23 February 2009

Press Conference on Maternal, Girls' Health, Neglected Tropical Diseases

23 February 2009
Press Conference
Department of Public Information • News and Media Division • New York


In the race to combat neglected tropical diseases and advance children’s health in today’s uncertain financial climate, there was an urgent need to creatively engage Governments, the private sector and civil society in developing solutions, said the head of the United Nations Office for Partnerships today.

“We cannot simply rely on philanthropy alone,” Executive Director Amir Dossal said at a Headquarters press conference.

He was joined by an expert panel which included Marianne Barner, Head of the IKEA Social Initiative; Bernard Pécoul, Executive Director of the Drugs for Neglected Diseases Initiative; Sophie Delaunay, Executive Director of Médecins Sans Frontières; Kari Stoever, Managing Director of the Global Network for Neglected Tropical Diseases Control; and Nikhil Seth, Director of the Office for ECOSOC Support and Coordination in the Department of Economic and Social Affairs.

Introducing the experts, who previewed this afternoon’s special event on philanthropy and the global public health agenda, Mr. Seth said that meeting was expected to attract 400 leaders from the corporate and philanthropic communities, including former United States President Bill Clinton.  It would foster discussion and enable the corporate philanthropy movement to hear Government perspectives.

Describing the IKEA Social Initiative, Ms. Barner said its funding provided infants with immunization and vitamin supplements, advocated for breast feeding, created a healthy environment for children at home and in school, and ensured better water safety and sanitation.  Its mission was to improve the life and “rights opportunities”for children.

With that, she announced a $48 million donation to the United Nations Children’s Fund’s (UNICEF) programme in India, which would impact 90 million people: 80 million children and young people, and 10 million women.  That brought IKEA’s total investment in India to $120 million, and its total commitment to UNICEF to $180 million globally until 2015.

“We believe that many small steps yield big results,” she said, adding that the Initiative took its lead from IKEA’s core values in striving to invest in simple, cost-effective and meaningful approaches.

Speaking next, Mr. Pécoul asked whether Governments had contracted sleeping sickness, as public sector investments in neglected diseases had been abandoned.  “We are far from finding solutions to these challenges, even if some Governments or some philanthropists have started to respond to this issue.”  Patients were still dying from the vicious cycle of poverty and disease.  It was time to act, as the poor were the most affected by economic crisis.

He explained that the Drugs for Neglected Diseases Initiative was created five years ago by Médecins Sans Frontières, the Pasteur Institute and four public research institutes from Kenya, Brazil, India and Malaysia.  Efforts centred on developing new treatments for sleeping sickness; kala azar, a parasitic disease prevalent in India, Bangladesh and parts of Eastern Africa; and chagas, prevalent in Latin America.

The goal was to bring six to eight new treatments to the market in 10 years, he said.  After five years, three had been delivered; two for malaria and a third -- a combination therapy -- for sleeping sickness, a fatal disease in all cases.

With the new combination treatment, there was now a safer alternative to the currently used arsenic derivative treatment, which, when injected, killed 1 in 20 patients.  The field needed to go further, and “we need to have an environment that is much more sustainable than the one we have today”, he explained.  Innovative funding was needed from the public and private sectors.

Moreover, he said, Governments had an important role to play in research and development, particularly in addressing intellectual property issues and providing support from regulatory bodies.  At the end of the day, however, most research and development had to be done by researchers, and he stressed the need for transferring technology and strengthening the capacity of developing countries.

At the same time, Ms. Stoever pointed out that “some of the best models of creative capitalism come through the neglected tropical diseases, and are often very understated”.

The Bill and Melinda Gates Foundation recently announced a $34 million grant to the Global Network to scale up control of several of the most neglected tropical diseases: intestinal parasites; schistosomiasis, the second most problematic disease among the poor in Africa next to malaria; lymphatic filariasis; onchocerciasis, or “river blindness”, which affected 37 million people mainly in Africa; and trachoma.  These were “tool ready” diseases, meaning that treating them was either free or at very low cost: less than 50 cents per person annually.  Together, they accounted for 90 per cent of the global disease burden.

The grant aimed to create regional funding mechanisms to expand coveragein countries -– a fundamental shift away from how aid traditionally was disseminated by large funding mechanisms, she said.  The Network hoped to partner with regions, countries and regional development banks in those efforts to get better coverage.

Second, it hoped to raise additional money.  “We are talking about pennies for many of these medications,” she said.  “In this economy, I think we have the right set of interventions for the right limited-resources environment we are in.”  By way of example, she pointed to work done in Viet Nam, which had almost eliminated trachoma and lymphatic filariasis.  Covering the remaining 24 million children would cost 3 cents per person per year, or $700,000.  “That’s something we can afford to do”.

Ms. Delaunay said there was a critical need for greater Government leadership to stimulate medical innovation for neglected diseases in the poorest corners of the world.  Médecins Sans Frontières doctors were forced to care for thousands of patients with chagas disease and African sleeping sickness, among others, with treatments, which, when available, were largely toxic, ineffective or unaffordable.  Treatments for the chronic form of chagas, which had been discovered 100 years ago, were non-existent.

Some 20 to 30 per cent of those with chagas would develop the chronic form, a process that could take 20 years to manifest, by which time the damage to the heart was catastrophic and available drugs were useless, she said.  The most effective treatment for kala azar -– Ambisome -- was too expensive for most health ministries.  For example, it was $450 per patient in Bihar, India, a price that could climb to $2,500 per patient.

She said the lack of safe and effective medicines for those neglected diseases was completely unacceptable; resorting to drugs or diagnostic tools that had not evolved in more than half a century was totally outrageous.  The support of Médecins Sans Frontières for the Drugs for Neglected Diseases Initiativewas a response to Governments’ “shocking” lack of urgency for the most neglected diseases, which, according to the World Health Organization (WHO), put 500 million people at risk.

Taking questions, first on a perceived drop in philanthropy in the current economic climate, Mr. Dossal said there remained a high demand to work on social causes.  The challenge facing the United Nations was how to engage a company in a way that satisfied its bottom-line commitment to shareholders.  He had just come from a meeting of the Committee Encouraging Corporate Philanthropy, in which there had been calls for investing in the poor so that they eventually could become consumers.  He added that there had been a change in the level of the wealth structure of financial institutions.

Ms. Stoever believed the current environment would make the field more efficient and “a little smarter” with resources.  It might cause attrition, but that was not always as bad thing.  It might increase competition or create efficiencies.  She was working with a Dubai private equity firm that was looking at emerging markets in Rwanda and Burundi.  It was funding her organization’s work because it recognized a link between development, economic prosperity and diseases of poverty.  If philanthropists could show value, for example, and an ability to discuss the social return on investment, they could make headway.  In India, $1.5 billion was lost annually in productivity from lymphatic filoraisis.

Mr. Seth added that official development assistance (ODA) would decline in the present financial crisis if history was any indicator, and stakeholders were looking at more innovative ways to meet that gap; low-cost solutions existed.

Asked about the Indian Government’s refusal to accept international help after the Asian tsunami, and whether it had been approached to fund disease projects, Mr. Pécoul said the Drugs for Neglected Diseases Initiativehad a strong connection in India, and expected funding to come in.

Ms. Stoever, asked to what extent her organization focused on capacity-building in developing countries, responded that there had been success in Africa in engaging communities.  Ten years ago, WHO had outlined a community-based approached to care, and there were today almost 500,000 trained drug distributors throughout Africa.  What if bed nets were added to that distribution network?

Taking a query on patent pools and whether pharmaceutical companies had done enough to allow for the development of generic drugs, Mr. Pécoul said patent pools could be an attractive strategy.  In the field of infectious diseases, “we have to combine different treatments to improve efficacy”, he said.  Ms. Delaunay added that Médecins Sans Frontières had been a great supporter of the patent pool.

Asked whether participants were optimistic about reaching their funding targets, Mr. Pécoul said he was not optimistic, but rather conscious of difficulty.  Ms. Stoever added that her Network needed $3 billion over three years; not much, but she was cautious.  The onus was on her as the Managing Director to show results and that her organization could make the most out of limited resources.  She believed that if it continued to show that, funding would continue.

Asked about the Democratic People’s Republic of Korea, Ms. Delaunay said the situation had not changed since her speech to the United States Congress in 2002.  The incapacity of the Office of the United Nations High Commissioner for Refugees to grant safe passage had not improved.

To a further question, she explained that Médecins Sans Frontières was a humanitarian organization with no political agenda.  It would be difficult to outline the impact of United States State Department policy towards the country.  The organization had supported Koreans, inside the country and those seeking asylum in third countries, for more than 10 years.  It had experienced both the “soft landing” policy and a tougher policy over the last eight years, but that had not affected its access to the most vulnerable.  Without a “common front” among non-governmental organizations to ask the “North Korean Government” to grant access, there would be no progress.

Asked about a recent report of Médecins Sans Frontières on the United Nations Organization Mission in the Democratic Republic of the Congo (MONUC), Ms. Delaunay acknowledged the United Nations difficulty in providing enough troops, but said that the experience in Haut-Uele was “outrageous”.  Everyone should bear responsibility for what was happening.  Hopefully, the report would push MONUC to obtain more resources to better protect that population.

* *** *

For information media • not an official record
For information media. Not an official record.