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Oxford Conference on Innovation and Technology Transfer for Global Health. University of Oxford. Bridging the Gap in Global Health Innovation: From Needs to Access. 9-13 September 2007. Health Innovation: The neglected capacity of developing countries to address neglected diseases.
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Oxford Conference on Innovation and Technology Transfer for Global Health University of Oxford
Bridging the Gap in Global Health Innovation:From Needs to Access 9-13 September 2007
Health Innovation: The neglected capacity of developing countries to address neglected diseases Carlos Morel Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Plenary lecture PURPOSE:To address all round tables of this Oxford Conference through the biased lens of a developing country citizen,researcher and decision-maker
Global, neglected and most neglected diseases (WHO & MSF) Most neglected diseases(e.g. dengue, Chagas) World pharmaceutical market(>$600 bn in 2005) Neglected diseases(e.g. malaria, tuberculosis) Global diseases(e.g. measles, diabetes)
Understanding global inequalities Private health spending Malaria cases Dorling D (2007) Worldmapper: The Human Anatomy of a Small Planet. PLoS Medicine 4(1)13-18
Public opinion sees illegal drugs as a major problem all over Africa
On the other hand the need to pay for medical and health care seems to vary among countries (e.g. Uganda x Mali)
Neglected tropical diseases “The neglected tropical diseases are a group of 13 major disablingconditions that are among the most common chronic infectionsin the world's poorest people” Hotez et al, Control of Neglected Tropical Diseases. N Engl J Med 2007, 357:1018-1027
Hotez et al, Control of Neglected Tropical Diseases. N Engl J Med 2007, 357:1018-1027
Relationships between science, technology and production Francisco Sagasti. Knowledge and innovation for development. The Sisyphus challenge of the 21st century, Cheltenham, UK; Northampton, USA:Edward Elgar, 2004. 151 pages
The Sisyphus challenge in Chile… Scientometrics72(1):93-103, 2007
The Sisyphus challenge in Chile… “Developing countries share disbelief about the benefits of the endogenous production of science as a tool for economical growth. Hence, public policies to strengthen science and technology and promote the culture of innovation are, in general, weak and sometimes incoherent” Scientometrics72(1):93-103, 2007
… and in Brazil Morel et al (2007) The road to recovery. Nature 449, in press
Entrepreneurship as ‘Conceptual Orphan’ “While the role of entrepreneurs and entrepreneurship has never been denied, its most debilitating facet is its limited, often cursory, coverage by the great thinkers on economics and business”… Hine and Kapeleris (2006) Edward Elgar Publishing Ltd, UK, 259 pp. ISBN-10 1 84376 584 4
Entrepreneurship as ‘Conceptual Orphan’ Hine and Kapeleris (2006) Edward Elgar Publishing Ltd, UK, 259 pp. ISBN-10 1 84376 584 4
Forms of knowledge and modes of innovation (Jensen et al, 2007) • I. Science, Technology and Innovation - STI • Based on the production and use of codified scientific and technical knowledge (“explicit knowledge”) • High priority to the production of “know-why” • Emphasis on the use of information and communication technology as tools for codifying and sharing knowledge • “Global” knowledge Jensen MB, Johnson B, Lorenz E, Lundvall BA: Forms of knowledge and modes of innovation. Research Policy 2007, 36:680-693.
Forms of knowledge and modes of innovation (Jensen et al, 2007) • II. Doing, Using and Interacting - DUI • Relies on informal processes of learning and experience-based know how • High priority to the production of “know how” and “know who” • Strategies emphasizing the role played by informal communication and communities of practice in mobilizing tacit knowledge for problem-solving and learning • “Local” knowledge Jensen MB, Johnson B, Lorenz E, Lundvall BA: Forms of knowledge and modes of innovation. Research Policy 2007, 36:680-693.
Forms of knowledge and modes of innovation (Jensen et al, 2007) • Know-what • Know-why • Know-how • Know-who Emphasis on STI mode Emphasis on DUI mode Jensen MB, Johnson B, Lorenz E, Lundvall BA: Forms of knowledge and modes of innovation. Research Policy 2007, 36:680-693.
Forms of knowledge and modes of innovation (Jensen et al, 2007): Situations • Situation IOrganizations are specialized in one of the two modes • Situation II Organizations try to manage the two modes STI DUI STI DUI Jensen MB, Johnson B, Lorenz E, Lundvall BA: Forms of knowledge and modes of innovation. Research Policy 2007, 36:680-693.
Forms of knowledge and modes of innovation (Jensen et al, 2007): Indicators Jensen MB, Johnson B, Lorenz E, Lundvall BA: Forms of knowledge and modes of innovation. Research Policy 2007, 36:680-693.
National Innovation & Learning Systems ACTIVENIS (Korea) PASSIVE NLS (Brazil)
GDP per capitaKorea x Brazil, 1975-2004 2004 Brazil: 7.531 Korea: 18.840 1975 Brazil: 5.502 Korea: 3.722
Science failures • Why: Insufficient knowledge • Example: Unknown vaccines • Viral: Dengue, avian flu • Bacterial: Leprosy, TB • Parasitic: Malaria, leishmaniases, trypanosomiases • Need: Basic or “user-inspired” research; “Mode 2” of knowledge production (*) • Innovation modality • New or improved products • New R&D strategies: PDPs; PPPs (Brazil: Innovation Law) (*) Gibbons M, Limoges C, Nowotny H, Schwartzman S, Scott P, Trow M: The new production of knowledge: the dynamics of science and research in contemporary societies. London; Thousand Oaks; New Delhi: SAGE Publications; 1994
Market failures • Why: High costs prevent access to existing interventions or the development and production of cheaper ones • Example: antiretrovirals; combination therapies; new TB drugs • Need: Cheaper production processes; new funding strategies • Innovation modalities • New methods/processes of production • New funding policies (Push: PDPs; Pull: Global Funds) • New budgeting policies • Increasing health budget (e.g. Brazilian taxation on financial transactions) • Decreasing health expenses (e.g. antiretrovirals IPR negotiations between Governments and private sector)
Public health failures • Why: Lack of good governance or sound priorities; corruption; crises/war; cultural or religious factors; etc., prevent the access to cheap and readily available interventions • Examples • Infectious diseases: polio vaccination (Religious or cultural factors); leprosy chemotherapy (Brazil: wrong policy, lack of priority) • Chronic diseases: obesity, tobacco (lobbying by multinational companies) • Needs: Education, civil society mobilization, human rights approach • Innovation modality: Process, strategy innovation • National Vaccination Days; WHO Tobacco Convention; educational TV campaigns (e.g. Brazilian soap operas with health messages); Tanzania’s experience in priority-setting in health systems (*) (*) Savigny, Kasale, Mbuya, and Reid (2004) Fixing Health Systems
A “health failures / innovations needed / country actions” matrix
A “health failures / innovations needed / country actions” matrix
A “health failures / innovations needed / country actions” matrix
A “health failures / innovations needed / country actions” matrix
A “health failures / innovations needed / country actions” matrix
Innovative Developing Countries, IDCs (*) Morel et al (2005) Innovation Strategy Today 1(1):1-15http://www.biodevelopments.org/innovation/index.htm
Innovative Developing Countries, IDCs (*) Morel et al (2005) Innovation Strategy Today 1(1):1-15http://www.biodevelopments.org/innovation/index.htm
LDCs IDCs OECD and the six components of health innovation 6 components or determinants LDCs IDCs OECD (*) Morel et al (2005) Innovation Strategy Today 1(1):1-15http://www.biodevelopments.org/innovation/index.htm
Developing Country Vaccine Manufactures’ Network • Brazil, Cuba, China, India, Indonesia, Mexico • WHO Developing Countries’ Vaccine Regulators Network • Brazil, China, Cuba, India, Indonesia, Russia, South Africa, South Korea, Thailand Morel et al (2005) Science 309:401-404, 2005
National Health Innovation System Morel et al (2005) Science 309:401-404, 2005
Collaborative research network on leprosy involving Brazilian researchers Morel et al (2007) The road to recovery. Nature 449, in press