By Marshall Stowell, Editor-in-Chief, Impact and Rolf Rosenkranz, Editor, Devex
The complex landscape of philanthropy and investment in global health is undergoing remarkable changes. Traditional government funders, critical for bringing life-saving health interventions to scale, are increasingly partnering with corporations, foundations, philanthropists and low- and middle-income governments.Data from the Institute of Health Metrics and Evaluation shows that high-income donor government funding to global health increased for approximately a decade, leveling off in 2009. Health has also remained a top priority among private foundations since 2001, according to theFoundation Center. Corporations and their foundations increasingly seek hands-on, long-term relationships with their nonprofit partners; “return on investment” has gained new meaning with the emergence of impact investing in development. Health priorities, too, are shifting as the needs of those in the partner countries evolve.
In this issue of Impact magazine, PSI partners with Devex, the leading source of international development news, analysis and advice, and Fenton Communications bring you a special report on the new era in philanthropy and investment in global health.
April 2, 2013
The Indian supreme court ruled against Novartis in its case to extend the patent of its cancer drug. Activists argue that the ruling will open the door for more generic drugs. From the AP:
Novartis had argued that it needed a patent to protect its investment in the cancer drug Glivec, while activists said the company was trying to use a loophole to make more money out of a drug that did not have a patent. The decision has global significance since India’s $26 billion generic drug industry supplies much of the cheap medicine used in the developing world.
Pratibha Singh, a lawyer for the Indian generic drug manufacturer Cipla, which makes a version of Glivec for less than a tenth of the original drug’s selling price, said the ruling sets a precedent that will prevent international pharmaceutical companies from obtaining fresh patents in India on updated versions of existing drugs.
The court ruled that a patent could only be given to a new drug, she told reporters outside the court.
“Patents will be given only for genuine inventions, and repetitive patents will not be given for minor tweaks to an existing drug,” Singh said.
Novartis did not immediately return calls for comment. It has previously said that patent protection is crucial to fostering new drug research and innovation and has suggested that Indians could be denied access to its new medicines if it believes its patents won’t be protected.
“Knowing we can rely on patents in India benefits government, industry and patients because research-based organizations will know if investing in the development of better medicines for India is a viable long-term option,” the company said in statement it sent to The Associated Press late last year.
The Swiss pharmaceutical giant has fought a legal battle in India since 2006 to patent a new version of Glivec, which is mainly used to treat leukemia and is known as Gleevec outside India and Europe. The earlier version of Glivec did not have a patent, because it was introduced into India before the country adopted its first patent law in 2005.
India’s patent office rejected the company’s patent application, arguing the drug was not a new medicine but an amended version of its earlier product. The patent authority cited a provision in the 2005 patent law aimed at preventing companies from getting fresh patents for making only minor changes to existing medicines — a practice known as “evergreening.”
Novartis appealed, arguing the drug was a more easily absorbed version of Glivec and that it qualified for a patent.
Imperia Acuña is a 52-year old transgendered woman that works for the organization MANU, a local NGO that receives support and technical assistance from Proyectos en Salud Integral (PSI Costa Rica), under the USAID Combination Prevention Program for HIV in Central America. Imperia has gone through difficult life experiences. She was rejected by her father, and endured human rights violations, physical and sexual abuse. Lack of information about HIV, education and stigma made her more vulnerable to HIV. The transgendered population is one of the most vulnerable to HIV in the region; it faces the most discrimination and has the least access to health services. According to non-official estimates, the HIV prevalence among transgendered persons is around 18 – 25 % in Central America.
“Even though I never engaged in commercial sex, I did expose myself to HIV and today I am HIV positive. That is why I started to learn more about human rights and how to support my peers,” says Imperia. In contrast to other programs and based on the combination prevention approach, prevention work in Costa Rica is led by peers like Imperia and is carried out in places where at-risk populations are located. Combination prevention is a comprehensive approach that includes referrals to complementary services that address structural factors such as human rights, gender-based violence, and stigma and discrimination, in addition to behavioral interventions, access to biomedical services such as HIV testing, and diagnosis of other sexually transmitted infections.
April 1, 2013
An estimated 240,000 children were not reached by a recent UN-backed polio vaccine campaign due to safety concerns along the tribal regions. AP reports:
Dr. Nima Saeed Abid, the acting WHO chief in Pakistan, said health workers have not been able to immunize children in the North and South Waziristan regions – Taliban strongholds – since July 2012.
Pakistan is one of the few remaining countries, along with Afghanistan and Nigeria, where polio is rampant. As many as 58 cases were reported in Pakistan in 2012, down from 198 in 2011.
He said polio transmission is now concentrated in core endemic areas – central Khyber Pakhtunkhwa province, the Federally Administered Tribal Regions or FATA, parts of Karachi, Quetta and nearby Killa Abdullah and Pishin districts in south western Baluchistan province.
Abid said there have so far been five polio cases reported this year. These cases were reported from Karachi in Sindh province, Bannu and Malakand and Mardan in KPK province and from Mianwali in central Punjab province, added Abid, the acting WHO chief in Pakistan.
Abid said that 15 health workers have been killed in the anti-polio campaign in Pakistan since July 2012. Pakistani militant groups oppose the vaccinations and accuse the workers of spying for Washington.
“Do haftey ho gaye kya?” or “Has it been two weeks ?” asks TB superhero Bulgam Bhai. It is an advertising campaign by Project Axshya, funded by The Global Fund. Partners include the Government of India’s Central TB Division, the International Union Against Tuberculosis and Lung Disease, PSI and the World Vision.
They feature the hero asking people with a heavy cough if it has been two weeks. Bulgam Bhai’s special power is cough detection and he pops up in places like the city market and on a motorcycle. If people have been coughing for two weeks, Bulgam Bhai tells them that they should go get tested for TB.
“The character keeps repeating, ‘Has it been two weeks?’ to drive home the point that two weeks of cough is dangerous. So far, all programmes have concentrated on TB treatment; this one focuses on detection” said Dr Sarabjit S Chadha of the The International Union against Tuberculosis and Lung Disease when the project debuted in Feburary 2012.
“My story is not an easy one. To begin with, I’ve experienced a lot of pain because being a sex worker is not easy.” These are the words of Grettel Quirós, a sex worker and leader in La Sala, a local organization in Costa Rica. Grettel is one of the approximately 9,200 women who work in sex trade in the country.
Although there is no official data for the HIV prevalence rate in this population, during just the 2012 fiscal year the USAID Combination Prevention Program for HIV found a rate of 3% among female sex workers through its voluntary counseling and testing services; this is triple the prevalence rate among the general population.
March 29, 2013
Parents and officials are going to great lengths to immunize children after militants imposed a ban on polio vaccinations in Pakistan’s restive North Waziristan. From IRIN:
The government is trying a carrot-and-stick approach to get the ban reversed.
“We are making what efforts we can to bring [the ban] to an end, so the anti-polio campaign can resume,” said Fawad Khan, health director at the Federally Administered Tribal Areas (FATA) Secretariat in Peshawar.
Nisar told IRIN that the Governor of Khyber Pakhtunkhwa (KP) Province, officials at the FATA Secretariat and the political agent – a representative of the federal government – in North Waziristan were “all attempting to talk to tribal elders and sort out matters so anti-polio drives could resume.”
In addition to the negotiations, they are also using colonial-era legislation to impose collective punishment on the areas.
In December 2012, using powers available to him under the Frontier Crimes Regulation of 1901, the political agent for North Waziristan put in place measures that included denying tribal people of North Waziristan passports, national identity cards and other official documentation if community leaders don’t overturn the ban.
A small honorarium to tribal elders was also stopped and development work in some areas has been suspended.
The steps were taken after the Wazir and Dawar tribes declined to back the anti-polio programme, Political Agent Siraj Ahmed Khan said.
Militants had also imposed a polio vaccination ban in South Waziristan but Nisar said this had since been “somewhat relaxed.”
A doctor, who asked not to be identified, at the hospital in Wana, the administrative centre of South Waziristan, told IRIN, “Generally people are allowed to bring people into the hospital to receive anti-polio drops, but teams are not permitted to move in the field to deliver them.”
So far, the government’s tactics in North Wazirstan have not led to a relaxation of the unofficial community ban.
This story comes to us from the Pan American Social Marketing Organization (PASMO), a PSI’s Central American affiliate.
On an early April morning, an HIV tactical prevention team meets around the central park of Sonsonate in El Salvador. The team is comprised of PASMO outreach workers under the USAID Combination Prevention Program for HIV, ASPHID outreach workers (an NGO working with transgendered population), outreach workers from Orquídeas del Mar (an NGO working with female sex workers), personnel from the laboratory of the local health center, PASMO vendors, and University volunteers who are students majoring in social science at Universidad Tecnológica de el Salvador, as well as personnel from the Alcohol and Drug Treatment Center.
This multidisciplinary team heads to the neighboring high-risk zone looking for bars, brothels, bus stops, or the nearby market and begins to identify and approach people from most at risk populations (MARPs) such as female sex workers and potential clients of sex workers considered men at risk for HIV.
March 28, 2013
Reports of looting in the Central African Republic following the coup by rebels which led the president to flee to Cameroon late last week. From the AP:
Aid groups and the international community on Tuesday condemned widespread looting in Central African Republic’s capital, saying that even hospitals had been robbed in the aftermath of a weekend coup that ousted the president of a decade.
Efforts to restore order to Bangui, a city of 700,000, came as a rebel leader declared himself the new president and announced he would stay in power for three years.
Continuing violence in Central African Republic was preventing critically wounded patients from getting the help they needed, said the French medical aid group, Medecins Sans Frontieres, or Doctors Without Borders.
“MSF condemns the looting and robberies of our facilities and reminds all parties that medical personnel must be respected and protected and must be granted all available help in the performance of their duties,” said Serge St. Louis, MSF head of mission in Bangui.
U.N. spokesman Martin Nesirky also said Tuesday that “widespread looting is continuing, including of one pediatric hospital.”
More than 1,000 armed rebels from the alliance known as Seleka attacked the capital on Saturday, forcing longtime President Francois Bozize into exile in neighboring Cameroon. The fierce fighting left at least 13 South African soldiers dead and an untold number of civilian casualties.
It was the latest political turmoil to destabilize Central African Republic, a country where leaders since independence from France in 1960 have come to power or been ousted in a series of coups and rebellions.
In Washington, State Department spokesman Patrick Ventrell sharply criticized the “illegitimate seizure of power.”
“We strongly condemn these actions,” Ventrell told reporters. “The Seleka leadership must account for its trail of destruction.”
A television advertisement in Kenya led to a public outcry against it and a national debate over how to encourage condom use.
The ad features two women who are gong about their daily routine. One of the women is having an extramarital affair. The second advises her to use a condom in order to prevent the spread of sexually transmitted infections, such as HIV.
Critics decried the ad saying that it promoted extramarital affairs rather then condemning them. The government responded by taking down the ad.
“There are better ways of passing useful information to society. This one has certainly failed,” said the Kenyan Anglican Church’s Bishop Julius Kalu to the Daily Nation.
“It openly propagates immorality, especially when all family members are gathered before television sets, waiting to watch news,” he continued.