SOCIAL ENTREPRENEURIAL SOLUTIONS FOR PHARMA INDUSTRY

Pamela Hartigan

October 7, 2008

From Mumbai –

I was last in Mumbai 37 years ago – and while I have been to India many times since, I had not been back to this city since then. Yet as my ancient black and yellow cab sputtered through town from the airport, I reflected on how little seems to have changed. The Indian economic “miracle” has certainly not reached the masses of people in this city of 13 million.

And yet, things have changed, in some cases dramatically. Certainly even 5 years ago I would not have been coming to a “roll up your sleeves” workshop with the world’s largest multinational pharmaceutical companies, their investors and social entrepreneurs for the purpose of identifying tomorrow’s business opportunities to provide access to medicines to low income populations. And what has changed even more has been the relative openness on the part of pharma companies to consider the drug development and distribution models that social entrepreneurs are testing, perfecting and growing to reach hundreds of thousands of people that pharma does not – because the profits are too low relative to the effort it takes to reach them.

Today, Thulsi Ravilla who heads up the renown Aravind Eye Care hospital in India and Chris Elias who leads PATH based out of Seattle and working globally, described what they did – and how – to an attentive group of major investors and pharma representatives. I truly relished sitting back and listening to questions from an almost incredulous audience who could not quite believe that Aravind, a hybrid non-profit, can provide quality and complete eye care, including cataract surgery, to half its needy clients for free – and still make solid profit by servicing paying clients – allowing Aravind to sustain itself and grow.

Chris Elias got the same excited reaction as he described how PATH, also a hybrid non-profit, worked with a Chinese drug development company and succeeded in bringing down the cost of Japanese Encephalitis (JE) vaccine from US$4.05 a dose to $0.16 a dose, allowing countries suffering from JE pandemics to prepare effectively to stave off outbreaks. The reason PATH is successful in these relationships has to do with sharing the risk with indigenous drug development companies as well as building the technical capacity of staff in these companies in the process.

And lest the group think that these two examples were unique, I shared more examples, including an alternative drug development group, Institute for One World Health - a pioneering non-profit pharmaceutical company in the US. IOWH has challenged successfully the assumption that pharma R&D is too expensive to create the medicines needed by the poor. Riders for Health, on the other hand, focuses on distribution of essential drugs and vaccines to rural communities by dealing with an overlooked problem – maintenance of vehicles – motorcycles and four-wheeled drives. Training health care workers on how to maintain these vehicles and building local capacity to service them, Riders has reduced the cost of fleet maintenance by 62% a year – and improved rural health dramatically in the African countries where it works. And to showcase how to creatively and successfully guarantee quality and consistency of drugs, I provided the example of the CFW Shop model in Kenya that takes advantage of local entrepreneurial drive in Kenyan communities to create a network of drug stores and medical clinics owned and operated by Kenyans trained in health care. These franchises, with an annual cost per client served of US1, have served over 2 million to date CFW’s inception ten years ago. Today, there are 68 shops in Kenya. The plan is to ramp up to 14 countries in the next five years.

Tomorrow we reconvene to consider the most pressing issues for pharma companies in emerging markets, the options, and how to move forward on opportunities. Hopefully today’s examples of innovators working at the “bleeding edge” of these markets will provide a source of inspiration in our deliberations.

Hearty congratulations to Sophia Tickell, Director of Pharma Futures and Chairperson of SustainAbility and Maggie Brenneke at SustainAbility and their colleagues for this pioneering, timely and stimulating effort.