GMF Summit Abu Dhabi

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GMF Summit Abu Dhabi Building Superior Healthcare
Systems How to fund basic research and how to
link local research laboratories with global
centres 1-3 May 2005 Dr Chris Hentschel, CEO,
MMV
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Health Warning !!

• This presentation is more about translational
  research for public good than basic research.
• The latter can only happen if the former is
  functioning effectively.

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Leading Causes of Death for Children under 5 in
the WHO African Region
Rank
of all deaths
Malaria
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20.3
Respiratory inf.
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17.2
Diarrhoea
3
12.3
HIV/AIDS
4
9.0
Measles
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8.4
Low birth weight
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5.8
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In 2005 we have the largest healthinequity in
human history
Aiko one day old. Born Osaka Japan
Mariam one day old. Born Freetown Sierra Leone
A girl born in Japan is expected to live on
average 50 years longer than one born in Sierra
Leone
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 Africa South East Asia are the main endemic
regions in 2005  
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 Middle East is relatively free of Malaria  

• In Africa, endemic malaria is absent only in
  Libya, Lesotho, and Tunisia.
• In the Middle East and Western Asia, including
  the Indian subcontinent, endemic malaria is
  absent in Bahrain, Cyprus, Israel, Jordan,
  Kuwait, Lebanon, the Maldives, and Qatar.
• There is no risk of malaria in Abu Dhabi, or
  Dubai
• Some limited risk in the northern emirates
  bordering Oman's Musandam Province reported by
  CDC.
• Malaria is inversely correlated with GDP
• per capita

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Resistance developmentneed for continuous drug
discovery
 Drugs can be very effective but inappropriate
use has led to a major problem of resistence  
The Thai border areas Nick White (Mansons
Tropical Diseases)
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Drug resistance ? Treatment failure ? Die of
malaria

• Evidence from Africa is that childhood malaria
  deaths rise 2 to 11 fold where resistance to
  outdated malaria drugs is found (i.e. almost
  everywhere).

Talisuna AO, Bloland P, DAlessandro A (2004).
History, dynamics and public healthimportance of
malaria parasite resistance. Clin Microbiol Rev
(2004)
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 MMV  Objectives and Remit (1)  

• MMV is
• A nonprofit organization created to discover,
  develop and deliver new affordable antimalarial
  drugs through effective public-private
  partnerships.
• Its vision
• A world in which affordable drugs will help
  eliminate the devastating effects of malaria and
  help protect the children, pregnantwomen, and
  vulnerable workers of developing countries from
  this terrible disease.

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But the road to new drugs is long, complicated
and very expensive!










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94 of Global Drug RD in just 8 countries in
1994 In 2005 US dominance even greater!
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MMVs approach Public-Private PartnershipThe
Win-Win Proposition using virtual RD
Public

• MMV Input
• Background IPR
• Link to WHO/RBM
• Malaria Expertise

• MMV Gets
• Rights for public use
• IPR in Field
• Drug Supply
• Return on private sales

Joint RD

• Pharma Input
• RD Facilities and staff
• Chemistry IPR
• Toxicology
• Know How
• Assets in Kind
• Technology
• Liability Insurance

• Pharma Gets
• Rights for private use
• IPR outside Field
• PR Benefit
• HR Benefit

Private
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Three stages of the Portfolio process
MMVs approach to RD partnership. Portfolio
Management
Product Extension or Life Cycle
Management Process
Front End Evaluation Process
RD Management Process
Many years needed for full cycle to evolve!
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MMVs approach to partnership. Portfolio
Management

• Portfolio management is one of the most
  important senior management functions for
  product successful innovation
• R.G. Cooper S.J. Edgett E.J. Kleinschmidt July
  2001 RD Management, vol 31, no. 4, 2001
• It Reduces Risk
• Creates Synergies
• Optimizes use of Resources

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MMVs RD efforts are virtual and use excess
capacity in the pharma and biotech industry.
OZ project
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The worlds largest ever malaria drug innovation
portfolio the GSK example
Exploratory Discovery Preclinical Clinical
Development Lead Lead Transition Phase
I Phase II Phase III Identification Optimization
Dihydrofolate reductase (DHFR)
Glyceraldehyde-3-phosphate dehydrogenase
Artemisone (semi-synthetic endoperoxide)
Chlorproguanil-Dapsone (LapDap) Artesunate
Fatty acid biosynthesis (FabI)
Falcipain inhibitors
Fatty acid biosynthesis (FASII)
New dicationic molecules
Peptide deformylase inhibitor (PDF)
Pyronaridine artesunate
DB289
Intravenous artesunate
Entantiomers 8-amino quinolines
DHA Piperaquine
Novel Tetracycline
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GSK DDW TRES CANTOS
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GSK DDW TRES CANTOS
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The GSK/MMV Projects arose from a history of
collaboration dating back to 1998

• December 1998 First MMV Call for Letters of
  Interest
• July 2000 - July 2003 Consortium LDH Inhibitors
  LSHTM, Bristol UK and GSK
• July 2001 Consortium Falcipains Inhibitors USCF
  and GSK.
• January 2002 Transfer of Falcipains Inhibitors
  Project to Tres Cantos
• June 2003 MMV-GSK Tres cantos Miniportfolio
  Agreement
• Q1 2004 Pyridones selected by MMV as Project of
  the Year 2003.
• May 2004 Pyridone GW844520 selected as candidate
  for preclinical development

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MMV receives funding from philanthropic
organisations

• Bill and Melinda Gates Foundation
• Rockefeller Foundation
• The Wellcome Trust
• ExxonMobil Corporation
• USAID
• Netherlands Minister for Development Cooperation
• Swiss Agency for Development and Cooperation
• United Kingdom Department for International
  Development
• World Bank
• World Health Organization
• Roll Back Malaria
• BHP Billiton
• Philanthropy Morality Enlightened Self
  Interest

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MMV receives funding from corporations

• Bill and Melinda Gates Foundation
• Rockefeller Foundation
• The Wellcome Trust
• ExxonMobil Corporation
• BHP Billiton
• USAID
• Netherlands Minister for Development Cooperation
• Swiss Agency for Development and Cooperation
• United Kingdom Department for International
  Development
• World Bank
• World Health Organization
• Roll Back Malaria
• Extractive industries suffer huge productivity
  losses in Africa due to malaria

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MMV receives funding from governments

• Bill and Melinda Gates Foundation
• Rockefeller Foundation
• The Wellcome Trust
• ExxonMobil Corporation
• BHP Billiton
• USAID
• Netherlands Minister for Development Cooperation
• Swiss Agency for Development and Cooperation
• United Kingdom Department for International
  Development
• World Bank
• World Health Organization
• Roll Back Malaria
• OECD countries have pledged to increase
  development aid to 0.7 GDP and malaria is
  considered one of the most tractable
  development problems

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MMV receives funding from international
organisations

• Bill and Melinda Gates Foundation
• Rockefeller Foundation
• The Wellcome Trust
• ExxonMobil Corporation
• BHP Billiton
• USAID
• Netherlands Minister for Development Cooperation
• Swiss Agency for Development and Cooperation
• United Kingdom Department for International
  Development
• World Bank
• World Health Organization
• Roll Back Malaria
• These organizations have malaria control as one
  of their core aims

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Conclusions

• MMVs publicprivate partnership operational
  model of virtual pharmaceutical RD has been
  recognised by a broad group of Stakeholders
  (investors) as very efficient and cost-effective.
• It can be franchised to any situation where
  healthcare innovation can benefit both public and
  private interests.
• It focuses on key added value RD steps and can
  help fast-track the healthcare innovation
  process

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Conclusions

• Excellence in healthcare is not only about how
  well one achieves local and regional aspirations
  it is also about the global impact.
• Innovation to produce global public goods in
  healthcare is one of humanities noblest pursuits

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Investment today gt Health Impact tomorrow
To end this cycle of suffering and poverty,
governments and the private sector must
accelerate malaria research Bill Gates, Manhiça,
Mozambique, 23 September 2003
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Thank You