At the end of February, the non-profit Novartis Vaccines Institute for Global Health (NVGH) was launched in Siena. The institute, which is offering access to Novartis' technology and expertise in vaccine development to potential academic and industry partners with vaccine inventions, will initially focus on the prevention of diarrhoeal diseases.

“There are 3 types of neglected diseases,” says Rino Rappuoli, Global Head of Novartis Vaccines and Diagnostics in Siena, Italy, “the first category includes diseases where more basic research is needed before a candidate vaccine can be generated, the second includes diseases for which a candidate vaccine can be created but drugs already exist that could cure the disease and the third — which is where we have put our priorities — are diseases with high mortality, without good drug treatment options, that we believe we can address with available vaccine technology.”

Novartis already has experience with such non-profit ventures — in 2002, it set up the Novartis Institute for Tropical Diseases (NITD), a drug discovery research institute that is currently engaged in ∼27 public–private partnerships (PPPs). Paul Herrling, Head of Corporate Research at Novartis and Chairman of the NITD Board, attributes the high number of collaborators to the appeal of accessing Novartis' technology. “The fact that a pharma company makes available their drug discovery or vaccine knowledge for non-profit indications makes it very attractive for some of the funding agencies who have the money and the mission but don't usually have access to a professional organization.”

Regina Rabinovich, director of infectious diseases development at the Gates Foundation, USA, agrees that industry is an important partner. “Traditionally, innovation has come out of academia but turning that into a product requires corporate partnership,” she says.

The Gates Foundation has been instrumental in the development of PPPs to tackle global health problems. “This method of activity probably began 8 or 9 years ago,” says John Boslego, director of vaccine development at the non-profit organization PATH (Program for Appropriate Technology in Health) in the USA, “but started much more in earnest in the past 3 or 4 years ... driven by the presence of funding from the Gates Foundation.”

Rabinovich's portfolio alone includes more than US$1 billion in grants for product development partnerships for the prevention, treatment, and research of infectious diseases. When selecting projects, Rabinovich follows set criteria to ensure that the disease to be tackled is a global health priority, followed by 'landscape analysis' which looks at how the proposed solution compares with technology in that area. Finally, the potential partner is evaluated to determine what their organizational viability is in terms of management and if they are able to deliver project commitments. Rabinovich explains, “Money is an important ingredient that allows everyone to participate in a project, but without leadership commitments projects will not succeed.”

For corporate partners, leadership is particularly important because, even if a product has received grant funding or non-diluting capital, it is a challenge to keep progressing non-profit projects. PATH addresses this issue by focusing on development of products that have value in the developed and developing world. Boslego says, “We think it is a win-win situation to help a company to develop a commercially viable product that would also be an addition to the health armamentarium for the developing world.”

Like the NVGH, PATH aims to translate academic inventions into products. Boslego continues, “We work with established manufacturers and sponsors such as big pharma or smaller biotechnology companies to get the technology developed and advanced to a point where it can either be manufactured large-scale by the developed world or transferred to the developing world for eventual manufacture for those populations.”

Although PPPs such as NVGH and PATH aim to create proof-of-concept products that can be manufactured large-scale by other sponsors, Alice Dautry — President of the Pasteur Institute in Paris — cautions that, even if you have a fantastic vaccine, without concurrent capacity building in the countries there will not be long-term sustainability. This includes building research in the countries, training local doctors and researchers to run clinical trials and follow the impact of vaccination campaigns, and working with the ministries of health to ensure there will be take-up of the vaccines. From his extensive experience in vaccine development, Rappuoli is aware of the importance of engaging governments, “If you don't, you get to a point where you have a vaccine but nobody will use it,” he explains.

Dautry also emphasizes that it is critical to correctly diagnose the infectious disease and feels that diagnosis is another area that has been neglected. Citing an example from the Sahel region in Africa, where there are regularly epidemics of meningitis due to different strains, she notes that misdiagnosis could result in people being vaccinated against the wrong strain, which would lead to lost money, effort and credibility. “Once you have convinced mothers to bring their children and the vaccine does not work, you will not get them back next time — you have lost a generation.” She concludes, “We must not be blinded by the idea that a big foundation or pharmaceutical company alone will solve these problems. Building a new vaccine is very important but in the long term it is not enough ... it must be a global effort of all players, public, private and governments.”