Hassan Masum, Abdallah S. Daar, Sara Al-Bader,
Ronak Shah, and Peter A. Singer
Accelerating Health Product
Innovation in sub-Saharan Africa
Before the Bill and Melinda Gates Foundation began to make its extraordinary
Beiträge, little funding was available for scientific discovery to address the
major health needs of the world’s billions of poor.1 The financial stimulus of the
Gates Foundation, along with investments from other foundations and govern-
ments and contributions from the private sector, has improved the situation dra-
automatisch.
Now many public-private partnerships, such as the Medicines for Malaria
Venture (MMV) and the Foundation for Innovative New Diagnostics (FIND),2
focus on product development to fill a hitherto largely empty product pipeline.
Hassan Masum is a senior research coordinator with the McLaughlin-Rotman Centre
for Global Health. He holds a PhD in Computer Science and has worked with aca-
demic labs, government, engineering firms, and the National Research Council of
Kanada. He is a contributing author to WorldChanging: A User’s Guide to the 21st
Century and Collective Intelligence: Creating a Prosperous World at Peace.
Abdallah S. Daar is a senior scientist at the McLaughlin-Rotman Centre for Global
Health, University Health Network and University of Toronto, and Professor of Public
Health Sciences and of Surgery at the University of Toronto. He is a fellow of the Royal
Society of Canada and of the Academy of Sciences for the Developing World (TWAS).
He won the UNESCO Avicenna Prize for Ethics and Science in 2005.
Sara Al-Bader is a PhD student at the McLaughlin-Rotman Centre for Global Health,
focusing on life sciences innovations in South Africa and Ghana that address health
needs.
Ronak Shah is a research assistant at the McLaughlin-Rotman Centre for Global
Health, working on ways to commercialize health biotechnology in Africa.
Peter A. Singer is interim director of the McLaughlin-Rotman Centre for Global
Health, University Health Network and University of Toronto, and Professor of
Medicine at the University of Toronto. He is also a fellow of the Royal Society of
Canada and the Canadian Academy of Health Sciences, a member of the Scientific
Advisory Board of the Bill and Melinda Gates Foundation Grand Challenges in
Global Health initiative, and recipient of the 2007 Michael Smith Prize for Health
Research from the Canadian Institutes of Health Research. He is the corresponding
author for this article: peter.singer@mrcglobal.org.
© 2008 Peter Singer
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The success of these partnerships is only now beginning to become apparent, pro-
haps most obviously in the fact that a malaria vaccine now seems within reach.
Newer initiatives like the Grand Challenges in Global Health,3 and delivery initia-
tives like Advance Market Commitments,4 have further enhanced the pipeline of
new products to address diseases of the poor.
We applaud these initiatives, believe they require increased support, and deeply
hope that as many affordable and effective products as possible will emerge from
the pipeline. Jedoch, now that we are beginning to see a global value chain of
health innovation, the time is right to reflect on the balance between innovation in
the northern and southern hemispheres. At present most of the discovery occurs
in the North, for delivery in the South.
In diesem Artikel, we address a core question: “How can we accelerate the science-
based development of health products and services in Africa?” We answer this
question by suggesting a concrete action plan, based on African voices: health con-
vergence centers and venture funding to stimulate the development of science-
based health products and services.
Before delving into the “how” of such an action plan, we want to address the
“why.” We see at least four good reasons for such a plan. Erste, as local entrepre-
neurs are in touch with local consumers, they know their needs and financial
restrictions. In der Tat, the Silicon Valley entrepreneur and inventor Bala Manian
pointed out that he had to unlearn all he had learned in Silicon Valley before he
could effectively innovate health products in India.5
Zweite, in the long term, dependency breeds resentment. Unless they partici-
pate actively in discovery and development, citizens of the developing world may
increasingly resent being excluded from the improvements in wealth and capabil-
ity that flow from innovation.
Dritte, local market demand is substantial and growing, and people want bet-
ter or more appropriate health products and services that are not yet available
locally. Local innovation can tap into this demand to create self-sustaining cycles
of local development and delivery.
Endlich, ingenuity knows no borders, as global firms discover when they seek to
identify talent in emerging economies. While the world is beginning to tap into
ingenuity in the emerging economies of India and China, ideas and talent are still
being wasted in Africa, because barriers keep ideas from getting to market and few
value-added jobs are available locally.
Science-based health innovation in Africa will be different from the U.S.
Modell. UNS. biotechnology developed with massive investments of public research
funds through the National Institutes of Health; venture capitalists then cherry-
picked the most commercially attractive prospects. The scorecard for the industry
as a whole is not compelling, although some firms have done extremely well.6
Innovation in Africa would proceed along a very different path, perhaps more akin
to the way Indian companies developed: focus initially on immediate market needs
to produce revenues and then use that revenue to move up the value chain and
grow by re-investing retained earnings.7
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Accelerating Health Product Innovation in sub-Saharan Africa
A question naturally arises: is an innovation-based approach more effective
than simply applying existing technologies better, such as by providing more med-
ical services and drugs? But this is a false dichotomy, as we must meet present
needs and pursue future opportunities simultaneously. Zum Beispiel, decades ago
vaccines evolved from a scientific novelty to a mainstay of global public health.
Ähnlich, why would anyone today want to use only bed nets to fight against
malaria? We should pursue both approaches: bed nets address immediate human-
itarian needs, while vaccines could, in the future, eliminate the need for bed nets.
This strategy should not be viewed as “either-or,” but rather as constructing the
near and longer-term future simultaneously.
Several high-level reports from the U.N., African Union, and other organiza-
tions have recognized the potential of the life sciences industry to address Africa’s
health and environmental challenges, and to channel growing indigenous scientif-
ic and entrepreneurial capacity toward innovative health products and services.
Other nations—including India, China, and Brazil—have already experienced suc-
cesses on this path. Surely the faster-developing and better-governed African
regions can move toward joining them, especially if they focus on areas of strength
and share best practices and resources among themselves. While it is not easy to
approach the depth of expertise and breadth of market opportunities of India or
China, a co-operating network in Africa would have the advantages of increasing-
ly integrated regional markets, external support, and prior models to learn from
(including some life science and health successes in smaller developing nations
such as Cuba).
Our research in Ghana, Tanzania, and Rwanda indicates that key elements of
science-based health innovation and commercialization do exist, but face a critical
obstacle: the lack of linkages and skill flows between scientists, entrepreneurs,
investors, and other actors. In Beantwortung, our proposed network of “health conver-
gence centers” would stimulate R&D-based health entrepreneurship, and the ven-
ture fund would invest in opportunities in the network and elsewhere. The goal is
to bring together science, business, and capital into a critical mass of cross-learn-
ing players. We believe this will lead to the development of entrepreneurship and
of affordable health products and services focused on local needs. Ultimately the
macro-economic benefits of high-quality job creation will capture the value of
indigenous innovation.
AFRICAN HEALTH CHALLENGES AND INDIGENOUS R&D
At present, no vaccines are effective against malaria, HIV, or TB. The millions of
African deaths each year from these and other diseases are an economic and
humanitarian disaster. Without HIV/AIDS, a Commission for Africa report sug-
gests, the GDP of 33 African countries would have grown an extra 1.1 percent per
year between 1992 Und 2002.8 The direct and indirect costs of malaria may total up
Zu 3 percent of GDP in the malaria-endemic countries of sub-Saharan Africa, yet
even this statistic understates malaria’s long-run cumulative effects.9
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But such statistics also indicate the possibility of dramatic “returns on invest-
ment” from effective health products, especially where low-cost products can treat
high-prevalence diseases like malaria. Effective investments in health innovation
can boost a nation’s long-term productivity and economic development.
Across the continent, investments in S&T (science and technology) are increas-
ing. Mohamed H.A. Hassan, the executive director of TWAS, the Academy of
Sciences for the Developing World, describes recent progress in African scientific
Kapazität:
Rwanda has boosted expenditures on science to 1.6% of its gross domes-
tic product (BIP), striving for 3% within the next 5 Jahre. Research and
development funding in South Africa is scheduled to grow to 1% of its
GDP by 2009. Nigeria plans to invest $5 billion to create a national sci- ence foundation. Uganda, with a $30 million loan from the World Bank,
will establish a fund for research initiatives to be selected through a
nationwide merit-based competitive process. Zambia, with a $30 million loan from the African Development Bank, will offer postgraduate fellow- ships to train some 300 science and engineering students in its country.10 Hassan also ties this progress into broader advances in life sciences capacity, as well as South-South cooperation.11 To give two other examples, the African Institute for Mathematical Sciences, in collaboration with the universities of Cambridge and Oxford, has been training a growing number of postgraduates since 2003; it aims to “expose some of the brightest people in Africa to scientific culture at the high- est level and thereby help them acquire the tools to develop desperately-needed fundamental new technologies.”12 And NEPAD, the New Partnership for Africa’s Development, has launched an initiative mapping the science landscape of Africa using science, Technologie, and innovation indicators.13 Investments in health R&D in Africa have already brought modest successes. The Medical Research Council (MRC) Laboratory in the Gambia, created in 1948, is the U.K.’s single largest medical research investment in a developing country, with high-quality clinical and lab research and direct provision of healthcare.14 The Navrongo Health Research Centre in Ghana, established as a field site in 1988, has grown into an international-standard health research facility; its research has brought about significant reductions in local child mortality.15 The TDR research and training program has been building health capacity in Africa for several decades.16 The African Institutes of Science and Technology is a multi-campus ini- tiative under development to build a world-class technical institution, with sup- port from IIT-Bombay, the World Bank Institute, the International Finance Corporation, and a diaspora network of African scientists and engineers.17 As these examples show, increased investment in science and innovation allows African countries to grow economically and develop the capacity to take control of their own destiny.18 In combination with improvements in governance and capac- ität, the UN Millennium Project report on Science, Technologie, and Innovation suggests building on the limited R&D investments to date, emphasizing the value 132 Innovationen / fallen 2007 Von http heruntergeladen://direct.mit.edu/itgg/article-pdf/2/4/129/704191/itgg.2007.2.4.129.pdf by guest on 08 September 2023 Accelerating Health Product Innovation in sub-Saharan Africa of science-based development and of creating “…conditions that will enable devel- oping countries to make full use of the global fund of knowledge to address devel- opment challenges.”19 Moreover, a recent report by the African Union High-Level Panel on Modern Biotechnology looks at Pan-African innovation strategies and emphasizes the value of increasing African S&T capacity, and of linking business and life sciences: Regional economic integration bodies are key institutional vehicles for mobilizing, sharing and using existing scientific and technological capac- ities, including human and financial resources as well as physical infra- structure for biotechnology R&D and innovation. The loci of action are primarily local innovation areas which have core research and business institutions. …Local Innovation Areas [würde] increase productivity and innovative capacity in individual businesses and in industry, and incubate new busi- nesses that in their turn buttress innovation and expand the center.20 Similarly, the Commission for Africa report of 200521 recommends that the inter- national community commit up to US $3 billion22 over 10 years to develop centers
of excellence in science and technology. But how, speziell, will the results of this
science be commercialized?
AFRICAN INNOVATION: FIXING A BROKEN PIPELINE
We need to know – what are the products that have been identified that
we can really look at and improve on and then produce? In the area of
malaria a lot of these herbal products make so many claims, but which of
them is authentic?
— Yaw Gyamfi, CEO, Dan Adams Pharmaceuticals, Ghana23
The shrub Cryptolepis sanguinolenta is indigenous to Africa. An aqueous extract
from it has long been used by traditional medical practitioners in west and central
Africa to treat several diseases including malaria. Studies have shown that its deriv-
atives have anti-malarial properties,24 and institutions in Ghana have studied its
toxicity and marketed a tea-bag formulation domestically.25
But if the drug is to live up to its potential, many steps are necessary. So far,
Cryptolepis derivatives have had only a minimal impact. Broader studies and trials
are needed to determine its effectiveness and optimal dosages in order to build
credibility and facilitate its export to larger markets. Production facilities and sup-
ply chains need to be built, and they must guarantee product quality to the end
user. Regulatory and human resource barriers need to be overcome. Sources for the
raw material must be found that can provide a steady and inexpensive supply. Alle
these steps, in combination, represent a quagmire for the inexperienced research
institution or small entrepreneur.
In Ghana, we met a professor who developed a diagnostic test for schistosomi-
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asis, a parasite infection. But as long as it remains stuck in his lab, it cannot help
Kinder, just miles away, who are suffering from the disease. In der Zwischenzeit, venture
capital is available, though not invested in life sciences. A good regulatory frame-
work exists, and the health minister wants to commercialize health products. Aber
these critical assets are not connected, and no one can get the diagnostic test from
the professor’s lab to the villages where it is needed.
Our main challenge has been getting partners, especially with industry, Zu
market our dipstick for commercial use.
—Professor Kwabena Bosompem, Noguchi Memorial Institute
for Medical Research, Ghana26
Unblocking the barriers that keep such research stuck in a lab will help realize eco-
nomic and health gains. These barriers come in a range of areas, such as financing,
clinical trials, intellectual property, licensing, manufacturing, delivery, and under-
standing motivations and markets.27
Similar barriers apply to inexpensive solutions that do not involve high-tech
Produkte. Zum Beispiel, we know of ways to innovate on pricing and systems that
can better deliver health products and services. In many such cases, enabling Africa
to develop its capacity requires developing good ideas into real-world solutions
and then scaling these solutions up into a sustainable route to health and wealth.
With the goal of understanding these barriers and potential solutions, we are
conducting research in Ghana, Tanzania, and Rwanda. A total of over one hundred
in-depth interviews have been conducted with a cross-section of entrepreneurs,
Wissenschaftler, government officials, civil servants, local representatives of internation-
al organizations, academics, and health experts. Although this work is still in
progress, we can share some early conclusions based on our analysis of the data so
far.
In Ghana, we conducted an assessment and case study of innovation in the
domestic health system, at the invitation of the health minister, Hon. Courage
Quashigah. We interviewed 35 stakeholders from academia, government, civil
society, and private industry, and subsequently analyzed these primary interviews,
in combination with research and analysis of secondary sources.28 Three key con-
clusions emerged:
• Many important elements of an innovation system exist. Jedoch, without more
synergy and knowledge flows between companies and S&T actors, it will be hard
to commercialize new health technologies.
• Innovative biomedical and health R&D show the potential to be commercialized.
• The financial incentives and resources for commercialization are currently inad-
equate.
In Tanzania, we conducted a case study at the invitation of Hon. Peter Msolla,
the Minister of Higher Education, Science and Technology. Like Ghana, Tanzania
has many key players in the health innovation value chain and significant research
Kapazität. Wieder, Jedoch, the knowledge is not flowing between groups to facilitate
the commercialization of new health technologies, especially between research
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Accelerating Health Product Innovation in sub-Saharan Africa
institutions and the private sector. Wieder, research remains stuck in a laboratory.
We floated the idea of convergence with the various stakeholder groups, all of
whom supported the idea and identified ways that such a mechanism could over-
come missing linkages and accelerate the path of innovation. One participant
highlighted this enthusiasm:
I am excited by it. I think a lot of the gaps are not real gaps but more
about getting the linkages to work. Für mich, that kind of convergence cen-
ter would be a good place to get these ideas processed, so the visions of
all the stakeholders are taken into consideration. So I would look at it
from the point of view of the farmer, Forscher, down the line to the
product, and then full commercialization with private sector – [A] bring-
ing together of the ideas.
In Rwanda, we conducted a case study in November 2007 at the invitation of Hon.
Romain Murenzi, Minister of Education, Wissenschaft, Technology and Scientific
Forschung, and our findings were similar. Our contacts showed a keen interest in a
biotechnology convergence center, perhaps in the context of a potential biotech-
nology agency, with the convergence center adding innovation and cross-pollina-
tion by bringing health and agricultural biotechnology applications under one
roof.
To further explore the viability of a platform to make these links, we organized
workshops in Ghana and Tanzania, in August 2007 and December 2007 respective-
ly. These workshops aimed to bring together the players with the knowledge and
resources to collaboratively develop and implement the best solution for their
country. Below, we explore the form such a platform could take, after first looking
more broadly at opportunities for health commercialization in Africa.
COMMERCIALIZING HEALTH:
AN OPPORTUNITY FOR A NEW APPROACH
In sub-Saharan Africa, very few places outside of South Africa move health R&D
out of the lab and into a tested product. One of the exceptions is KEMRI, the Kenya
Medical Research Institute, which has developed diagnostic kits for hepatitis-B and
HIV, and has more in development.29 Overall, Jedoch, little research is being
translated into real world deployment:
Scientific and technological breakthroughs do not necessarily lead to the
public’s access to a new product. There is no automatic, smooth transfer
from laboratory to product, and then to delivery and uptake by the user.
…In order to deal with the health challenges faced by Africa, individual
countries need to consider innovative architectures that bring together
different ‘partners’ from health, Wissenschaft, industry, finance etc who all have
a part to play in ensuring a technology is developed and/or delivered.30
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Despite the challenges, many African markets offer opportunities, especially with
the emergence of regional trading blocs that increase the size of easily accessible
markets. In terms of purchasing power, 20 of the 53 African nations, with a com-
bined population of over 260 million people, have a gross national income per
capita greater than that of India.31 While heterogeneous and not as easy to serve as
a single-country market of the same size, this higher-income subset of nations
illustrates the potential aggregate opportunities available to a network of conver-
gence centers.
Other data points show further opportunities:
• According to BIO Ventures for Global Health (BVGH), the potential private mar-
ket demand for effective malaria vaccines is over $100 Million, with a public market demand several times greater.32 Their work also suggests significant potential markets for TB drugs, microbicides, and TB and dengue vaccines.33 • The WHO estimates that improved TB diagnostics could yield roughly 100 mil- lion patient evaluations per year; this adds up to a substantial market, varying across countries by per-unit pricing.34 • The international donor community, including foundations such as the Bill and Melinda Gates Foundation, has committed substantial ongoing funds to pur- chase effective health products and services through mechanisms like the Global Fund to Fight AIDS, Tuberculosis and Malaria;35 these funds can boost the over- all market demand for new, high-quality health products. • Annual spending on health in Africa by low-income consumers is estimated at $18 Milliarde (PPP – purchasing power parity estimate). 36
Some success stories are already demonstrating that R&D-based health com-
mercialization is possible in Africa. Bioclones of South Africa has been producing
and marketing recombinant human erythropoietin since 1998. Several novel prod-
ucts are under development, including a new class of antibodies for improved vac-
cine production.37
In Ghana, LaGray Chemical Company has launched its active pharmaceutical
ingredient factory, producing branded generic and licensed drugs to treat diseases
of sub-Saharan Africa. The product line will include antiretrovirals, broad-spec-
trum antibacterials, and topical anti-infectives.38 A to Z Textile Mills of Tanzania,
Africa’s largest manufacturer of malaria bed nets, is directly impregnating into the
bed net fabric an insecticide that should last for up to five years. Several million
nets are being produced annually, and a variety of innovative distribution channels
are being explored to reduce the cost to the user.39
These success stories can be built on and scaled up. Many precedents for such
innovative health R&D exist in emerging economies like India and China. In India,
Zum Beispiel, Shantha Biotechnics used an innovative process and cost efficiencies
to bring down the price of Hepatitis B vaccine from $15 a dose to 50 cents,40 mak- ing it possible for India to include the vaccine in its Expanded Program on Immunization. More than half the children vaccinated in the world are immu- nized by products from the Serum Institute of India, a leading Indian pharmaceu- 136 Innovationen / fallen 2007 Von http heruntergeladen://direct.mit.edu/itgg/article-pdf/2/4/129/704191/itgg.2007.2.4.129.pdf by guest on 08 September 2023 Accelerating Health Product Innovation in sub-Saharan Africa tical manufacturer. In China, SiBiono GeneTech commercialized the world’s first gene therapy product, for head and neck squamous cell carcinoma, and Shanghai United Cell Biotech is a pioneer in making oral cholera vaccines available.41 Indeed, a growing number of health innovation success stories are emerging in other developing nations like Brazil, Jordanien, Cuba, Mexiko, and Malaysia. Africa can create its own unique path to success, but it must begin. As Rwanda’s president H.E Paul Kagame has said, We in Africa must either begin to build up our scientific and technolog- ical training capabilities or remain an impoverished appendage to the global economy…There is no reason to believe that Africa cannot achieve what others have achieved in these fields. 42 CONVERGENCE CENTERS TO ACCELERATE HEALTH INNOVATION Many studies have suggested that support structures, both virtual and physical, are needed to stimulate innovation and peer learning, to nurture technologies meet- ing societal and economic needs, and to bring these technologies to market.43 Successful science parks, Zum Beispiel, have been nodes of change in China and India. While the scale of investments and local capacity surrounding these science parks and similar locations in North America, Europa, and East Asia can be huge, the approach in Africa will differ, with investment and local capacity being thinner on the ground. We nevertheless believe and will show that a similar approach can be feasible in some African nations. A key to sustainability will be matching the monetary and time scales of investment to local capacity and finding ways to con- centrate and network that capacity so that it can generate competitive outputs. African nations are starting to invest in innovation infrastructure to achieve technological progress and boost business development. This is happening in South Africa where centers like Acorn Technologies, Cape Biotech, and the Innovation Hub have facilitated the creation of several successful companies.44 Meanwhile, in northern Africa, the Tunis Science and Technology Park contains 35 Firmen, in addition to two schools and a visitor’s center. Susanna Wolf quotes Nejib Abida of this park as saying, “When young engineers see all of this activity, they become less likely to pursue employment with the government, or to look abroad…We are trying to offer them space for creativity and innovation.”45 The convergence center that we suggest represents not a revolution, but an evolution from other models such as incubators, clusters, and science parks. While an incubator is a physical location providing space and facilities to grow a small company, a cluster is a broader construct involving a range of companies and com- mercialization services, a strong research base, and formal and informal knowledge sharing: Clusters consist of co-located and linked industries, government, acade- mia, finance and institutions for collaboration…[Sie] offer a fertile innovations / fallen 2007 137 Von http heruntergeladen://direct.mit.edu/itgg/article-pdf/2/4/129/704191/itgg.2007.2.4.129.pdf by guest on 08 September 2023 Masum et al. ground for innovation and upgrading of competitive advantage by firms.46 A convergence center can be seen as a hybrid of an incubator and a cluster, com- bining physical tenants with an extended virtual network beyond the physical space. It would provide both the breadth of services necessary to grow nascent sci- entific and entrepreneurial capacity into a fully realized cluster and the knowledge sharing and networks to accelerate this process. Such a center would act as the focal point for a combination of science, business, and capital to form novel products and services while maximizing health and economic impact. A concrete example is the MaRS center in Toronto, created with the explicit goal of realizing benefits from the wealth of life sciences research in Canada.47 (Natürlich, as noted above earlier, the model for African innovation and investments would differ greatly from the U.S. or Canadian model.) In the African context, a convergence center will include three main compo- nen. The first is infrastructure: flexible tenant space along with reliable, hoch- quality support services (e.g. Internet, labs, communications, Elektrizität, confer- encing). Im Idealfall, it will be located close to a university or existing business cluster; In der Tat, a new breed of innovative African universities and business schools may be critical partners.48 The second component is the tenants and talent, selectively chosen by the cen- ter managers and investors with an eye to current competence and future poten- tial. Anchor tenants can include established yet innovative manufacturers, phar- maceutical R&D firms, or university labs. A center could also include start-ups and smaller companies tackling new challenges, adapting a known business model or product to the local environment, or even doing contract research. In addition to science innovators, these start-ups may be innovators in either process or price, similar to pioneers such as the Aravind Eye Care System that have used process innovation to provide quality eye care at unprecedentedly low prices.49 As C.K. Prahalad points out, if innovation is to have an impact for low- income consumers, it must work backward, starting with what they can pay, and it must use the best technological and process ingenuity available to respond to those constraints.50 In the African context, the simple fact of overcoming constraints on delivery, price, and localization can have as great an impact as developing a new treatment. In der Tat, tenants will have many different pathways to generate health impacts. Four approaches are especially relevant: • Develop a novel drug for a local disease from candidates identified by tradition- al medicine or biodiversity studies.51 • Make a cheaper or more effective diagnostic device that is both affordable and targeted to local diseases. • Decrease the local cost of preventive methods, such as insecticide-impregnated bed nets for malaria prevention, vaccines, or family planning devices. 52 • Implement novel delivery mechanisms, such as health-related micro-enterprise networks along the lines of Living Goods (Uganda), CareShops (Ghana), Und 138 Innovationen / fallen 2007 Von http heruntergeladen://direct.mit.edu/itgg/article-pdf/2/4/129/704191/itgg.2007.2.4.129.pdf by guest on 08 September 2023 Accelerating Health Product Innovation in sub-Saharan Africa CFWShops (Kenya).53 A complementary set of tenants could include professionals who facilitate entrepreneurial success, including technology-transfer firms, law firms, verwalten- ment skills trainers, venture capitalists, and banks and other funders. Social entre- preneurs and policy groups can help both to engage local people and to improve product adoption; as professionals better understand actual local needs by work- ing with users, the businesses that develop will be more demand-driven, und Prod- ucts will be better matched to local constraints. Convenience tenants like restau- rants, clinics, and internet cafés can make the convergence center an enjoyable place to be, and help encourage peer learning and serendipitous interactions. The third component is the activities and services, starting with conference facilities and a critical mass of interesting people passing through. Training pro- grams such as bio-entrepreneurship courses or competitions to develop business plans can connect young entrepreneurs with experienced mentors and capital. Face-to-face and virtual initiatives around common problems can bootstrap learn- ing, engage a wider community to share solutions and business opportunities, and maintain a sense of community. And inter-regional networking (both within Africa and globally) can leverage the network of health convergence centers to trade ideas, Erfahrungen, and technology. FINANCING AND DEVELOPING THE CENTERS How much will all this cost? The largest capital costs are for renting or building facilities and could be reduced if existing universities or labs could offer space at below-market rents. Other operating costs include salaries, Ausrüstung, entrepre- neurship programs, IP (Intellectual Property) outlays, and regulatory costs and compliance at national, regional, and global levels. Our preliminary estimates are that the total outlay over the start-up period and the first five years of operation might be on the order of $10 million per cen-
ter, though this depends on many variables such as potential donations of real
estate or use of existing facilities. Individual countries may choose a larger or
smaller physical center and provide co-investment in cash or in kind (e.g. Land, tax
breaks, export support).
Since it is important to minimize fixed costs,54 some locations might use a vir-
tual network for an extended start-up phase, and then graduate to the full physical
setup once they have grown to critical mass. In this staged approach, the initial vir-
tual network would use low-cost rented or online venues for workshops and train-
ing, as well as networking between scientists and business-people, mentoring of
start-ups, and planning the next stage of the convergence center itself. This sce-
nario allows centers to scale up their costs over time in proportion to the oppor-
tunities they develop.
In der Tat, the network of convergence centers itself should be scaled up sequen-
tially, with earlier centers providing proof of concept and acting as learning labs for
later ones. If the first physical center is put in place early in the process, and other
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locations use virtual networks in spaces with low fixed costs, then all parties can
learn from the implementation process and still make progress at all locations.
Partial models for this network-of-centers approach already exist in Africa.
The SEDA Technologies Program supports 17 regional technology business centers
in South Africa, in specific sectors including health biotechnology.55 The African
Incubator Network, which aims to develop a collaborative pan-African network of
incubators and other business development service providers, is currently active in
many African nations including Ghana, Kenya, Rwanda, South Africa, Und
Uganda.56
The value of such convergence centers will rise not just as they create technol-
Ogy, but also as they create connectivity with the right people, leading to other
interactions: social innovation, mentorship, creative problem solving, and empiri-
cal testing of prototype solutions. The goal is to marry a technological focus with
Politik, Systeme, and social innovation—building capacity for both sets of partners
to facilitate sustainable and innovative implementation.57
On the revenue side, what kind of financial income would a convergence cen-
ter receive? Rental is a major component of income for successful incubators in
Africa and would cover a major fraction of operating costs.58 Other income could
come from facilities and services owned and offered by the center, including rentals
of conference facilities and space for retail tenants, as well as consulting and men-
toring services, and other services like information technology or specialized labs.
Centers could also offer training for entrepreneurs, technology managers, execu-
tive MBAs, or senior public officials, perhaps in partnership with an educational
institution.
Each country will need to adapt the plan to suit its local circumstances and
make many and varied decisions:
• What local strengths could be initial foci for investment?
• With which institutions could a center collaborate or share space?
• What is the right balance between virtual and physical services?
• Who are the local champions and risk takers who will make it happen?
• Should the center include health delivery businesses and microfranchisers, als
complementary and critical vehicles for investment?
In Ghana, during our August 2007 Werkstatt, we helped local professionals
consider and begin to answer some of these questions. The conversations led to a
specific focus on diagnostics and traditional medicine. Participants reacted posi-
tively to the idea of a health convergence center. They also recommended a task
force to start the planning process, and representatives from the various ministries
and stakeholders did establish one.
In Tanzania, in December 2007 we helped the Ministry of Higher Education,
Science and Technology to conduct a workshop with a cross-section of stakehold-
ers: local entrepreneurs, academics, funders from private enterprise, government
officials, philanthropic foundations, and other local leaders. The active involve-
ment of local business schools and science policy leaders led to a focus on gener-
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Accelerating Health Product Innovation in sub-Saharan Africa
ating a viable draft business plan for a Tanzanian center in advance and refining it
based on subsequent adaptation and planning by local stakeholders.
Funding support for capital and operational costs will be critical in the early
stages and may come from sources such as foundations, local governments, Und
the African Development Bank, as its 2007 Strategy for Higher Education, Wissenschaft,
and Technology includes several themes parallel to the convergence center idea.59
By addressing the lack of incentives to invest in the kind of infrastructure that
facilitates later-stage R&D, it would be possible to structure the convergence cen-
ter as a non-profit, one that will be seen as a piece of critical infrastructure. Diese
who want to maximize the revenue of a bridge do not raise the tolls sky-high, Aber
instead aim only to cover its costs while maximizing the value it adds to business-
es and citizens—and helping them recognize that value. Ähnlich, the convergence
center is a bridge between science, business, and capital, and the many others who
will benefit from its resulting products and services.
A VENTURE FUND FOR HEALTH INNOVATION
Remarkably, we know of almost no venture capital invested in life sciences innova-
tion in Sub-Saharan Africa, except for the one significant fund, Bioventures, based
in South Africa. This means it is extraordinarily difficult to bring ideas to market.
A key issue for any proposed fund is finding good investment opportunities.
Hier, a venture fund and convergence center could be symbiotic. The non-profit
convergence center could act as a magnet, attracting commercializable ideas from
across an entire country; for venture funders, it would be an easy entryway for
seeking investment opportunities.
An African health venture fund would also address an enormous market fail-
ure. If an established company in Africa has high revenues or land that can serve
as collateral, it can borrow money, but the rates are high: commercial bank loans
in Ghana and Tanzania often have interest rates of 20 percent or more. But a new
company with minimal revenues—like many health technology start-ups—often
cannot borrow money at all.
The venture fund could respond to this problem by pulling together a combi-
nation of investors:
• Profit-maximizing investors: Largest and most liquid pool of investors.
• Multiple bottom line investors. Willing to invest funds at a lower required rate of
return on capital.
• Development banks and funds. Investment from organizations such as the
African Development Bank or IFC could bring resources, expertise, and risk
mitigation for other investors.
• Foundations. Concessional funding can offset costs and mitigate risks, e.g.
through funding investment research or operations, so investors’ funds can go
directly to business opportunities.
By using a variety of financing sources, each with different expectations of return,
a venture fund can reduce both the risk and the effective cost of capital, daher
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increasing the range of financially viable business ventures the center can take on.
Investments in start-up companies might average $1 Million, spread through several stages of several hundred thousand dollars each, with the understanding that some fraction of those companies will fail at each stage.60 Smaller investments could be useful for prototyping or early-stage trials. Larger follow-up investments will be needed to scale up operations and production for those start-up companies that succeed. Much of the portfolio of the proposed venture fund will likely consist of seed- stage investments; these will benefit from more advice and oversight, such as that available from a new breed of companies like Acumen Fund with a multiple bot- tom line approach to venture capital.61 Acumen has invested in and helped devel- op innovative African health product rollouts, such as A to Z’s bed nets and Voxiva’s use of mobile phones and related technologies for health.62 We suggest that investments could be spread across five countries that have macro-economic stability and a promising R&D base. In this scenario, the alloca- tion per country might average from $5 million to $10 Million, but the overall fund size could be $30 million to $50 Million, allowing it to benefit from economies of scale in management expenses and investment analysis capability.63 And in each country, the convergence center would serve as a key point of entry for the venture fund. If an experienced multilateral institution were to co-invest, it would improve the level of capital and expertise available to the fund. Zum Beispiel, the International Finance Corporation (IFC) has invested in life sciences funds in India (APIDC Biotech), China (BioVeda China), and South Africa (BioVentures). It has also invested directly in well-known successes like Bharat Biotech of India and Hikma of Jordan.64 Indeed, as of April 2006, it had invested at least $127 mil-
lion in a dozen life sciences companies in emerging economies.65
In a promising development, the IFC in partnership with the Bill and Melinda
Gates Foundation released a report in December 2007 on opportunities for pri-
vate-sector approaches to health in sub-Saharan Africa.66 The press release states
that there are plans to mobilize up to $1 billion in investment and advisory servic- es support over the 2008 – 2012 time frame, including an equity investment vehi- cle starting with $100 Million (growing to up to $300 – $350 million over this time
frame).67 These equity investments are to be made in health care entrepreneurs and
businesses, of which life sciences and innovation-based models will be a part.
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Accelerating Health Product Innovation in sub-Saharan Africa
RISKS AND LONG-TERM BENEFITS
The objective of research is to find better ways of solving problems which
people face. It is therefore imperative that research findings should reach
end users, and in this case it is the people.
— Dr. Ali Mohamed Shein, vice president of Tanzania68
Why invest in African countries? Private equity funds have recently found Africa to
be a land of opportunity.69 The three countries we have discussed—Ghana,
Tanzania, and Rwanda—have all been experiencing substantial economic growth.
But we must weigh the challenges.
One challenge is corruption. Corruption, Jedoch, is present to varying
extents worldwide. Measured by the well-known Corruption Perceptions Index of
Transparency International, Tanzania ranked in the same category as India, Und
Ghana in the same category as Mexico.70 Yet corruption in Mexico and India, while
a concern, has not deterred growing numbers of foreign investors and partners.
Despite serious challenges, inspirational African voices and investment success sto-
ries are becoming easier to find.71
Another challenge is measuring financial potential. Do Africa’s universities,
labs, and early-stage companies really have enough commercializable health inno-
vations to make productive use of the proposed venture fund and convergence
center? We have shown specific examples where the answer is yes, and companies
in sub-Saharan Africa are already innovating in the health product field. Given the
presence of several research institutes and the lack of major venture funding out-
side of South Africa, it is certainly true that more research is being conducted than
commercialization. How big is this gap? How much innovative research can be
pulled out to the market through commercialization initiatives? These questions
can only be answered by starting the process. Novel opportunities also exist to tap
synergies between health and agriculture.
A final challenge is financing. Will the convergence center break even financial-
ly, and is it the best use of scarce infrastructure and development funds? We believe
that by developing a solid business plan with local partners, the center’s leaders can
understand costs and minimize the downside risks. Another layer of independent
checks will come from investors and funders in each country (for convergence cen-
ters) and for the region as a whole (for the venture fund), as they will each conduct
their own due diligence before investing. The physical center will have to weigh the
tradeoffs between “safe” tenants that can definitely pay the rent but do not push
the envelope of health innovation, and more risky tenants who may fail but may
also make enormous contributions in social or economic value in the long run.
In der Tat, whatever challenges it faces, the center will help create a cadre of sci-
entific entrepreneurs and bring them together to interact with business and finan-
cial players. Dabei, it will amplify local talents, and create a new category of
relationships among those involved in science, capital, and funding. Along with the
human benefits—training and empowerment, and long-term capacity develop-
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ment—the core real estate asset is very likely to appreciate.72
What would be the long-term macro-economic and social benefits? A success-
ful health convergence center network and venture fund will create business rev-
enues and high-quality jobs that would not otherwise exist, particularly through
the accelerated growth of small and medium-size enterprises. Investors should see
these benefits as part of the return on their investment in the center. This return is
captured as each center incubates and facilitates businesses, which pass on their
benefits to the surrounding society.
Investors concerned with this kind of return include governments, founda-
tionen, social investors, and development banks. Any country that wants to compete
in today’s global economy must develop value-added businesses. Just as entrepre-
neurs saw no need to remain locked into land lines,73 African countries need not
remain stuck in the low-wage economy trap, forever consigned to agricultural
economies.
In the category of health benefits, we showed above that poor health imposes
very real economic costs on any society. daher, reducing this burden consti-
tutes a real economic benefit. Consider malaria, Zum Beispiel: better malaria diag-
nostics could annually save the lives of up to 480,000 Africans, mainly children.74
One approach to quantifying this burden economically is a recent Nigerian study
that asked families how much they would be willing to pay for malaria treatment
insurance; it found that, if the insurance and treatment were both effective,
Nigerian households would collectively be willing to pay approximately 1.8 pro-
cent of the country’s GDP to access this insurance.75
To the extent that a health convergence center generates positive health
impacts, it will directly impact the country as a whole, including savings to the
health system, fewer working days lost, higher workforce productivity, and long-
term economic competitive advantage.
CONCLUSIONS
…there can be no peace, no security, nothing but ultimate disaster, Wann
a few rich countries with a small minority of the world’s people alone
have access to the brave, and frightening, new world of technology, sci-
enz, and of high material living standards, while the large majority live
in deprivation and want, shut off from opportunities of full economic
Entwicklung; but with expectations and aspirations aroused far beyond
the hope of realizing them.
— Lester B. Pearson, former prime minister of Canada, on June 13,
197276
Given the potential benefits, the high demand and need, and the feasibility we have
demonstrated here, we see a strategic opportunity to create a network of health
convergence centers linked with a sub-Saharan health venture fund. Creating this
critical infrastructure will help translate indigenous talent, capital, and know-how
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Accelerating Health Product Innovation in sub-Saharan Africa
into positive health and economic impacts in a sustainable way.
Our proposed approach includes several key actions. Develop the convergence
centers through a country-by-country process, driven by a broad-based coalition
of local experts and stakeholders who create their own solutions. Pilot a first cen-
ter, apply lessons to subsequent centers, and scale up if successful. Consider co-
locating centers with existing institutions, to lower costs and leverage existing cen-
ters of expertise, and explore potential synergies between health and other sectors
such as agriculture.
On the investment side, link the convergence centers with a venture fund, Also
that the centers act as opportunity generators for the fund to invest in, and the
fund supports many businesses in the centers. Endlich, assess the potential “deal
flow” for this venture fund through research into existing health R&D that could
be commercialized.
If this combination of centers and fund succeeds in the health and life sciences
Bereich, it could serve as proof of concept for an even more ambitious goal: expand-
ing the model to include water, Energie, Umfeld, and other key technology
domains. Imagine a network of implementation centers that channels funds and
expertise to amplifying and facilitating local solutions, harnessing the tremendous
entrepreneurial resources available into a self-sustaining improvement cycle that
can tackle many other basic human needs.
A key issue is at stake here. Several African countries have invested in human
capital and succeeded in creating democratic governance and stable macro-
economies. Jetzt, will they enter the higher-value, knowledge-based sectors of the
global economy? By tackling their own problems and implementing their own
Lösungen, indigenous talent can combine with investment to create sustainable
innovation capacity and positive health outcomes.
Danksagungen
Helpful comments and suggestions were received from Philip Auerswald, Natasha
Bhogal, David Brook, Winthrop Carty, Sarah Frew, Brian Guest, Miranda Lin,
Maya Maliakkal, Rahim Rezaie, Ken Simiyu, Helen Snively, and Andrew Taylor.
We gratefully acknowledge funding from Genome Canada through the
Ontario Genomics Institute, the Ontario Research Fund, and the Bill and Melinda
Gates Foundation. This study was also supported through a Canadian Institutes of
Health Research Michael Smith award to Dr. Singer. Co-funders are listed at
1. In the quarter century from 1975 Zu 2000, nur 16 von 1393 new chemical entities marketed were
for “neglected diseases” predominantly affecting the poor (i.e. tropical diseases and tuberculosis).
See Patrice Trouiller, Piero Olliaro, Els Torreele, James Orbinski, Richard Laing, and Nathan Ford,
“Drug development for neglected diseases: A deficient market and a public-health policy failure.”
The Lancet, 359 (Juni 22, 2002): S. 2188–2194.
2. Sehen
(Foundation for Innovative New Diagnostics).
3. A list of the 14 Grand Challenges and corresponding project details can be found at
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Masum et al.
4. Aus
mitment to subsidize the future purchase (up to a pre-agreed price) for a vaccine not yet available
if an appropriate vaccine is developed and if it is demanded by developing countries.”
5. Remarks during “Mobilizing the Private Sector” conference, Toronto, May 2–4 2007.
6. Some have even asked whether the financial and health return on this massive investment has
been sufficient, and suggested changes in industry anatomy such as emphasizing translational and
cross-disciplinary research and sharing over patenting by universities. See Gary Pisano, “Can
Science be a Business? Lessons from Biotech.” Harvard Business Review (Oct 1, 2006): pp 114–24.
7. SE Frew, R Rezaie, SM Sammut, M Ray, AS Daar and PA Singer, “India’s health biotech sector at a
crossroads.” Nature Biotechnology, 25 (2007): S. 403–417.
8. Ö. Shisana and L. Letlape, “The impact of HIV/AIDS on the sub-Saharan African economy.”
Position paper commissioned by the Commission for Africa; September 30, 2004. Available at the
Commission for Africa site:
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10. MHA Hassan, “A new dawn for African science.” Science, 316 (5833) (Juni 29 2007): P. 1813.
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12. The institute is based in Cape Town
13. Sehen
14. “Improving Health, Improving Lives: MRC-funded research in Africa.” Medical Research
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15. See e.g. JF Phillips, AA Bawah, FN Binka. “Accelerating reproductive and child health programme
impact with community-based services: The Navrongo experiment in Ghana.” Bulletin of the
World Health Organization 84(12): pp 949–953, 2006. The Centre’s site is
16. TDR is the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training
in Tropical Diseases. Sehen
17. Sehen
18. International Journal of Technology and Globalisation (IJTG), Special Issue on Science and
Innovation in Africa: New Strategies for Economic Growth, Volumen 2, Issue 3/4, 2006.
19. Task Force on Science, Technology and Innovation, UN Millennium Project (Lead Authors
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20 African Union High-Level Panel on Modern Biotechnology, “Freedom to Innovate:
Biotechnology in Africa’s Development”, August 2007, p x and 16. Available at www.nepadst.org,
the site of the African Ministerial Council on Science and Technology.
21. Our Common Interest: Report of the Commission for Africa, 2005. Complete report available at
22. All financial statements in this paper are in US dollars, unless otherwise noted.
23. Yaw Gyamfi is CEO of DanAdams Pharmaceuticals, a Ghanaian-owned company incorporated
in May 2004. The company is focusing on economically-targeted areas in the pharmaceutical
industry which have strong social implications for Ghana.
24. CW Wright, “Recent developments in naturally derived antimalarials: Cryptolepine analogues.”
J Pharm Pharmacol., 59(6) (Juni 2007): S. 899–904.
25. Fieldwork by the authors in Ghana in 2007. See also Simons AJ, Dodet-Malenge H, Phillips D,
Brendler T, Muriuki J, Muasya S., “Herbal Anti-malarials in Africa: An electronic compilation of
the proceedings of a CDE-ICRAF meeting on advancing knowledge, use and marketing of anti-
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(ICRAF), 2006. Proceedings online at www.worldagroforestrycentre.org/treesandmarkets/anti-
malariameeting/proceedings/
26. Kwabena Bosompem is a Professor of Medicine with the Noguchi Memorial Institute for
146
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Accelerating Health Product Innovation in sub-Saharan Africa
Medical Research in Ghana. He is the project manager for WACIPAC, the West African Centre
for International Parasite Control, and his research led to development of the schistosomiasis
dipstick mentioned in this article.
27. PA Singer, K Berndtson, CS Tracy, ERM Cohen, H Masum, JV Lavery, and AS Daar, “A Tough
Transition.” Nature, 449(7159) (Sep 13, 2007): S. 160-3.
28. This and the other case studies discussed will be featured in academic articles currently in prepa-
ration.
29. Sehen
opment in the region, see Komen J, Bananuka J, Mugoya C, Virgin I. “Biotechnology Product
Development Partnerships: Emerging Institutional Capacities in East Africa.” Asian
Biotechnology and Development Review, 7(3): 25–36.
30. J Chataway, K Chaturvedi, R Hanlin, J Mugwagwa, J Smith, D Wield., “Technological Trends and
Opportunities to Combat Diseases of the Poor in Africa.” Background Policy Paper for NEPAD
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(Die
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Partnership
Africa’s
Neu
Jan
für
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www.bvgh.org/documents/MVIBCG.malariaMA.2005.pdf. With an estimated annual demand
of millions of doses a year from private vaccinations, and tens of millions from publicly-funded
vaccinations, the annual market would translate to hundreds of millions of dollars in Africa.
33. Sehen
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the pyramid. World Resources Institute, 2007. Verfügbar um
www.wri.org/publication/the-next-4-billion. This estimate is for private-sector spending, Und
does not include governmental or international funds.
37. Company presentation during “Mobilizing the Private Sector” conference, Toronto, Mai 2-4
2007.
38. Sehen
Sector” conference, Toronto, Mai 2-4 2007.
39. Interviews with company officials, Acumen Fund information, and a World Economic Forum
case study available at
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a crossroads.” Nature Biotechnology, 25 (2007): S. 403–417.
41. SE Frew, SM Sammut, AF Shore, JK Ramjist, S Al-Bader, R Rezaie, AS Daar, and PA
Singer.”Chinese health biotech and the billion-patient market.” Nature Biotechnology 26, (2008):
S 37-53.
42. Sehen
43. See for instance C Ketels, G Lindqvist, O Solvell. “Cluster Initiatives in Developing and Transition
Economies,” Center for Strategy and Competitiveness, Stockholm; 2006. Verfügbar um
manche
bei
that have
from Acorn
“graduated”
Firmen
44. A
list of
Ist
45. Susanna Wolf, “Encouraging Innovation for Productivity Growth in Africa.” African Trade Policy
bei
16. Verfügbar
Centre Work
(Januar
in Progress No.
2007),
54
P
46. O Solvell, G Lindqvist, C Ketels (foreword by Michael Porter). The Cluster Initiative Greenbook,
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2003. Available from www.cluster-research.org/greenbook.htm. The cluster concept was initial-
ly introduced by Michael Porter, though informal clusters have existed for centuries. Incubators,
cluster initiatives, and science parks have been introduced to increase microeconomic competi-
tiveness throughout the world. In der Tat, the Global Cluster Initiative Survey 2005 (available at
developing economies.
47. The MaRS complex is a life sciences convergence centre located in Toronto, Canada –
venture capitalists, MaRS brings together research and business incubation facilities, investors,
professional services firms, tech transfer offices, and the MaRS Venture Group. See pp 97-98 In
Sir David Cooksey, “A review of UK health research funding”; VEREINIGTES KÖNIGREICH. Treasury Report, London,
England, Dezember 2006.
48. C Juma and H Agwara, “Africa in the global knowledge economy: Strategic options.” Int. J.
Technology and Globalisation, 2 (3/4) (2006): S. 218–231.
49 Mahad Ibrahim, Aman Bhandari, Jaspal S. Sandhu, and P. Balakrishnan, “Making Sight
Affordable (Teil I): Aurolab Pioneers Production of Low-Cost Technology for Cataract Surgery.”
Innovations: Technologie, Governance, Globalization, 1 (3) (Sommer 2006); pp 25–41.
50. CK Prahalad. The fortune at the bottom of the pyramid: Eradicating poverty through profits.
Philadelphia: Wharton School Publishing, 2006.
51. XeChem of Nigeria, Zum Beispiel, is currently ramping up production of a new drug for sickle-
cell anemia, which arose out of traditional compounds and work done in Nigerian labs.
52. The Serum Institute of India, Zum Beispiel, provides vaccines used in more than half the chil-
dren’s immunizations worldwide. The lower prices of their vaccines are a key factor in this health
success story.
53. Sehen
54. A similar point about African franchise businesses is made in African Development Bank Group
(Private Sector Department), Enhancing Development in Africa: Franchising Report. African
Development Bank Group, 2003. Low fixed costs increase the range of viable businesses.
55. Sehen
56. The African Incubator Network’s site is
the InfoDev Program, a World Bank initiative using information and communication technolo-
gies to promote education, health care and small business entrepreneurship;
sehen
57. Charles A. Gardner, Tara Acharya and Derek Yach, “Technological and Social Innovation: A
Unifying New Paradigm For Global Health.” Health Affairs, 26(4) (2007): S. 1052–1061.
58. The Innovation Hub, a successful South African facility, produces detailed annual reports that
provide a financial point of comparison and insight:
59. Two goals of this strategy are strengthening national and regional centers of excellence in science
and technology, and linking higher education, Wissenschaft, and technology to the productive sector.
The strategy also looks at links to poverty reduction and economic growth, and to other devel-
opment sectors, in particular agriculture and health. See African Development Bank Group,
“Strategy for Higher Education, Wissenschaft, and Technology,„Juli 2007 Entwurf (available at
60. These and other similar figures in this passage are from preliminary modeling, and discussions
with venture capitalists familiar with emerging economies.
61. Jacqueline Novogratz, “Meeting Urgent Needs with Patient Capital.” Innovations: Technologie,
Governance, Globalization, 2(1–2) (Winter/Spring 2007): S. 19–30.
62. Acumen Fund’s health investments:
63. The higher overhead of management, investment analysis, and mentorship for growth SMEs in
developing markets is a key issue in making venture funds work within a development or SME
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Accelerating Health Product Innovation in sub-Saharan Africa
focus. See Alan J Patricof and Julie E Sunderland, Venture Capital for Development. Diskussion
paper from Brookings Institute, 2005. Verfügbar um
64. Sehen
65. Presentation by Mario Gobbo, Head of Life Sciences and Pharmaceuticals at the International
Finance Corporation, at the BIO 2006 Konferenz.
66. International Finance Corporation (IFC). “The Business of Health in Africa: Partnering with the
Private Sector to Improve People’s Lives.” IFC, 2007. Verfügbar um
67. International Finance Corporation (IFC). Press release, Dec 18, 2007. Verfügbar um
68. DR. Ali Mohamed Shein is Vice President of the United Republic of Tanzania. See his speech on
control of neglected tropical diseases at
69. For some examples, see the African Venture Capital Association:
70. Transparency International, Global Corruption Report 2006, S. 300–301. Verfügbar um
with detailed examples of corruption in health investment and delivery.
71. See for instance the TEDGlobal 2007 talks from Arusha, Tanzania at
72. The design and location of the centers will be important in de-risking the initiative. For exam-
Bitte, incorporating flexible design elements for alternate future revenue-generating uses will
make it more likely for businesses and others to invest in the building itself.
73. NP Sullivan, You Can Hear Me Now: How microloans and cell phones are connecting the world’s
poor to the global economy. San Francisco: Jossey-Bass, 2007.
74. ME Rafael, T Taylor, A Magill, YW Lim, F Girosi, R Allan. “Reducing the burden of childhood
malaria in Africa: The role of improved diagnostics.” Nature, 444 Suppl 1 (November 23, 2006):
S. 39–48.
75. A Jimoh, O Sofola, A Petu, T Okorosobo. “Quantifying the economic burden of malaria in
Nigeria using the willingness to pay approach.” Cost Effectiveness and Resource Allocation, 5:6
(2007). Verfügbar um
an empirically justified proxy measure for both the economic burden of malaria, and the poten-
tial market size of an effective malaria treatment method.
76. Lester B Pearson’s Public Address in London, Juni 13, 1972, upon receiving the Victor Gollancz
Humanity Award. Full text at
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