Center for Global Health R&D Policy Assessment

In the world of global health R&D policy innovation, we often tend to look to North America and Europe for the exciting new ideas. It is true that a number of new policies and programs, such public-private partnerships (starting with MMV in Geneva and IAVI in New York in the late 1990s), the advance market commitment (spearheaded by the governments of the UK and Italy), and priority review vouchers (a US FDA program), originated in the North.

But what about policy innovations in Southern countries? My recent visit to India brought home forcefully that many important R&D policy initiatives are also likely to be percolating in developing countries, especially in the large emerging science and technology giants like India, China, Brazil, and South Africa.

What I came across in my few days in Delhi was no doubt only the tip of the iceberg, yet it was still impressive:

•Dr. Altaf Lal, the CEO of the newly established Hilleman labs, told me about the new business model he is heading up to develop new or better-adapted childhood vaccines, starting with the vaccine to prevent acute rotavirus diarrhea. Hilleman, set up last year as an independent non-profit joint venture of Merck vaccines and the Wellcome Trust, is hiring scientists and seeking additional funding to design and test these cheaper vaccines that meet the needs of developing country clinical conditions. On-going work includes efforts to develop oral vaccines and vaccines that do not require refrigeration. Revenues on future sales will be ploughed back into the lab.

•Dr. Shirshrendu Mukherjee, the Strategic Advisor for the Wellcome Trust’s India's R&D Initiative from the Department of Biotechnology, explained to me about the extensive partnership between Wellcome, the large UK-based biomedical philanthropy, and the government of India to build scientific capacity. Wellcome and the government are together sponsoring fellowships worth tens of millions of pounds for Indian researchers to work with Indian research institutes, at the same time that Wellcome has contributed 40 million pounds to the Hilleman Labs.

•At the India offices of PATH, the departing country director Steve Davis, the incoming office director Tarun Vij, the VP for country programs Ayo Ajayi, and one of their key technical advisors, Lysander Menezes, described the wide range of collaborations that the Seattle-based organization is undertaking in India with local companies to manufacture new vaccines to prevent Meningitis and other diseases and to develop new diagnostic tests and nutrient rich foods.

Underpinning all of these efforts, the Indian government is investing money and political capital to strengthen the country’s position as a biomedical innovator and product developer. Two key government departments, the Department of Biotechnology (DBT) and the Central Scientific and Industrial Research agency (CSIR) are pouring literally tens of millions of dollars each year into a variety of programs aimed at small Indian biotech firms, university research groups, as well as CSIR’s own network of public research institutes. And they are sponsoring cutting edge programs such as CSIR’s Open Source Drug Discovery project for new tuberculosis drugs.

So where is India heading with its government and public-private collaborations? Will this have a large and demonstrable impact on the development of new, affordable, and highly effective drugs, vaccines, and diagnostics? Will these new health tools help the poor of India and other countries? How effective are these ongoing projects and initiatives? -- there appear to be relatively few evaluations of them.

Clearly, there are many unanswered questions and uncertainties. But I came away from my short visit to India thinking “When it comes to biotechnology policy innovations, watch this space – exciting things are happening.”