Health Biotechnology Innovation in Developing Countries by dffhrtcv3

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									                       Role of the Health System in
                       Health Biotechnology Innovation
                       in Developing Countries

Halla Thorsteinsdóttir
University of Toronto

IKD Research Workshop,
Bridging the gulf between policies for innovation, productivity &
industrial growth & policies to reduce poverty
London 18-20 November 2005
      Main questions

1. Are the health biotechnology sectors in
   developing countries aimed at local health
   needs?

2. If they are, are the roles of the health
   systems likely to be confined to being users
   of the local innovation or are they active
   contributors to the innovation as well?
      Common belief


Developing countries’ researchers and firms do not
focus on their local health problems but are rather
focused on the health problems of people in
industrially advanced countries.

•It carries more prestige to study health topics that the
        leading scientists in the world are researching
•There are better chances for the research to be accepted
        for publication in the most influential journals.
•For firms in developing countries it is most lucrative to focus
        on health problems in industrially advanced countries,
        where the largest profit margins lie.
Health Biotechnology Innovation in
Developing Countries

              How have developing
              countries that have
              developed successes in
              health biotechnology been
              able to do it?

               Countries: Brazil,
               China, Cuba, Egypt,
               India, South Africa,
               and South Korea
                   PROJECT TEAM


       CANADA
    Abdallah Daar
     Uyen Quach                                                  SOUTH KOREA
                                                     CHINA        Joseph Wong
     Peter Singer
                                                  Li Zhenzhen
Halla Thorsteinsdóttir
                                                 Zhang Jiuchun
                                  EGYPT              Wen Ke
            CUBA              Basma Abdelgafar
         Tirso Saénz                            INDIA
                                            Nandini Kumar
                                          Hemlatha Somsekar
                BRAZIL
             Marcela Ferrer    SOUTH AFRICA
                                Marion Motari
                     Case Studies

• Semi-structured interviews with key informants - private
  sector enterprises, governmental departments, public
  and private research institutes, educational institutions,
  regulatory agencies, relevant associations, major interest
  groups, relevant NGOs etc.
  Interviewed 207 experts from developing countries

• Background documents - relevant published information,
  governmental reports , policy briefs, legal and regulatory
  arrangements, official statistics

• Data on publication and patents in health biotechnology
Specialisation indices

Express the intensity of research in a
specific field that a country publishes in,
relative to the intensity of publications in
that field by the rest of the world.

Indices of larger than 1 means a country is
relatively specialised in a field/subfield
           Specialisation indices in subfields of
           health biotechnology
                                                                            South   South
Country                             Brazil   China   Cuba   Egypt   India   Korea   Africa
Biochemical & Molecular Biology      1.02                                            1.12
Biomedical Engineering                1.5      1.8   3.75     2.1    3.2     2.26    3.92
Genetics & Heredity                                                          1.02
General Biomedical Research                    3.3                  2.11      1.3
Immunology                                           2.05
Microbiology                         1.67                    2.51   1.39     2.03    2.44
Miscellaneous Biomedical Research               1                   2.27
Nutrition & Dietition                                               1.69
Parasitology                         6.69                           1.49
Virology                                                            1.03     2.13
Dentistry                            2.85
Dermatology & Venereal Diseases                                     1.53             1.37
Fertility                                                           1.27
General & Internal Medicine           2.9      4.5   1.99           1.25     1.54
Ophthalmology                                                       1.95
Pharmacology                                   1.9
Tropical Medicine                   11.68      2.2          31.12    2.3
Veterinary Medicine                  1.76                            3.3     2.44
                                    Communicable Diseases - 2002

             70000
             60000                                                        HIV/AIDS
DALY (000)




             50000                                                        Diarrhoeal diseases
             40000
             30000                                                        Malaria
             20000                                                        Childhood diseases
             10000                                                        Tuberculosis
                 0




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 DALYs (Disability Adjusted Life years) due to                           Source: WHO 2004
 Communicable Diseases
Estimated proportion of total deaths by cause
in India (all ages, 2005).




                       Source: Reddy et al, 2005
 Interviews on health biotechnology
 innovation in developing countries



How do you see the role of health
biotechnology in your country in the context
of health delivery and public health?
        CUBA



Main driving force for the
health biotechnology
sector was solving local
problems



 Purified
 Meningococci
 Meningitis B and C
 Vaccine
 Produced by
       Cuban health biotechnology

• Cuban procurement policies favour local
  health products to imported ones.
• Tight linkages, with clinicians in Cuba heavily
  involved in the innovation process, and are
  active in the biotechnology cluster, West
  Havana Scientific Pole.
• A researcher in a public research institute
  said, for example: We have feedback from
  the clinical trials to the lab. This is not a linear
  process. The cycle is a good ground for
  innovative thinking. It has definitely improved
  our products.
            INDIA

 Governmental support to biotechnology since early 1980s
 but not instrumental policies towards solving particular
 health problems
India has a great market. I mean we have so many diseases. So
there is no, I think, there is no better place , no better market for
you, we have a billion people here and everybody needs three
things in life, I think. You need ‘roti’, ‘kapda’ and ‘makaan’
[food, clothing, shelter] so and you need ‘davai [medicine]’.
So, you have, I mean, that is definitely there is a market. In a
country, if you have more people, you have more health
problems
     Shanvac-B
     Recombinant hepatitis B vaccine surface antigen

     Produced by
       Indian health biotechnology

• To go global was a theme in the interviews
• Extensive exporting through supplying
  vaccines to UN agencies, e.g. UNICEF and
  WHO
• Health sector is important for clinical trials but
  not much emphasis on close linkages and
  knowledge flow between
  researchers/entrepreneurs in health
  biotechnology and health system
           BRAZIL


•Active in scientific publishing in health biotechnology
•Concerns that Brazilians were relatively weak in
developing health biotechnology products & services

   We have certain competitive advantages. What are these
   competitive advantages? Our needs. For example, the
   problem of public health. Now, besides the need, we have
   capacity. We have a way to generate our industry. We also
   have specific health problems that carry us to develop
   certain things. Another advantage we have is that it is
   cheaper making some things in Brazil than making them
   outside of the country. We have human resources
   Biobrás and Federal University of Minas Gerais developed
   recombinant human insulin
       Brazilian health biotechnology


• Lack of linkages and knowledge flow have
  been between the major actors in health
  biotechnology innovation system

• Procurement policies have been detrimental
  to local innovation
            Main answers

1.   Are the health biotechnology sectors in developing countries
     aimed at local health needs?   Yes
        Both quantitative and qualitative data has
        supported that health biotechnology sectors in the
        countries discussed have attempted to meet local
        health needs
2.   Are the roles of the health systems likely to be confined to
     being users of the local innovation or are they active
     contributors to the innovation as well? Yes   and No
        In most of the countries the linkages between
        researchers and entrepreneurs in health
        biotechnology and the health systems could be
        closer
      Additional statistics in demand

• How many of the health biotechnology
  products reach local markets versus
  exporting markets?
• What are the earnings the producers have in
  the different markets?
• To which countries do developing countries
  export their health biotechnology products?
• What proportion of their exports are through
  purchasing by UN agencies?
• What are the health effects of the health
  biotechnology products?
                Funding support




              Bill and Melinda Gates Foundation
           McLaughlin Centre for Molecular Medicine
                  The Rockefeller Foundation

Funding partners for the Canadian Program on Genomics and Global Health
                      listed at www.geneticsethics.net

								
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