New Medicines for the Poor; A New Model for the Pharmaceutical Industry

By Bill Shore | March 6, 2007

Victoria Hale from the Institute for One World Health, the first nonprofit pharmaceutical, delivered a keynote address this weekend at the Social Enterprise Conference at the Harvard Business School.

Although Victoria has received numerous awards for social entrepreneurship, including from the Skoll and Schwab Foundations, it was clear that her career was shaped and driven not by social entrepreneurship, but by the opportunity to save lives. It was only after she became a model of nonprofit success that others adorned her with the label of "social entrepreneur."

More than 400 students from the Business School, the Kennedy School and other nearby colleges filled the Burden Auditorium on Sunday, many of them having been inspired by the speakers to consider a career in public service or the nonprofit sector. Cheryl Dorsey, president of the Echoing Green Foundation began with a powerful speech cataloging problems around the world that social entrepreneurs could address. Then Victoria Hale, whose organization is newer and less well known, described their impact so far and shared strategies that could be valuable to a wide range of organizations.

Hale spoke in a quiet and low-key voice, as if presenting the results of academic research, but it was clear from the words she chose, as well as her track record since 2000, that a passion, perhaps even an anger, fuels her work. She used a slide presentation to show the faces of the poorest of the poor around the world who she described as those the Institute for One World Health is designed to serve. She explained that young girls in one photo, from the Indian state of Bihar, had reddish hair because of malnutrition and dehydration from diarrhea. Two million children a year die from it. "This is the 21st century. Why does that happen?" she asked softly, almost as if addressed to herself.

Hale explained that "these people don't need the same medicines we do. There is a problem with how we make medicines. Medicines are miracles. There is an incredible beauty and power to them. In 2000 I began pulling together scattered ideas based on both my pride in the industry and my shame that we hadn't figured out how to make medicines for all. We went to India first because we knew we could have success early on. The size and scope of the success is less important than that it be a success. So as we adopted the mission of making safe, effective and affordable drugs, we wanted to develop an organization that would show the industry a new way of working."

The Bill and Melinda Gates Foundation immediately took notice of this innovative model and became the principal funder of the Institute for One World Health.

Hale went into greater detail about their first victory, the effort to eradicate visceral leishmaniasis (VL). "It is curable, but you probably haven't heard much about it because those who get it are very poor and very rural. It kills – who knows how many. And the disease is from a single cell parasite that you get from the bite of a sand fly. The parasite goes to the spleen and the liver and then it goes to the bone marrow. Parasites are brilliant. This one knocks out the ability to make white blood cells and red blood cells. Bihar is the center of the epidemic, with one half of the world's VL located right there. The opportunity exists to eliminate the disease if we have the will. It doesn't get much easier than this to eliminate a disease."

"Our first success was with paromomycin," Hale continued, "which costs about $10 for a 21-day therapy and gives you a lifetime cure. It gave us proof of concept as a nonprofit pharmaceutical. But drug approval is not enough. You have to get it to people. That's how you save lives. We were warned by everyone not to do distribution. We had to turn on its head the notion that advanced technology is not for everyone, that it is only for is in the west. You must always turn complexity on its head and make it simple by looking at it another way."

Hale's political savvy and pragmatic side came through when she advocated that "mainly, we need to engage the pharmaceutical industry. If we don't it is a missed opportunity and we won't be all that we can be. The industry does not know who the poorest people are and we can't expect them to know what needs to be done. But the carrot is more powerful than the stick and we must ask: ‘What is it you need in order to engage?' And also, ‘What are you afraid of?' Corporations want to do well and good and we should respect their individuals capacity and potential. Don't presume you know the answers. Ask! And balance patience with persistence because it always takes longer than you hope or dream."

While Victoria Hale is widely perceived as a leader working in the field of social entrepreneurship, she actually paints on an even larger canvas, one whose backdrop is sweeping changes converging from the three fields of philanthropy, entrepreneurship, and science. She concluded her remarks to the Harvard Social Enterprise Conference by urging "Trust the universe. If your intentions are good, the universe brings you what you need."