College of Arts and Sciences

Public-Private Partnerships and Their Role in Managing and Preparing for Emerging Infectious Diseases: Portraying Covid-19 and the Future

April 28, 2020

Collaboration between public and private entities is more important than ever to a world battling a pandemic and to helping to prevent future global health catastrophes.
While governments have been deploying different methods to respond to the Covid-19 pandemic as efficiently as possible, scientists and researchers are making the most of expediated resources to tackle the virus. In only a few weeks, dozens of partnerships have formed to combat the coronavirus, but for these to succeed, understanding the complexities of public-private partnerships becomes crucial. 
A collaborative research team featuring Dr. Vijay Pereira, Associate Professor of Humanities and Social Sciences at Khalifa University, has published an article in the Academy of Management Perspectives journal to examine how a multi-stakeholder strategic partnership approach can help avoid a catastrophe caused by emerging infectious diseases.
“The extent and impact of neglected diseases has been well documented in the public health and medical science literature,” explained Dr. Pereira. “However, from a strategic management and organizational perspective, there is a gap in understanding the complex relationships that underpin Product Development Partnerships – a type of partnership formed to develop pharmaceutical solutions for low and middle income countries.”
Dr. Pereira co-authored the article with Dr. Yama Temouri, also of Khalifa University, Dr. Swetketu Patnaik of Anglia Ruskin University, and Dr. Kamel Mellahi of the Dubai Chamber of Commerce. 
“The evolving pandemic caused by the novel coronavirus is an illustration of the lack of effective drugs leading to catastrophic consequences,” said Dr. Pereira. “Additionally, the World Health Organization identifies antimicrobial resistance as one of the greatest threats to global health. The resistance to existing classes of antibiotics, combined with greater incidences of emerging infectious diseases, necessitates the need for faster development of new and effective drugs.”
Developing new medications is a collaborative effort involving a wide range of actors and stakeholders. Public-private partnerships (PPPs) are considered crucial in addressing the challenges associated with medical research, and although they are hardly a new phenomenon, these arrangements have gained momentum since the 1993 call from the World Health Assembly to mobilize and encourage support from various partners to address global health challenges. 
The collaborative relationships mostly include governmental agencies and intragovernmental organizations (such as the World Health Organisation (WHO) as public actors, and university and research institutes, commercial pharmaceutical companies and professionals as private actors. While Product Development Partnership (PDPs) are formed to create new medicines, ‘pre-competitive PPPs’ are formed to generate novel scientific concepts and infrastructure by pooling complementary expertise and knowledge, and sharing the rewards. 
“Notwithstanding the increasing formation of PPPs in general and PDPs in particular, and their significance in the global health system, there is a gap in the strategic management and organizational literature on the phenomenon,” explained Dr. Pereira. “We agree that PDPs are a critical mechanism to address the deficiency of necessary drugs for many diseases, particularly the ones that affect the poorest countries the most. 
“We wanted to identify the importance of PDPs in the development of new drugs for emerging infectious diseases and also identify the key stakeholders, their relationships and levels of dependencies through the resource dependency lens. We found complex interrelationships between various stakeholders and discovered that power, trust, and governance are key challenges in this area.”
A significant number of PDPs emerged in the late 1990s in response to a growing concern over the lack of new drugs for so-called neglected diseases—those diseases that predominantly affect people in low and medium income countries. Many pharmaceutical companies had gradually disengaged from developing new drugs for tropical diseases by the 1980s, primarily due to the lack of any health insurance system and the reduced ability of the users in these countries to afford and pay for the medications. 
“As a direct result, between 1975 and 1999, only 13 new drugs were developed for neglected diseases, and almost all these new drugs were essentially either combinations or extensions of existing drugs,” explained Dr. Pereira. 
The first two PDPs—the International AIDS Vaccine Initiative and the Medicines for Malaria Venture—were established in the late 1990s, with support from the Rockefeller Foundation, the WHO Special Programme for Research and Training in Tropical Diseases, the United Nations Development Programme, and the World Bank. Since then, PDPs have transformed the R&D landscape for neglected diseases. More than 300 organizations from private and public sectors are currently engaged in the development of a combined pipeline of 374 drugs and vaccines for 23 neglected diseases. 
“We’re now seeing the rapid formation of PDPs to develop new vaccines for the novel coronavirus,” added Dr. Pereira. “In this context, PDPs function as ‘system integrators’ in the sense that they facilitate the development of new drugs by bringing together the expertise of different stakeholders in the broader health innovation ecosystem. They work towards generating funds from key funders and tap into the knowledge base of partners from academic, public and private sector organizations and various international agencies to leverage each other’s strengths towards a common goal.
“The coronavirus pandemic puts new urgency on understanding the complexities of public-private partnerships so these critical collaborations can operate at peak efficiency.”
For these partnerships to succeed, the interrelated partners need to trust each other. Funders must trust the staff to find the right scientific and operational partners without micromanaging simply because they are providing the funds. Sharing the power in the relationship can also help PDP staff and governing boards function better. 
The team now plans additional research in the area of shared risk, such as the current Covid-19 situation, where the Bill & Melinda Gates Foundation have invested in PDPs and factories, with a hope that only two of these may succeed in the required 18-month period.
“In the current global health crisis, risk taking needs to increase,” said Dr. Pereira. “The question now is how should parties be rewarded for their diligent efforts on treatments or vaccines if they fail? This is to be expected in any scientific exploration, but pandemics mean delays need to be avoided. The need for treatments and vaccines to be affordable places another burden on these partnerships that are already complex.”
Most importantly, the research team hope their findings highlight the need for better worldwide preparedness in the future. 
“We can’t wait and go from one disaster to the next.”
Jade Sterling
News and Features Writer
28 April 2020

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