Global Healthcare on the Ground: IFPMA Engages Global Bodies to Push Health Efforts Forward

The complexity of global health concerns requires the engagement of national and regional governments, the private sector, nongovernmental organizations, and other civil-society organizations. For the pharmaceutical industry, this involvement can be through individual companies and collective industry actions. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) is an important instrument of collective participation on global health concerns. IFPMA represents 29 multinational research-based pharmaceutical companies and 45 national industry associations in North America, Western Europe, Japan, Australia, Central and South America, Asia, and Africa. Eduardo Pisani, IFPMA's director general, recently spoke with Pharmaceutical Technology to discuss the association's policy objectives and action plans in global health.

Eduardo Pisani

IFPMA's scope of action

"The mission of the IFPMA is to engage with international organizations to build mutual understanding and to find effective and sustainable solutions to major global health issues with a focus on medicine quality, innovation, and access," says Pisani. To that end, IFPMA, based in Geneva, has formal consultative status with the United Nations, UN specialized bodies, including the World Health Organization (WHO), the World Bank, and the World Trade Organization.

Three core areas—quality, innovation, and access—serve as the framework for IFPMA's specific work in global health, which increasingly requires partnerships between the private and public sector. "Nowadays, most of the work accomplished in the global public health arena is collaborative in nature, so multistakeholder partnerships are encouraged," says Pisani, pointing to partnerships in R&D, capacity-building, training, or technology transfer.

He points to the collaborative focus inherent in the UN Millennium Development Goals (MDGs), a set of eight time-bound targets for addressing extreme poverty, hunger and disease, gender equality, education, and environmental sustainability. "MDG Goal 8 specifically mentions the need for cooperation with pharmaceutical companies in the development of a global partnership to provide access to affordable, essential drugs in developing countries," says Pisani. To illustrate IFPMA's role in the MDGs, Pisani noted that IFPMA member companies have approximately 210 projects in place, worth an estimated $9.2 billion that address the health-related MDGs. By 2015, the date set for the MDGs to be realized, if the present trend is maintained, the value of these projects is expected to increase to $20 billion (excluding companies' expenditures on R&D for diseases of the developing world), he adds.

Noncommunicable disease. Noncommunicable diseases, particularly cancer, cardiovascular disease, respiratory disease, and diabetes, are a growing health problem in the developing world. Noncommunicable diseases have become a problem in certain countries as lifestyle choices, such as an unhealthy diet and tobacco use, accompany a rise in the overall standard of living for middle-income countries as the economies of these countries improve.

To address the problem, the UN is holding a first-ever UN General Assembly high-level meeting on noncommunicable diseases this month (September 2011) in New York. IFPMA will be responsible for conveying the research-based pharmaceutical position on chronic diseases. "We believe that the experience in the developed world demonstrates the crucial role of changing risky behaviors and prevention," says Pisani. "We also will be advocating for the effective, multistakeholder strategies at the global, regional, and national levels that are fully integrated into healthcare systems."

In this multistakeholder framework, Pisani says that governments, the research-based pharmaceutical industry, civil society organizations, and health professionals can play a role in increasing education and awareness, improving early detection and disease surveillance, and facilitating implementation of prevention programs.

Influenza pandemic preparedness. Influenza pandemic preparedness, including access to vaccines for developing nations, is a crucial issue in global public health and was one of the topics addressed by the World Health Assembly, the decision-making body of WHO, which met in May 2011, in Geneva. At the meeting, the World Health Assembly agreed to the Pandemic Influenza Preparedness (PIP) framework. IFPMA contributed to the deliberations of the WHO Open-Ended Working Group (OEWG) of Member States on PIP, which was tasked with improving the global system for responding to future influenza pandemics. The OEWG adopted an agreement in April 2011 for a PIP Framework, which was endorsed by the World Health Assembly in May.

IFPMA supported the OEWG's plan, in particular for addressing key challenges, such as increasing the capacity of vaccine production and enabling access in developing countries. IFPMA also supports the WHO's financial parameters for the industry for the WHO Global Influenza Surveillance Network (GISN).

The OEWG recommendation includes specific requirements for users of the GISN to ensure that vaccines and antivirals are made available to developing countries in the event of a future pandemic. During the most recent H1N1 pandemic, IFPMA vaccine manufacturers committed 166 million doses to meet the WHO target of 200 million vaccine doses for developing countries, according to IFPMA.

In commenting on the PIP framework, IFPMA recognized the importance of local production of vaccines and antivirals in pandemic preparedness and said it would continue to explore local production, pointing to investment made by member companies in several countries, including Mexico, Brazil, China, Indonesia, and Thailand. During the OEWG/PIP consultations, individual IFPMA members confirmed that they also were willing to voluntarily undertake a selection of actions in the event of a future pandemic, including production-capacity expansion and access to reverse-genetics technology, dependent upon skills, knowledge, financial management, public-health policy, and national regulation.

Counterfeit drugs. Counterfeit drugs in the developing world are a large public health concern and represent a key strategic focus for IFPMA. In 2010, 1735 incidents of fake medicines were reported by the Pharmaceutical Security Institute, a Washington, DC-based nonprofit organization, a nearly 10% increase compared with the prior two years. One third of these cases reached licensed wholesale distributors and/or pharmacies in 37 different countries.

In 2010, IFPMA partnered with its member association, PReMA, the national pharmaceutical industry association in Thailand, the International Association of Patients Organization, and the US Pharmacopeia to raise patient awareness about the health risks imposed by counterfeit medicines in Southeast Asia. IFPMA also chairs the working group on anticounterfeiting technologies of the International Medical Products AntiCounterfeiting Task Force (IMPACT). WHO established IMPACT in 2006 as the organization's drug anticounterfeiting group.

Looking forward

IFPMA has additional initiatives underway in the areas of neglected tropical diseases and antimicrobial resistance. Pisani emphasizes that the pharmaceutical industry's participation in solving global health concerns is part of a larger collaborative, multistakeholder approach. In that effort, he says transparency, cooperation, and trust are key. "We have to walk the talk," he concludes, underscoring not only the industry's participation in the dialogue on global health concerns, but its specific involvement in solutions.