Advocacy at every step

Advocacy at every step

Devise and test solutions

Advocates help close gaps so that health solutions can be designed, tested, adapted, and validated as quickly as possible

Encouraging investment in tomorrow’s solutions, today. In 2008, advocates from the Global Health Technologies Coalition helped secure US government investment for new tools to fight HIV. Today, those investments are saving lives.

Spotlighting innovation. How do you identify and advance health innovations with the most promise to save lives? PATH’s Innovation Countdown 2030 initiative found a way.

Learn more

Health worker separating pills on a tray.
Photo: PATH/Minzayar

Global Health Technologies Coalition

Encouraging investment in tomorrow’s solutions, today

The opportunity

By 2008, effective, more affordable antiretroviral drugs to treat HIV were offering new hope to millions of people in low-resource countries. Yet the epidemic remained a health crisis. The previous year alone, a staggering 2 million people had died from AIDS-related illnesses (Joint United Nations Programme on HIV/AIDS, 2008 [2.13 MB PDF]).

In addition, even in countries where less-expensive generic drugs were available (and that still wasn’t everywhere), they were not enough to stem the devastation. Sometimes, initial treatments failed due to viral resistance or created unmanageable side effects for patients. When that happened, alternative drugs were prohibitively expensive—increasing the cost of treatment anywhere from two to eleven times as much.

Unless more manufacturers became interested in making affordable antiretroviral drugs, or more public-sector donors became willing to fund research and development for new tools, new options were likely to arrive slowly or not at all—costing lives.

Around the same time, advocates saw a promising window for action. In the United States, the President’s Emergency Plan for AIDS Relief (PEPFAR)—the largest investment, by any nation, to combat a single disease around the world—was up for reauthorization in the US Congress. With it came a new chance to invest in lifesaving research and development (R&D) for desperately needed drugs and technologies.

Recognizing this opportunity, advocates from across sectors came together via the Global Health Technologies Coalition (GHTC)—convened by PATH—and sprang into action.

The challenge

In early discussions on PEPFAR reauthorization, US legislators focused primarily on increasing funds for existing technologies, rather than supporting new innovation. Yet health advocates, including PATH and other GHTC members, knew that overturning the status quo also required investment in the R&D of affordable new tools and technologies.

GHTC advocates worked to ensure that commitments to fund R&D would be included in PEPFAR.

How advocacy unlocked health innovation

GHTC provided the structure to keep up momentum, coordinate efforts, and achieve consensus. With PATH as convener, the group agreed on commitments they wanted to see included in the PEPFAR reauthorization bill. These focused on the overall need for R&D on vaccines, HIV prevention, and diagnostic tools, as well as on specific approaches that make it less risky for manufacturers and developers to pursue new solutions.

With their requests clearly outlined, members of the coalition and their networks met with a wide variety of policymakers. They enlisted support from the Center for Global Development; Gavi, the Vaccine Alliance; and the World Bank. They met with US Treasury representatives to win their support for innovative financing models. They held briefings with the US Congress, and more.

Hands holding an HIV self-test stick and illustrated instructions.
New tools—such as this HIV self-test—are key to combatting HIV. Investment in research and development makes them possible. Photo: PATH/Matthew Dakin.

The outcome

Thanks to the coalition’s work, the PEPFAR reauthorization included not only the anticipated billions in funding, but also robust new support for R&D.

Until the world has the tools to stop HIV altogether, the fight against HIV/AIDS will continue.

Since 2008, however, years of combined efforts by thousands of organizations, governments, and communities worldwide—including GHTC—have made progress. Between 2005 and 2013, deaths from HIV/AIDS have dropped by more than 35 percent (WHO, 2016). In many communities, treatments that once cost as much as US$10,000 a year are now available for around $150 (United Nations Development Programme, 2015).

At the same time, GHTC has grown into an even more effective force for change, addressing not only HIV/AIDS, but a wide variety of health issues. Today, it’s more than 25 nonprofit members (including think tanks, product development partnerships, and advocacy groups) continue to advocate for sustained investment in R&D across health areas. Together, we are building the groundwork to bring more products to widespread and lifesaving use.

Project partners: Center for Global Development; Gavi, the Vaccine Alliance; and the World Bank

Three health care workers practicing with a neonatal resuscitator and an infant mannequin.
Photo: Courtesy of Laerdal Global Health

Innovation Countdown 2030

Spotlighting innovations with the greatest potential to transform health

The opportunity

Between 1990 and 2015, the world made tremendous progress in improving the health of women and children, including drastically reducing the number of women dying from complications in pregnancy and childbirth and the number of children under five who die each year.

Over that time, PATH and other global health leaders learned a lot about what works to save lives. One clear insight was that effective, affordable health technologies and approaches (tools like vaccines, diagnostics, and family planning options) are critical to reaching ambitious health goals.

And—because it takes time to find, develop, or advance those tools—the sooner we start developing them, the better.

At the same time, the world reached the end-date of the Millennium Development Goals (a set of targets established in 2000 for reducing extreme poverty) and began formulating the ambitious Sustainable Development Goals (SDGs) to guide health and development efforts through 2030.

PATH saw an opportunity: If health experts could identify—and advance—solutions with the most potential to transform health, those tools and approaches could help bring global goals within reach, saving lives.

The challenge

The problem? Too many great innovations weren’t reaching users. Some had demonstrated an ability to improve health—or were even being used at a small scale—but never got the support or investment to reach large-scale use. That left much of their true potential unrealized. In other cases, products had stalled earlier, lost in the development pipeline that brings ideas from early prototype to finished product. Without the right backing, they weren’t able to complete the many steps—from testing, to regulatory approval, to successful introduction—that allow products to reach users.

One reason was that, in a world full of good ideas, there was no single mechanism to curate solutions: that is, to identify and showcase the most promising options to attract expertise, funding, and interest. In addition, innovation was increasingly coming from all parts of the world, not just from well-funded groups in wealthy countries. That was good, but it was also a new way of thinking for many investors and leaders, who had not quite adjusted their approaches to this changing context.

Other gaps also stalled progress. For example: How could leaders determine which solutions would be both effective and cost-effective? How should governments make investments to advance innovation? What other players had to come to the table to fill gaps in funding?

How advocacy unlocked innovation

PATH established the Innovation Countdown 2030 (IC2030) initiative to close the gap. The effort brought independent, global stakeholders together to identify, evaluate, and showcase 30 innovations with the potential to transform health. First, we crowdsourced more than 500 ideas from entrepreneurs, academics, investors, and nongovernmental organizations from nearly 50 countries. Next, we tapped more than 60 independent experts to evaluate and rank the ideas to create a list of finalists. In addition, we developed a sophisticated modeling process to determine the health impact and cost of products and applied it to several innovations. The model quantified lives saved, cases of disease averted, and relevant costs—a set of metrics that are often very elusive.

With this information in hand, IC2030 published an easy-to-read report, Reimagining Global Health: 30 High-Impact Innovations to Save Lives. Combined with advocacy at key global health events and meetings with high-level global leaders, the report galvanized discussion, interest, and support worldwide.

Girl watching a nurse fill a syringe in a vaccination campaign tent.
Too often, lifesaving innovations—like vaccines—do not reach the people who need them most. IC2030 aimed to fill a gap in identifying, evaluating, and showcasing promising innovations. Photo: PATH/Aaron Joel Santos.

The outcome

Overall, the IC2030 initiative not only raised the profile of the 30 innovations in the report but also sparked new interest in health innovation more broadly.

In the lead-up to the United Nations General Assembly in 2015 (where the SDGs were officially adopted), the report gave advocates a way to share the value of health innovations and convey how important it would be to feature innovation prominently in the new goals. It also helped leaders understand that we need to look for great ideas everywhere in the world, not just from well-funded laboratories and research centers in wealthy countries.

These efforts culminated in inclusion of language and indicators focused on the development of new technologies in the SDGs—a win that will support innovation for years to come.

Now, PATH is continuing these efforts: expanding the evidence base for high-impact innovations and advocating for policies that promote and support research and development worldwide.

Project partners: Norwegian Agency for Development Cooperation (NORAD), the Bill & Melinda Gates Foundation, the United States Agency for International Development