT for remote expert advice Software to assist in diagnosis and referralsSoftware to assist in diagnosis and referrals Health system management changesHealth system management changes Tilting innovation in health systems toward the poor and vulnerable Distribution of Essential New Products Distribution of Essential New Products Micro-insuranceMicro-insurance Pooled procurementPooled procurement Social marketingSocial marketing Social franchisingSocial franchising Conditional cash transfersConditional cash transfers Resource Generation Service Provision Health Information Stewardshi p