WHO Emergencies Head Praises Collaboration With Pharma On Ebola, Calls For Expanded “Strategic” Collaboration

The current Ebola outbreak in the Democratic Republic of Congo (DRC) is the second largest ever, occurring in a “perfect storm” of a densely-populated conflict zone. Yet thanks in large part to a strong collaboration between the World Health Organization and the pharmaceutical industry, the outbreak has so far remained confined to two DRC provinces, says Peter Salama, WHO deputy director general for emergency preparedness and response. 

Peter Salama takes a question at IFPMA’s event

Salama spoke yesterday at a panel on global health security at the annual assembly of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) in Geneva, also marking the 50th anniversary of the federation’s creation.

In an opening address, Thomas Cueni, IFPMA director-general, said future private-public sector cooperation will need to involve greater focus on health systems strengthening, adding that industry is ready to “leave the trenches of our comfort zones and work together.”

“We see governments struggling to provide basic services. It is not just about medicines but about health systems,” Cueni said. “We are here today to build bridges among the world’s best global health actors.… We need to reach out in partnerships … to better serve the needs of underserved populations, to be part of solutions, champion and deliver better health for everyone.”

Salama cited the intensive cooperation occurring right now between public and private sector actors over the DRC Ebola outbreak, as a foundation for expanded strategic collaborations.

“The current outbreak is occurring in the context of what I have described as a ‘perfect storm’,” Salama said in a keynote address. “An outbreak of a terrifying viral haemorrhagic fever with case fatality rates between 50 and 80 percent, in the midst of a brutal civil conflict with more than 20 active armed rebel groups, in a dense urban setting … with a highly mobile population of refugees and internally displaced persons, close to international borders, in a province with an unregulated, mainly private and traditional health sector which has become a vector for disease transmission, and all this, during an election period.”

Yet so far the outbreak has been confined, not crossing international borders, Salama noted, saying. “One of the main reasons for this is the strong collaboration between WHO and your members under the Research and Development Blueprint.”

As part of the blueprint collaboration, WHO together with the DRC Ministry of Health, has managed to vaccinate more than 40,000 people in the DRC province of North Kivu under a research protocol with the investigational VSV-EBOV vaccine (which needs to be maintained in challenging cold chain conditions of -60°C to -80° C prior to use).

Investigational therapeutics are being given to patients under ‘compassionate use’ – “the drugs that you or I would want to receive were we to contract Ebola and be medically evacuated to our home countries,” Salama added.

And two weeks ago, the first-ever randomized clinical trial for Ebola therapeutics was launched in the DRC. “Collectively, we have sent a very strong message to a marginalized community, traumatized by decades of violent conflict – that we believe they should have access to the same type of medical products that others have around the world – in fact even more so, because they are at greater risk,” Salama said.

Citing DRC as a “poster child,” Salama said he wants to see expanded partnerships with the private sector based upon broad “strategic” aims addressing those most in need.

“Our partnerships need to move from a transactional approach to a strategic one,” Salama said, designed around broad common interests rather than limited corporate social responsibility projects.

The countries falling furthest behind are not necessarily the poorest, but those with the weakest health systems, particularly fragile states in conflict zones, he added.

Salama also said in his remarks:

“Think plague in Madagascar, wild polio on the Afghan-Pakistan border, yellow fever in Angola, cholera in Yemen, diphtheria among Rohingya refugees in Bangladesh, measles in Venezuela, meningitis in northeastern Nigeria or Ebola in DRC. Conversely, when we review our global goals under the Sustainable Development Framework, we see that the same set of countries accounts for more than 50 percent of most of the unmet targets- whether for under 5 mortality, maternal mortality or under-immunized children. Most of our global health battles will be won or lost in these countries.”

“This is why our director general, Tedros, talks about global health security and universal health coverage being the twin sides of the same coin…

“So how do we do it?” Salama asked. “Industry needs to, of course, continue to do what it does best – to innovate, to bring the safest and most effective products to licensure, and to market at the scale required, and to create value.

“However, I would argue that you will increasingly need to work even more closely with International organisations such as WHO to help define the public health priorities, to rely on us to provide the normative and enabling environment, to be an impartial broker and to help overcome market failures, in collaboration with GAVI, CEPI, GFATM and others, in order to ensure that your products reach the poorest and most vulnerable, in the fastest and most equitable manner, and therefore have the great public health impact.

“We are on the ground in more than 150 countries – we can help you walk in the shoes of the people living in the most precarious settings on earth and the clinicians working without internet, electricity, or running water. We must remain relevant to their needs at all times. As WHO, we should also not be shy in asking you to support global public health goods from which you derive a direct benefit, such as PIP [pandemic influenza preparedness], the blueprint or WHO’s Contingency Fund for Emergencies, at a scale commensurate with your means, as major publicly listed companies…. Not as a charitable contribution … but as an investment. A safer world benefits everyone. UHC [universal health coverage] will benefit everyone.

“And finally, let’s continue to challenge our assumptions, both epidemiological and commercial. We once considered Ebola to be a disease affecting only a few countries in central and east Africa with rural, isolated outbreaks that may have largely been self-limited. Now we see the transmission pattern is changing…. This will demand a different response from governments keen to protect their national security interests…. It will also have major implications for the markets for such products. As Ebola marches through the Kivus towards the east African transportation hub of Goma, the virus is exploiting social vulnerabilities and fault-lines nationally, regionally and globally, just as HIV and other diseases have done in the past. These are the issues, contexts and priorities for global health in the future. We count on our partnership with IFPMA to tackle them. “

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Separately, at the IFPMA Assembly, David A. Ricks, chairman and chief executive officer, Eli Lilly and Company, was elected as president of IFPMA, taking over from Ian C. Read, Chairman of the Board and Chief Executive Officer, Pfizer.

An IFPMA press release said that Ricks will highlight the need for “forward-looking policies that encourage innovation, as well as strengthened health systems in order to sustain the last-half century’s hard-won global health gains.”

 

Image Credits: IFPMA.

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