Private-Sector Mercy

VICTORIA HALE - New York Times: "BY almost every measure - the spreading disaster of H.I.V. infection and AIDS, the vast suffering caused by malaria - the world is failing to meet the health needs of its poorest people. Yet in the world of public health, there is a growing mood of cautious optimism and commitment based on a novel way of approaching these problems; one that does not rely on Western governments.

In the West, and in developing countries, people and organizations are using proven business strategies to devise workable solutions. This social entrepreneurship is transforming global public health.

Consider the long-standing problem that developing countries have faced in obtaining affordable, effective drugs. The profit-making pharmaceutical business model that works well in generating effective treatments for many diseases in the developed world doesn't work at all for diseases limited to people who have little or no money. Yet it has produced drug leads that could treat and even cure some of the worst diseases that afflict the world's poorest people.

These promising leads are languishing because companies can't justify the enormous costs involved in turning them into therapies that won't return a profit, or even research and development investments. Thus with few exceptions, the pharmaceutical industry has abandoned research on drugs to treat tropical parasitic diseases.

In one case, there had been good evidence that paromomycin, a drug that was first developed 50 years ago as a broad-spectrum antibiotic, would be effective against black fever (visceral leishmaniasis). Black fever afflicts as many as 1.5 million people in the developing world, killing about 200,000 of them annually. Yet the final stages of development for paromomycin were not completed because the drug was no longer being manufactured.

Champions of the drug in Kenya, Sudan and India ensured that paromomycin was not forgotten. Because the patent had expired, my organization, the Institute for OneWorld Health, in partnership with the International Dispensary Association in Amsterdam and the World Health Organization, was able to take paromomycin through the final stages of development without provoking the kind of opposition that, for example, the Brazilian government did with its decision in June to produce a generic version of a patented antiretroviral that AIDS patients in that country desperately need.

Following rigorous testing with guidance from the Indian government, we intend to begin delivery of paromomycin in 2006 in South Asia. Another nonprofit organization, the Drugs for Neglected Diseases Initiative in Geneva, will bring paromomycin to Africa.

Paromomycin won't make anyone rich, but it will save lives and alleviate hideous suffering. For efforts like this to continue to succeed in addressing global health inequities between the richest and poorest, the world needs new business models. There needs to be a more flexible way of addressing intellectual property that encourages and protects innovation yet makes the advances of modern medicine available to most of humanity. Unused intellectual property - drugs, diagnostics and other medical technologies - can be reinvigorated and reinvestigated to ease suffering and save lives.

BUT people are the most important factor - none of these recent successes would have been possible without shared research and the contributions of skilled volunteers from the pharmaceutical field and other professions. Yet it's difficult to take time away from a demanding job as a scientist or financial planner or doctor to do the volunteer work that makes these new approaches possible. What if it weren't?

Just as law firms set aside resources for pro bono work, there should be a systematic way for people from the world's most successful companies to contribute their time and expertise to advance global health. Imagine a kind of Peace Corps for pharmaceutical professionals.

Today, public health is primarily a government responsibility. While we do need governments for implementation and scale, we need to encourage individuals and corporations to bring fresh ideas. And especially, we need to tap innovative social entrepreneurs like Govindappa Venkataswamy, an Indian doctor who turned an 11-bed clinic into the largest eye care facility in the world, and Vera Cordeiro, a Brazilian doctor who is building a health care system to prevent recurring illnesses in poor children. These entrepreneurs use the classic strategies of a start-up business - product innovation, efficiency improvements and a keen understanding of the customer - to find new solutions to the challenge of improving health.

We have the means to help millions of people attain better health and escape poverty. We'll get there faster by creating innovative solutions and making legal and logistical space for these approaches to flourish.

Victoria Hale is founder and chief executive of the Institute for OneWorld Health, a nonprofit pharmaceutical company."