I have always believed that “Good health is a good business”. I presume most people in the for-profit healthcare business also do. I also believe that most of the challenges that this industry faces have been existing for well over 10 years now and are largely known to every provider, insurer and donor. Some of these challenges include unsustainable market payment mechanisms, low health insurance penetration (in emerging and marginalized countries), poor health infrastructure, health personnel deficit and poor drug accessibility (the issue of discussion in the blog).
What we need right now is new and innovative solutions – innovative in terms of business model, distribution model and payment mechanisms etc. to mitigate the known healthcare challenges. These solutions will not only help in addressal of unmet needs of large patient pools (newer market access) but also improve the global health indicators in general. These solutions need to be pursued not only because of the immense revenue opportunity but also because it is our moral, social and ethical responsibility.
The Need & Scope of Opportunity
I was looking at the incidence (the number of new cases in a year) and prevalence (the total number of people currently afflicted with the condition) of a few diseases globally and it completely flummoxed me! I have just chosen a few communicable diseases below to illustrate my point:
- Tuberculosis - Incidence = 7.8 Million; Prevalence = 13.9 Million
- HIV/ AIDS - Incidence = 2.8 Million; Prevalence = 31.4 Million
- Malaria – Incidence = 241.3 Million; Prevalence = 2.24 Billion at Risk (Diseases like Malaria do not have prevalence because it is not a long-term condition, patient are either cured or die within a year)
- Diarrhea - Incidence – 4.6 Billion; Prevalence = n/a (Same reasoning as for malaria; Typically adults have about 4 episodes of diarrhea each year and it is easily treatable with rehydration salts)
Apart from these there are “Neglected Tropical Diseases” which are called so because they are only present in highly marginalized and neglected countries and currently affect more than 1 Billion people globally!!!
Since healthcare always remains a subsidized public commodity, most of the health interventions in low income and emerging countries are carried out through donor funding. To give you an idea of the magnitude of such funding, I have listed out the disease specific funding from a few funds for the above diseases.
- USAID – Tuberculosis = US$ 249 Million; HIV/ AIDS = US$ 3.7 Billion; Malaria = US$ 346 Million
- Bill & Melinda Gates Foundation – Tuberculosis = US$ 121 Million; HIV/ AIDS = US$ 221 Million; Malaria = US$ 243 Million; Diarrhea = US$ 61 Million
- The Global Fund – US$ 21.7 Billion for Tuberculosis, Malaria & HIV/ AIDS
- WHO - US$ 488 Million for Tuberculosis, Malaria & HIV/ AIDS
- UNICEF ~ US$ 280 Million for Diarrhea in Children
Why Care?
Apart from the immense revenue opportunity that exists (highlighted above), the very fundamental reason to be concerned about is this – In the one hour time it took me to write this blog, this happened (globally)*:
- 194 people died due to Tuberculosis
- 205 people died of HIV infections
- 114 people died of Malaria
- 171 children under age of 5 and 126 children over 5 and adults died of Diarrhea
- 183 people died due to the neglected tropical diseases
*assuming the deaths were linearly distributed through the year
So, What is the solution? - More on this in my next post….
You have articulated the problem really well. I am waiting for the solution
All the best!
Let me try to get a better understanding of the post –
How is the funding distributed across countries and pharma industries in a country?
I have not yet looked at that split but the data should be available from the donors’/foundations’ annual reports.
On a high level, most of the funding is geared towards sub-saharan Africa and south east Asia…
[...] Additionally, against an extremely challenging backdrop of declining R&D productivity, a looming “patent cliff” in which more than US$ 150 billion worth branded drugs lose patent protection, industry consolidation – focusing even more on R&D has become an imperative. As Andrew Witty, CEO – Glaxo SmithKline says “The pharmaceutical industry needs to do more with less and still be innovative”. Such challenges could not be more apt for open collaborations between pharma companies, academia and niche specialist firms for rapid innovation. (The importance of alliances in my previous post – here) [...]
[...] my earlier post, I have detailed out the current context in terms of global disease prevalence and the opportunity [...]