Global Public Goods in Communicable Disease Control

Cover prints Pantone 7417 and black ONLY SPINE - adjust as necessary BACK COVER FRONT COVER Expert Paper Series Expert Paper Series Expert Paper Series One About this book Infectious Disease Epidemics begin and endure as local and regional affairs. They reach globally. Helping countries strengthen their disease control systems and capacities is clearly in the public interest. So are research on infectious diseases Expert Paper Infectious and early warning systems. This volume explores these issues. One Disease Infectious Disease Other books in the Expert Paper Series Two: Global Commons A growing body of evidence demonstrates that global warming is accelerating. A multi-track strategy is required to address its long-term Three: Financial Stability consequences. Financial turbulence tends to cross borders and endanger development and economic growth across regions. Secretariat of the International Task Force The current moment of relative Four: International Trade calm is a time for preparedness not International trade is a key driver of complacency. development and economic growth. Despite its remarkable evolution, the multilateral trading system is not yet Five: Peace and Security quite as global, as public or as good Without an effective collective as potentially it can be. security system, war, terrorism and other forms of strife will increase and international prosperity will be at Six: Knowledge risk or even reversed. Knowledge is crucial in addressing global issues, whether infectious disease or climate change. Yet, the knowledge gap between rich and Seven: Cross-Cutting Issues poor countries is growing and the balance is shifting from public to Cross-cutting issues affect the private knowledge. provision of global public goods, including the effectiveness of o n international and regional institu- Global Public Goods tions, the availability of financing Read the Main Report: and the capacity of nations to Meeting Global Challenges negotiate and implement interna- The report explores the concept of tional agreements. global public goods using historical evidence and illustrates their impor- tance where their provision is critical. It suggests broad strategies in six priority areas for more effectively providing the good in question. www.gpgtaskforce.org Infectious Disease Copyright © 2006 by the Secretariat of the International Task Force on Global Public Goods. All rights reserved. ISBN: 0-9788790-2-3 For electronic copies of this report, please visit www.gpgtaskforce.org. For hard copies of this report, please contact the Secretariat of the In- ternational Task Force on Global Public Goods, PO Box 16369, SE-103 27 Stockholm, Sweden. After 31 December 2006, please contact the Department for Development Policy, Ministry for Foreign Affairs, SE- 103 39 Stockholm, Sweden. Printing: Erlanders Infologistics Väst AB, Stockholm, Sweden Design: Grundy & Northedge, London, United Kingdom Editing and layout: Communications Development Incorporated, Washington, D.C., United States This publication may be reproduced in full or in part if accompanied with the following citation: Secretariat of the International Task Force on Global Public Goods. 2006. Expert Paper Series One: Infectious Disease. Stockholm, Sweden. Contents Biographies of Authors vii Acronyms and Initials ix Preface xi Papers commissioned by the Secretariat of the International Task Force on Global Public Goods xiii Chapter 1 – Transnational Public Goods for Health Scott Barrett 1 Disease control—always a global public good? 6 Surveillance, notification and control 7 Elimination and eradication 11 Limiting resistance 15 Knowledge 17 Conclusions 19 Notes 21 References 22 Chapter 2 – Global Public Goods in Communicable Disease Control Michael Kremer 25 Institutions 27 Administering drugs and vaccines 29 Other tools to combat communicable diseases 31 R&D for vaccines and drugs 33 Knowledge about health programme effectiveness 38 Conclusion 42 Notes 43 References 44 Chapter 3 – Ensuring Markets for New Drugs and Vaccines for Poor Countries: Institutional Requirements and Possibilities Ronald G. Ridker 47 Other necessary conditions 51 Organizational considerations 52 iii The guarantee provider 53 Conclusions 61 Appendix: Global health partners’ efforts to expand production of artemisinin-based combination therapy products for treating malaria 63 Notes 65 References 67 Chapter 4 – Microbicides as an Option for HIV Prevention Pasi Penttinen 69 The need for prevention options 70 Mechanisms of action 70 Research pipeline 73 Research: opportunities and challenges 74 Epidemiology 74 Public health and economic impact 74 Challenges ahead 76 Conclusions 77 Note 78 References 78 Annex 1: Timeline of developments in microbicide research 79 Annex 2: Descriptions of candidate microbicides 82 Annex 3: Who’s who in the microbicides field (some of the major entities involved in microbicide advocacy as of 2004) 83 Chapter 5 – The Role of the World Health Organization in the Control of Communicable Diseases Christopher J.L. Murray 87 Global public goods for communicable diseases 88 WHO background 89 Research and development 95 Multi-country disease control programmes 96 Advocacy 97 Norms and standards 98 Epidemic surveillance and response 99 Monitoring and evaluation 103 Strengthening national capacity and commitment to collect and analyse health data 104 Advocacy, technical assistance, monitoring and evaluation 106 Discussion 112 Notes 114 References 114 iv Infectious Disease Chapter 6 – Health System Capacities in Developing Countries and Global Health Initiatives on Communicable Diseases Uma Lele, Ronald Ridker and Jagadish Upadhyay 119 Effectiveness of the global programmes in building national capacities 120 The challenge posed by communicable diseases 126 Seven global programmes for control of communicable diseases 131 Tuberculosis: the Stop TB partnership 142 Malaria: the Roll Back Malaria partnership 146 HIV/AIDS: UNAIDS and the Global Fund (GFATM) 150 UNAIDS 152 The Global Fund for AIDS, Tuberculosis and Malaria 155 Immunization: Global Alliance for Vaccines and Immunization 165 Systemwide issues: research, procurement and human resources for health 168 Conclusions and recommendations 180 Acknowledgements 182 Notes 182 References 188 v Biographies of Authors Scott Barrett is a professor and the director of international policy at the Johns Hopkins University School of Advanced International Stud- ies and a distinguished visiting fellow at the Yale Center for the Study of Globalization at Yale University. His recent and forthcoming articles have been on topics ranging from global climate change to disease eradication and global catastrophes. He is currently writing a book in association with the International Task Force on Global Public Goods to be published by Oxford University Press. Michael Kremer is the Gates Professor of Developing Societies in the Department of Economics at Harvard University and a senior fellow at the Brookings Institution. He is a fellow of the American Academy of Arts and Sciences and a recipient of a MacArthur Fellowship and a Presidential Fac- ulty Fellowship. Kremer’s recent research examines education and health in developing countries, immigration and globalization. He and Rachel Glen- nerster have published Strong Medicine: Creating Incentives for Pharmaceutical Research on Neglected Diseases. His articles have been published in American Economic Review, Econometrica and the Quarterly Journal of Economics. Ronald Ridker received a Ph.D. in economics and international re- lations from the University of Wisconsin in 1958. Since then he has taught at Washington University in St. Louis and Syracuse University in New York State; was responsible for a research program in population, resources and the environment at Resources for the Future; served as economic adviser to the USAID Mission in India; and was a senior adviser in the Operations Evaluation Department of the World Bank, where he was responsible for human resource sectors. Since retiring from the World Bank in 1994, he has served as a consultant for vari- ous international agencies. His publications include Economic Cost of Air Pollution Damage; To Choose a Future: Resource and Environmental Conse- quences of Population Growth; Population and Development: The Search for Selective Interventions; and numerous journal articles. vii Pasi Penttinen is a public health professional working as medical/public health adviser for International SOS in the Indonesian province of Papua. His current activities include implementation of HIV, TB and malaria control programs at a district level. He previously worked at the Swedish Insti- tute of Infectious Disease Control as a senior medical officer in surveillance and outbreak response for communicable diseases. His training includes a medical degree and a PhD in epidemiology from Kuopio University and an MPH in quantitative methods from Harvard University. He is a fellow of the European Program on Intervention Epidemiology Training. His current research interests are in applying time-series methodology in communicable diseases, describing functional public-private partnerships and developing survey methodology for challenging environments. Christopher Murray is the director of the Harvard University Glo- bal Health Initiative and the former executive director of the Evidence and Information for Policy Cluster at the World Health Organization. A physician and health economist, his early work focused on tuberculosis control and the development of

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