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Panel Detail:

Tuesday, April 28, 2009
2:30 PM - 3:45 PM

Global Health: New Business Models

Moderator:

Seth Berkley, President and CEO, International AIDS Vaccine Initiative

Larry Brilliant, President of the Skoll Urgent Threats Fund and Philanthropic Advisor to Google.org, discusses innovative approaches to delivering health care in developing nations.

Kari Stoever observed that in many cases, such as with neglected tropical diseases, easy fixes exist, but delivery is the big problem. Health philanthropies know where the need is and pharmaceutical companies have donated the medicine, yet they cannot actually deliver the medicine to the communities that need it.

Stoever suggested that one of the reasons for this failure is the need for a regional financing structure that allows communities and regional governments to focus their resources on the particular set of diseases most relevant to the area. Janice Culpepper noted that the Gates Foundation uses grants to encourage pharmaceutical companies to enter into product development that they wouldn't normally touch, such as developing new mosquito pesticides, which do not have a compelling market driver. Culpepper added that this works in part because of public opinion, with pharmaceutical companies desiring to be seen as good global citizens.

Larry Brilliant added that another very specific method of funding global health in underserved markets is to have the rich subsidize care for the poor. According to the Seva model, wealthier clients needing eye care pay for a private room, subsidizing the poor, who cannot otherwise afford care. Seva found that one paying customer subsidizes three unpaid ones (getting the same quality care). Via this model, one of their centers in Nepal has seen enormous revenue surpluses despite treating 80 percent of their patients for free. Alternately, in Bangladesh, Seva convinced Muhammad Yunus to give microloans to individuals needing eye surgery, requiring the loans to be repaid when the person can work again.

In all of this, panelists emphasized the need to listen to communities and practitioners regarding local needs. Stoever also put emphasis on the need for greater efficiency in health spending. She recommended rewarding efficiency, for instance, by having a carry-over, rather than a "use it or lose it" system.

Creative solutions like this are required to address the issues of health funding generally. Much of the financing for diseases is forced into silos such that, even though schistosomiasis appears to be strongly correlated with the higher prevalence of AIDS in young women in Mozambique, practitioners in that country cannot use to $700 million in AIDS treatment funding to help address schistosomiasis.

Culpepper stated that one way around this would be to get people not traditionally from the health field to weigh in on health issues to get new information and new thought into the system. She suggested that agencies are underutilizing human capital because they think only researchers in America and Europe can solve these problems.

Panelists concluded that global health agencies should be looking to everyone they can for answers, even if they are outside the methods traditionally embraced by the public health community, and look for a new way to work in the poorest parts of the world. Potter agreed: "This is where all of us as leaders have to step up and challenge the companies with which we have affiliations."

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