NEW PARTNERSHIP ON NEGLECTED DISEASES IN INDONESIA
On 27 February 2014, Indonesia launched a new initiative to increase access and delivery of health technologies for tuberculosis (TB), malaria and neglected tropical diseases (NTDs). The initiative, known as the “Access and Delivery Partnership”, was launched by Prof. AgusPurwadianto, Senior Adviser to the Minister of Health Indonesia, in the presence of over 20 policy makers from government agencies in Indonesia.
The Access and Delivery Partnership is a jointly implemented project of the United Nations Development Program (UNDP), the World Health Organization Special Programme for Research and Training in Tropical Diseases (WHO/TDR), and PATH, an international, non-profit global health organization.
Policy makers from the various Directorates within the Ministry of Health addressing disease control, health care financing, strategic policy and planning, and health technologies and globalization; the Directorate of Patent of the Ministry of Law and Human Rights; the National Agency of Food and Drug Control; the National Public Procurement Agency; the National Development Planning Agency (BAPENAS); the Country Coordinating Mechanism on Global Fund Indonesia and the Kimia Farma pharmaceutical company, participated in the two-day project planning workshop held in Bandung on 26-27 February. The workshop was organized by UNDP, WHO/TDR and PATH.
Clifton Cortez, Practice Leader of HIV, Health and Development, UNDP Asia-Pacific Regional Centre, highlighted the integrated approach of the Access and Delivery Partnership at the opening of the project planning workshop on 26 February. He said, “UNDP is excited to be involved in the Access and Delivery Partnership because it offers a multi-disciplinary and innovative approach to address complex substantive and systemic challenges”.
In consultation with the policy makers in Indonesia, the Partnership will work towards identifying and addressing bottlenecks within the health system to ensure the effective introduction of new health technologies. The Partnership will seek to work together to strengthen health system capacities in Indonesia under five key areas: coherent policy and legal frameworks; enhanced capacity for evaluation of epidemiological studies to identify country specific needs; strengthened health sector capacity for monitoring of Phase IV clinical trials; improved capacity to ensure sustainable financing, and developed capacity for commercialization to ensure appropriate pricing and adequate supply; and enhanced capacity in supply chain and delivery systems.
In his remarks at the close of the workshop, Prof. Agus Purwadianto expressed his satisfaction that the new initiative would contribute to the objectives of the Indonesian Integrated Plan of Action for Neglected Tropical Diseases (2011-2015), which aims to achieve the elimination and sustained control of the most important neglected tropical diseases in Indonesia: lymphatic filariasis, schistosomiasis, leprosy, yaws and soil-transmitted helminths. He noted that Indonesia has improved treatment and monitoring of TB and is on track to eliminate malaria by 2030.
Prof. Agus also expressed his appreciated for the health systems approach of the Partnership, and also noted the participation of the policy makers from beyond the health sector: “I am pleased that Access and Delivery Partnership has made the effort to facilitate consultations with the various government agencies involved. This Workshop demonstrates the spirit of collaboration, which will be critical for the success of the capacity strengthening activities under the Partnership.”
The Access and Delivery Partnership is made possible by UNDP funding from the Government of Japan under its Global Health Policy 2011- 2015 to stimulate new approaches and new technologies to tackle TB, malaria and NTDs.
Tuberculosis, malaria and the neglected tropical diseases (NTDs) are chronic infectious diseases, which have such significant impact on human and sustainable development that they are collectively defined as poverty-promoting. Around the world, they occur primarily in LMICs, and in these countries, are concentrated in poor urban areas and remote rural areas. They affect marginalized populations, and in many countries contribute to further isolation through stigma. They adversely impact child health and development, maternal safety and adult productivity. They kill and debilitate, and account for 11.4% of the global disease burden. Yet of the 850 new therapeutic products registered in 2000—2011, only 37 (4%) were indicated for neglected diseases, including 25 products with a new indication or formulation, and eight vaccines or biological products. Only four new chemical entities were approved for neglected diseases (three for malaria, one for diarrhoeal disease), accounting for 1% of the 336 new chemical entities approved in that period. Finally, of the 148,445 clinical trials registered from the beginning of 2000 to the end of 2011, only 2016 (1%) were for neglected diseases.
The Access and Delivery Partnership is a five-year (2013 – 2017), US$15.5 million project, established to help low and middle income countries (LMICs) expand the their capacity to access and introduce new health technologies for TB, malaria and other NTDs, as these technologies become available. Led and coordinated by UNDP, the project is a unique partnership between UNDP, the World Health Organisation Special Programme for Research and Training in Tropical Diseases (WHO TDR), and the Program for Appropriate Technologies in Health (PATH), which seeks to leverage the expertise within each organization to provide the full range of technical skills necessary to strengthen capacity in LMICs.
The Access and Delivery Partnership is implemented against the background of the continued disproportionate impact of these diseases on LMICs. Together, TB, Malaria and the other NTDs, account for 11.4% of the global disease burden and affect 15% of the world’s population (the so-called bottom billion). It also takes account of the geographic distribution of these diseases: affected populations live predominantly, but not only, in LMICs.