Leveraging Markets for Global Health

An analyst at the National Quality Control Laboratory in Kenya conducts a test on a pharmaceutical sample. / Tobin Jones, Chemonics

Innovations are critical to help the international development community achieve goals in the fight against malaria, HIV and other global health challenges.

New products, like a household insecticide that kills malaria-carrying mosquitoes in areas where older sprays no longer work, can protect some 50 million people from malaria over four years.

And lower-dose antiretroviral medications could dramatically lower HIV treatments costs, while shrinking pill size and reducing side effects.

But inventing these new products is not enough.

Efficient markets need to motivate suppliers to manufacture, wholesalers to distribute, and retailers to sell.

Donors, national governments, advocates and other global health stakeholders can play an important role in identifying and seizing market-shaping opportunities to maximize market forces for global health goals.

“With so many breakthroughs, we’re spoiled in the HIV world, and there is a groundswell of support for these new drugs,” said Francois Venter, the deputy executive director of the South African research organization Wits Reproductive Health and HIV Institute, which is overseeing a critical clinical trial for new antiretrovirals.

“But these products won’t deliver themselves, and we need everyone working together to succeed,” he said.

A member of a local malaria control team in Ethiopia gets ready to apply indoor residual spray. Brant Stewart, RTI/Courtesy of PMI

Unrolling New Insecticide Sprays

In February, UNITAID and Innovative Vector Control Consortium launched a market-shaping partnership with the President’s Malaria Initiative (PMI), USAID’s Center for Accelerating Innovation and Impact, PATH, Abt Associates and the Global Fund to stimulate development of and facilitate access to new insecticides for malaria control.

The $65 million Next Generation Indoor Residual Spray Project uses a co-payment program to lower the cost of novel, long-lasting residual sprays while strengthening demand forecasting and fostering competition to keep prices affordable over the long term.

By supporting the use of these new sprays in 13 African countries, PMI and the Indoor Spray Project protect communities from malaria where older insecticides are largely ineffective due to increasing resistance in mosquitoes.

At the same time, broader use of new sprays expands the market and builds a business case for prospective suppliers.

A malaria control team heads out to a rural village in Kenya to provide indoor residual spray services. / Brant Stewart, RTI/Courtesy of PMI

Marketing Low-Dose HIV Treatment

In the HIV space, treatment programs have long used antiretroviral therapy, but transitioning to new drugs will still require a complex rollout: registering new products, training providers on new regimens, and phasing out older drugs.

Each of these steps compounds uncertainty around the size and timing of demand, and this uncertainty hampers the ability of suppliers to invest in adequate production for low-income markets.

Given these challenges, global health experts need to be proactive in analyzing how to encourage a competitive market that meets demand at affordable and sustainable prices.

To further this effort, the U.S. President’s Emergency Plan for AIDS Relief, USAID’s Office of HIV and AIDS and the Center for Accelerating Innovation and Impact are supporting the OPTIMIZE project, which is charged with bringing new antiretroviral drugs to market.

Led by the Wits Reproductive Health and HIV Institute, this innovative consortium brings together an unusually diverse set of partners to draw on expertise in clinical research, market access, and advocate engagement.

Collaboration is a cornerstone of any market-shaping intervention, and the OPTIMIZE consortium will work with partners on reducing manufacturing costs, accelerating product registrations in developing countries, and facilitating production planning with more demand visibility.

From insecticide sprays to new HIV treatments, USAID’s Center for Accelerating Innovation and Impact leverages USAID’s financing, technical expertise and convening power to shape markets where needed.

For these and other health areas, we hope to forge partnerships on both the demand and supply side to help inefficient markets operate more effectively, get better value for money for our investments, and — most importantly — accelerate access to lifesaving innovations and health impact.

This post is part of the #MarketsMatter blog series.

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