Value Proposition and Innovative Models for Multi-Sectoral Engagement in Global Health Proceedings of a Workshop (2020) / Chapter Skim
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5 Approaches and Models for Multi-Sectoral Engagement
5 Approaches and Models for Multi-Sectoral Engagement
Pages 39-66
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From page 39... ...
. • Partnership energy and momentum can best be sustained through measuring partnership impact, particularly when an evaluation shows that an initiative is positively affecting society, saving lives, and allowing people in low-income countries to lead productive lives (Stevens)
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This chapter summarizes the discussions of both panels. BOX 5-1 Objectives for Session 2: Approaches and Models for Multi-Sectoral Engagement To examine approaches, policies, and models for multi-sectoral engagement with the goal of identifying barriers to engagement and opportunities for facilitating more effective models by • understanding the motivations and approaches of key global health stake holders for multi-sectoral engagement; • highlighting challenges and barriers for different sectors to engineer multi sectoral partnerships; and • discussing models of multi-sectoral engagement by focusing on o value proposition, o barriers encountered and conditions that enabled success, o definitions of success for the different partners, and o measures of success.
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From page 41... ...
To cover both bases, the World Bank focuses on developing durable country institutions and sustainable business models. The World Bank uses a "systematic country diagnosis" to inform its country partnership framework, which delineates its engagement with each country over a period of about 3 years.
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The political dynamics were such that powerful constituencies on the board of the Global Fund opposed the expansion of AMFm and caused its subsequent "integration" into the Global Fund's more traditional grantmaking activities. In reflecting on this example, Adeyi emphasized the importance of determining whether scientific evidence really informed development assistance and the global development of health systems or whether political interests and the convenience of powerful constituencies were the dominant factors.
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Byrkit noted that the Healthy Markets Project is a shared-value approach. Byrkit next outlined, based on the experience of PATH's team, some of the steps a nonprofit may want to take if it seeks to partner with the private sector.
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As a result, more than 4,000 cases of HIV have been diagnosed, and more than 90 percent of these people have received treatment. Such partnerships are important for helping the Vietnamese government reach its goal of eliminating HIV by 2030.
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In total, UNICEF has about 50 global corporate partners; 150 large national partners in the countries where UNICEF operates; and many other small and medium partners in program countries. UNICEF engages with the private sector mainly because engagement can have a broad and significant impact on children.
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Improve SHARED Strengthen and maternal and on maternal and development adolescent GOALS support global child deaths child nutrition outcomes well-being ecosystem Indicator Indicator Indicator Indicator Indicator Drive next INDICATORS generation Indicator Indicator Indicator Indicator Indicator priorities WORKSTREAM ACTIONS Thought PARTNERSHIP Leave No One Building One Partnership & Resources & Country Coalitions Agile Reimagined PRINCIPLES Behind Narrative Co-Investments Ownership & Partners Evaluation Technical Assistance Co-Creation v.2018.10.12 FIGURE 5-1 UNICEF and Gates Foundation shared goals and partnership framework. SOURCE: As presented by Oren Schlein on November 15, 2018.
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World Health Organization Building on Singer's earlier presentation, Gaudenz Silberschmidt, director for Partnerships and Non-State Actors at WHO, focused on WHO's approach for enhancing multi-sectoral engagement based on the FENSA.3 Silberschmidt noted that although Brink proposed in an earlier session the necessity of equitability between private- and public-sector partners, the 194 member states of WHO do not consider themselves to be on equal footing with the private sector because WHO is constrained by the boundaries of its role as an intergovernmental organization. Because WHO is a regulatory agency, private-sector partnerships are required to have clear rules of engagement and address global health challenges with limited funding.
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The organization also belongs to more than 100 partnerships and collaborative arrangements and has more than 700 collaborating centers in academic institutions and government, 214 non-state actors in official relations, and thousands of individual engagements. According to Silberschmidt, WHO has accepted in-kind contributions from companies such as Merck and Novartis and has received 1.2 billion tablets of medication for neglected tropical diseases through private-sector donations.
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Silberschmidt concluded by emphasizing that WHO is committed to strengthening engagement in order to reach the triple billion targets of its 13th General Programme of Work, which Singer mentioned previously. DISCUSSION As session moderator, Valdez opened the discussion by asking speakers for their suggestions about how to raise confidence and comfort levels with public–private engagement and how to expand the reach of public– private collaborations.
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Mutual learning of how each partner functions is essential for forging and operating successful partnerships. Silberschmidt also addressed the misconception that the only people who are needed to work in the health field are doctors and emphasized how people with other skill sets, including partnership and business expertise, are also needed.
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The IFC and World Bank partnered with the Kenyan government and with General Electric to make these diagnostic services more readily available. Monahan asked the speakers to elaborate on the brokering function and to specifically address how to understand brokering subtleties within partner relationships.
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In doing so, the Global Business Coalition was able to identify opportunities that individual partners were unable to identify on their own. The participant also noted that partners included mining and pharmaceutical companies as well as nontraditional private-sector
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This new entity could consider conflicts of interest, opportunities, and pitfalls and could offer advice on how to accelerate initiatives through partnerships. MODELS OF MULTI-SECTORAL ENGAGEMENT AND VALUE CREATION As session moderator, Seema Kumar, vice president of Innovation, Global Health, and Science Policy Communication with Johnson & Johnson, explained that the goal of this session would be to examine several models of multi-sectoral engagement that have successfully created value for partners in both the private and public sectors.
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Regarding funding, Kaszubska explained that pharmaceutical companies typically match every pound MMV donates and provide even more in-kind contributions. With respect to the drug development pipeline,
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leading to visible, measurable confirmatory inreview Preclinical volunteers exploratory success terms of human Post approval lives saved. MMV has estimated that more than 1.5 million lives were Lactate Cysteine dehydrogenase proteinase inhibition inhibition saved by the end of 2017 thanks to successful partnerships.
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For example, one of the diseases to which DNDi was initially founded to respond to is called Human African Trypanosomiasis, or African Sleeping Sickness, which is currently heavily concentrated in the Democratic Republic of the Congo. The disease, transmitted by the bite of the tsetse fly, claimed hundreds of thousands of lives between the 1970s and the 1990s, as well as millions of lives during prior centuries.
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De-linkage "de-links" the cost of financing R&D from the price of products and volume-based sales. DNDi has incubated and helped launch the Global Antibiotic Research and Development Partnership (GARDP)
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Novartis Rebecca Stevens, head of Access Partnerships and Public Affairs at Novartis Social Business, explained that Novartis has had several different models of engagement in the public health space since 2001 and that its goal has been to help enable access to medicine for populations around the world. The company's first global health program focused on malaria.
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Gavi, the Vaccine Alliance Gavi is a PPP created in 2000 to improve childhood immunization coverage and accelerate access to new vaccines in developing countries. Gavi works toward its goal by leveraging the financial, technical, and business expertise of its partners, which include United Nations agencies, country governments, the pharmaceutical industry, the private sector, foundations, and civil society.
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In return, the companies had to ensure a sufficient supply of the vaccine would be available in case an outbreak occurred; apply for approval to use the vaccine in emergency settings; and continue to develop the vaccine and apply for vaccine licensure. Bilimoria noted these efforts were intended to signal to manufacturers that a market for a licensed Ebola vaccine existed.
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The outbreak in the Democratic Republic of the Congo in early 2018, for example, was contained largely because of the effective use of the Ebola vaccine (WHO, 2019)
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Even though MMV built its scientific expertise over time and has been recognized for that expertise, MMV still needs to effectively influence pharmaceutical partners when it comes to drug development strategies. Stevens suggested that trust continues to be a significant challenge.
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She pointed out that the "feel-good effect" of receiving this form of positive feedback sustains energy and that "success begets success" -- referencing the enthusiasm she witnessed among her R&D colleagues as they worked to develop pediatric versions of existing drugs in order to forge solutions to the burdens of disease. Kumar then agreed with the notions that success begets success and that multi-sectoral global health initiatives are significant drivers of employee engagement within the private sector.
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Cohen responded that, although the support of political leaders has been very important, this type of support for neglected tropical diseases such as Human African Trypanosomiasis (African Sleeping Sickness) has never occurred.
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In closing the session, Kumar noted themes of impact and urgency in each model presented and illuminated that each example illustrated either a market failure or another pressing issue (e.g., an Ebola outbreak) that brought together people who may distrust each other.
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