Free Advice, Trevor

To state the obvious, the billions of dollars given way by the Bill and Melinda Gates Foundation (BMGF) have enabled much good and improved global health over the past ten years, but, as with most philanthropic endeavors, the foundation has been weak in measuring the effectiveness of its grants and the performance of its grantees.   Consequently, the effect of the Foundation’s largess has been diminished by supporting a legion of intermediary organizations with their attendant bureaucracies and overhead costs and, according to one report, through diversion by the unscrupulous at one major beneficiary (“Fraud plagues Gates Foundation-backed global health fund,” Komonews article).  Since its easy to be a critic, I have blogged about deficiencies in the BMGF’s programs that are specific to my interest in creating new products and global health businesses.  I noted in one posting that the Foundation doesn’t spend much on technology discovery and development (less than 5% of its annual dole) and that the most of the grants goes to academic groups (“The Gates Foundation:  For-Profits Need Not Apply?” 11/24/09) and that, while paying lip service to “investing,” the Foundation heavily favors grants and, hence, has no stake in the outcome (“BMGF Ventures LLP,” 4/14/11).  For a broad, politically-oriented criticism of the BMGF, one can skim the Global Health Watch’s undated review (GHW review).

But to confirm that I am not missing reports of technology development supported by Gates grants, I checked the Foundation’s Global Health “What We’re Learning” page for progress or research and evaluation reports (Search), and found only 7 items in this category, none relevant.  I also looked at the disease-specific “Strategy Reports” and noted they were current as of 2009 (Strategy Reports).  When I looked at the foundation’s key program for grants for invention  of new technology for global health, the Grand Challenges program that has given out a total of $458 million in grants since 2005 (Grand Challenges), I found that each grantee is required to have a Data Access Plan (Our Commitment), but no where is it described how one accesses the data/results of the grants.  The Challenges are now in Round 8; what’s resulted from Rounds 1-7?  If I was an entrepreneur (and self-funded) and wanted to invest in the development of a product resulting from one of the 17 Phase II projects that received $1 million each (Grants Awarded), whom do I contact?

Maybe the new guy, Trevor Mundel, will change that.  As was announced two weeks ago, Dr. Mundel will be the new president of the global health program (Marketwatch article) replacing Tachi Yamada on December 1 (see my post, “Over to the Dark Side,” 6/30/11).  Dr. Mundel is currently global head of development for Novartis Pharma AG in Basel, Switzerland, and, according to Science Insider had been hired by several companies, including a local player, Alkermes, Parke-Davis, and Pfizer, “to shake up their research and development programs and streamline the process of translating basic research into new drugs (Science article).”  According to the In Vivo blog, he’s had a mixed record of delivering drugs for Novartis, one (Ilaris for gout) was rejected, a drug for stomach cancer got narrower indications, and a COPD drug (indacaterol) was delayed, but the multiple sclerosis drug Gilenya was the first approved oral therapy (In Vivo blog).  And, but not a big deal, he was born, raised, and went to college in South Africa (Africa News article).

My (free) advice to the new guy is to unclog the Gates Foundation-funded pipe line of “maybe” drugs and other products for global health, for example:

  • require the Grand Challenge grant recipients to report what they’ve done;
  • require the technology transfer offices at the grant recipients’ universities to write and implement technology commercialization plans (after all, typically half of the grant is for university overhead costs);
  • give more grants (or make investments) in translational programs (like at companies), and
  • get a venture-formation team to review all grantees for commercializable IP, which they will package in a prospectuses with development and financial projections (inadequate as they are), and circulate to wannabe entrepreneurs with an offer of a one-to-one match on the funding they raise.

I read in the above-cited Global Health Watch review that the Foundation’s pattern of funding ledsome health activists to question if the Foundation is converting global health problems into business opportunities.”  That actually sounds like a good idea to me and I hope Trevor adopts it as Global Health Program’s motto.


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