2015 GHIT Annual Partners' Meeting:
Japan's R&D Innovation for Global Health
In opening remarks, BT Slingsby, CEO of the GHIT Fund, reflected on how far the partnership has come in two short years. "Our progress is not only remarkable, its necessary," he said. "GHIT has driven R&D forward. We're breaking down barriers, fostering collaboration, and producing solutions to critical and difficult global health challenges. We are making a difference."
The diversity and progress of GHIT's development partnerships are emblematic of that difference. GHIT has invested $40 million in the development of much-needed innovations, co-leveraging the sum with other funders to bring its investment portfolio value to over $70 million. In a video message to event attendees, Margaret Chan, Director-General of the World Health Organization, applauded these investments and the incentives they create to develop technologies for diseases that traditional markets do not serve. "The GHIT Fund has stepped in to provide an incentive in a pioneering model of partnership that brings Japanese innovation, investment, and leadership to the global fight against infectious diseases," she said. "…[GHIT's] investment portfolio is well-targeted and fills an important gap…."
A major theme from the opening remarks was the urgency behind efforts to find solutions that lessen the socioeconomic impact of disease in the world's most vulnerable communities. Keynote speaker Naoko Saiki, Director-General of the Economic Affairs Bureau at Japan's Ministry of Foreign Affairs, provided context for global health's continued ascension to the top of the international agenda. The 2014 Ebola epidemic in West Africa served as a brutal reminder of the tragic and rapid impact of infectious disease on mortality and entire national economies. The epidemic illustrated how rapid urbanization and human mobility have put everyone, in all corners of the world, at risk.
While Ebola served as the most recent international rallying cry for the mobilization of resources against infectious disease, Ms. Saiki flagged another set of diseases—malaria, TB, and NTDs, which affect exponentially more people than Ebola—with grave socioeconomic consequences for developing countries. Against this backdrop, Ms. Saiki remarked that global health would be a priority at the G7 Summit in Germany, which took place just days following GHIT's Annual Partners' Meeting. Japan is an active leader in G7/G8 discussions, said Ms. Saiki, noting the country's longstanding commitment to filling global investment gaps around malaria, tuberculosis, and NTDs. She assured participants that substantial discussions around drug resistance, NTDs, and global health crisis management would take place between heads of state.
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- Japan's commitment to global health will only increase in importance, particularly given Japan's role as G7/G8 host in 2016. In light of this fact, Ms. Saiki noted that "Japan is looked upon as an important pioneer in the crucial area of active global health leadership. Building on the foundation of our global health policy, we are determined to continue to play a leadership role in these health discussions in the future." She went on to say that research and development will serve as a key platform for such leadership. "Japan's R&D capacity is world-class. We are science and technology leaders, particularly in international patents and new drug development. Considering the level of technology and capacity that we have here in Japan, there should be much more potential for Japan to contribute to global health R&D."
The GHIT Fund, noted Ms. Saiki, plays a key role in realizing this potential. By creating new R&D partnerships between Japanese and non-Japanese institutions, GHIT helps fill the infectious disease investment gap, and its governance structure provides a compelling model for other countries. "The GHIT Fund has introduced a decision-making process that is results-oriented and contains the highest level of transparency," said Ms. Saiki. "Its funding mechanism leverages untapped world-class Japanese innovation and technology for the benefit of the poorest nations. Its efforts enhance the health of people around the world, as well as promote global economic growth."
A compelling panel of world-renowned experts followed, delving deeper into each of the calls to action and global health challenges described above.
Moderator Kaori Iida, Senior Editor of the Economics News Division at NHK interposed a pressing question: The complexity of global health problems often requires that several elements—access to services, innovation in science, political leadership—be aligned in order to make an impact... Why should we focus on R&D?
Effectively communicating the necessity of R&D is a common challenge that the global health community faces, responded Trevor Mundel, President of the Global Health Program at the Bill and Melinda Gates Foundation. "People ask: ‘Why invest in innovation when the problem is often infrastructure? Why not just build better infrastructure – clinics and healthcare systems?' This kind of development is ongoing and important, but if you think about the enormous lack of infrastructure in developing countries you realize that the march toward effective and efficient health systems is going to take many decades. The key role of innovation is to accelerate health progress beyond the pace of [infrastructure] development."
Creating the right conditions for innovation that benefits developing countries requires not only partnership between industry and government, but also collaboration across other sectors. Dr. Mundel reflected that involving multiple stakeholders can dramatically impact problem-solving. For the Gates Foundation, co-involving NGOs, multilateral organizations, philanthropies, product development companies, and others has resulted in tremendous global health successes. He cited the sweeping impact of a public-private partnership known as the TB Drug Accelerator Program, where eight pharmaceutical companies have agreed to share their compound libraries in order to pool previously-confidential information about TB drug structures in favor of faster, improved TB drug development. Dr. Mundel noted that it is the largest enterprise in drug discovery ever assembled against one disease and that within it he sees many echoes of GHIT.
GHIT's even broader mandate fills investment gaps across global health, spanning multiple technologies and infectious diseases. In the last two years, GHIT has created 39 cross sector partnerships between Japanese entities and international organizations. Six clinical trials have been funded in countries such as Tanzania, Burkina Faso, Uganda, and Peru.
The success of the GHIT Fund's first two years steered the conversation to the possibility of replicating the institution's governance and financing model elsewhere in the world. That, said Keizo Takemi, Member of Japan's House of Councilors and Chairman of the Special Mission Committee on Global Health, would require domestic political alignment and support from the highest international bodies. Ultimately, he added, there may be potential for Japan to use its leadership at the G7 to promote the GHIT Fund as a model that will inspire other G7 nations to establish similar mechanisms within their own specific country contexts. The result could be a global alliance for innovation and investment around NTDs. "The world's problems cannot be solved by individual nation states. International bodies like the G7 can be catalytic in their ability to mobilize limited resources to solve global health problems that effect us all."
Peter Piot, Director of the London School of Hygiene and Tropical Medicine, elaborated on the importance of international forums. "We can only really move agendas—even move mountains—when the stars are aligned: science and innovation, delivery systems, universal healthcare, and politics. That is where the G7 and other bodies, from the UN General Assembly to the World Economic Forum, have an important role to play."
He continued by emphasizing the need for Japanese leadership in international settings. "The next 18 months offer an unique opportunity for Japan to shine," he said, reminding that Japan will host the 2016 G7/G8 summit and that it will also have an important chance to strengthen partnerships with countries in need at next year's Tokyo International Conference for African Development in Africa.
Tachi Yamada, Chief Medical & Scientific Officer and Executive Vice President of Takeda Pharmaceuticals International Inc., proceeded to outline the ways in which Japan's leadership and the GHIT model have changed the paradigm for cross-sector collaboration. Solutions begin with finding ways to incorporate industry, he said. "The world's pharmaceutical companies have a compact with society: take the best-available science and create solutions for substantial healthcare problems. The responsibility for that effort isn't limited to providing only for people who can afford medicines," said Dr. Yamada. He elaborated by explaining that pharmaceutical industry leaders regularly grapple with the challenge of sustaining their business while also creating and providing access to much-needed health tools that may not be profitable.
Before GHIT's establishment, no mechanism existed to help the Japanese pharmaceutical industry utilize its strengths to pursue beyond-profit endeavors. Traditionally, Japan's companies ranked low on the global Access to Medicines Index, and Japan's contributions as a nation centered largely on infrastructural investment and specific bilateral assistance. Industry leaders recognized this gap and worked with the Government of Japan to build game-changing domestic and international partnerships to fill it. And in 2013 GHIT's establishment created a new opportunity to realize Japan's untapped innovation and investment potential. "Japan should not only make contributions with money," said Dr. Yamada, referencing the significant overseas development assistance that Japan provides. "Japan can also contribute with its very strong science and industrial base, and with its human resources—which include intellectual know-how and commitment."
Following panelist remarks, two key Japanese government officials and CEOs of the Japanese pharmaceutical companies that partner with GHIT engaged proactively in the conversation, sharing their views on current and future challenges for global health. The format reflected the GHIT Fund's unique governance model. Private sector members of GHIT do not participate in organizational or funding decisions. This transparent and open model promotes sharing of innovative technologies and knowledge, allowing private sector companies to participate without conflict of interest.
The meeting closed with moving remarks from Kiyoshi Kurokawa, Chair of the GHIT Board. He reminded the audience how far global health has come and cautioned about the need to both maintain and advance this progress. "When I was a child, up until 1950, the leading cause of death was TB. It was like that everywhere in the world. It was like that in Japan. When you flew to the United States you had to carry full-scale x-rays to prove that you did not have an active form of TB before clearing customs.
"Decades ago, Japan eradicated malaria, tuberculosis, polio, and other diseases. The x-ray experience is unimaginable today, but the same threat is also still present: disease knows no borders." He continued, stating: "people often ask, ‘why global health?'" One important argument for global health is the domestic threat of disease. But human security is also paramount: only when they are in good health can people achieve a meaningful life. "Malaria, TB, and NTDs still affect hundreds of millions of people living below the poverty line," said Dr. Kurokawa. "The GHIT Fund draws upon the strength of Japanese innovation and investment to create affordable, accessible solutions where they are most needed."