Last week I was pleased to attend the 5th anniversary reception for the Cambridge MA-based Institute for Pediatric Innovation (IPI), a not-for-profit founded by one of my technology transfer mentors, Don Lombardi. After a career in business and technology transfer at Children’s Hospital Boston, Don started IPI to address the lack of new technology and therapies to treat children. Its mission is “to identify which new devices and drugs clinicians need to provide better pediatric health care, and strive to turn those into available products,” and to date, the IPI has built a network of hospital and clinicians as sources of technology but has the ongoing challenges of funding and converting prototypes into products.
Of course, improving pediatric health is not a problem of the US only. In developing world, in addition to the dangers of birth (the main cause) and inadequate nutrition causing children’s mortality, infectious diseases like pneumonia, diarrhea, HIV/AIDS, malaria, and rabies take their toll resulting in about 8 million children under the age of five dying each year (Global Health Council summary). Aarthi Rao summarized the problem succinctly in a recent post (Center for Global Health Policy Assessment blog, “But What About the Kids,” Rao post), noting three needs: access to and application of existing tools and methods (a problem in health care delivery), adaptation of existing technology and treatments for pediatric use (e.g., development of pediatric dosing and safety data for drugs, see WHO’s Essential Medicines for Children, WHO Meds for Kids), and development of new technologies specific to kids. NGOs, international agencies, and foundations are focused mostly on the first area and somewhat on the second, and so I see a need and an opportunity for companies in the third, applying technology to improve ROW (rest-of-world) pediatric health. Here are a few specific needs I have noted:
- Tuberculosis diagnostic: since children cannot cough up enough sputum for an adequate standard diagnostic sample, a better method is needed (Rao above and WHO Fact Sheet);
- Diagnostic to differentiate fever: sick kids have fevers but proper treatment requires knowing the cause, so a diagnostic that can differentiate between malaria and pneumonia, for example, is needed (see BVGH IQ Prize Case Statement);
- Pulse oximetry and oxygen delivery: studies have shown that a reliable system of measuring blood oxygen and delivery of oxygen as needed can reduce child mortality from pneumonia by 35% (Duke et al 2009) and some simple oximeters have been prototyped (e.g., Zaman lab);
- Sickle cell treatment: as I mentioned in a previous posting (“A Really Neglected Disease,” 7/29/10), underlying sickle cell disease in children in Africa is likely a contributing factor to upwards of 250,000 deaths per year, so a treatment will be life-saving (see All Africa article); and
- Vaccines: some infectious microbes have serotypes that are specific to kids whose developing immune systems make them vulnerable, so new vaccines are needed (e.g., bacterial meningitis and dengue).
But getting new technology development funded is the rub. In the pediatric disease field there are huge donor-funded programs to improve health care delivery (as there should be), but few funders who understand the risks and rewards of technology development. The Bill and Melinda Gates Foundation is one of the few foundations that is trying to and recently announced that one of its Grand Challenges will be for “scientists, innovators and entrepreneurs to seize the opportunity to contribute to the field of family health through the discovery and development of medicines, medical devices, diagnostics and other lifesaving tools.” It will be funded at $35 million (Gates press release) and I hope will have advice from successful entrepreneurs. There are currently small grants are available through the Grand Challenges Explorations program in which Round 6 included maternal and infant health as a goal (Explorations), but as I have noted previously the grantors favor academics. Also recently the Gates joined USAID, the governments of Norway and Canada, and the World Bank to launch the Saving Lives At Birth Grand Challenge (Saving Lives) to fund innovations in both delivery and technology. Of 19 finalist organizations under consideration for a share of $14 million in funding, seven have a technology component (Finalists), and if a few of these receive adequate funding and help from experienced product developers, one may actually create something that saves lives at birth.
One would think that companies with global health corporate responsibility programs would have an interest supporting technology development for neglected pediatric disease. Two candidates are Alere, an international diagnostics company that has donated HIV/AIDS diagnostics (Alere), and Laerdal Global Health, which sells maternal and neonatal health products and training (Laerdal). As for the big corporations, in 2010, the Johnson and Johnson Company made a five-year but unspecified dollar commitment to the WHO’s “Every Woman, Every Child” program (JnJ press release). Although the press release mentions research and development of new medicines as a goal, the program website does not (Every Woman). This month the General Electric Foundation provided Jhpiego, a Johns Hopkins University affiliate, with $1.6 million to “develop low-cost, lifesaving technologies that can transform health care for women and children in developing countries” (Jhpiego press release). That is generous but limited to JHU and not much money for the intended “early-stage innovation and then, for selected projects, field-testing and product introduction.” Bottom line: cultivation of the corporate sector is needed.
Meanwhile back at the Institute for Pediatric Innovation, there is one project with a global health slant which is to perform a “detailed review of the medical anthropology” to “help advance pharmaceutical reformulation for children by sensitizing drug developers and marketers to important cultural and social issues” (Evaluating Global Reformulation Needs, IPI project). I’m unclear on the concept and the results are still forthcoming. My suggestion to Don to have a bigger impact on global pediatric needs: review the IPI technology portfolio for opportunities that have global health relevance, write-up development, funding plans, and strong arguments to convince potential licensees that products for kids can have profit margins, and start knocking on doors in the for-profit world.