Bay Area Leading in Health Aid

November 17, 2002

Bay Area biotech leaders are in the forefront of a movement to teach our profit-driven drug development industry how to make medicines for the world's poor.

The latest evidence came during a panel discussion last week at an investment conference in Burlingame.

Panel moderator Brook Byers, of the venture capital firm Kleiner Perkins Caufield and Byers, got down to the nitty-gritty of making medicines for people so poor that they don't have clean water to wash down a pill.

"I think we blew some minds," Byers said. "People were on pins and needles."

With help from speakers including UCSF biochemist Joe DeRisi and San Francisco financier Paul Klingenstein, Byers laid out the formula that's got the biotech industry buzzing.

It begins with socially responsible firms like Chiron Corp. that have patented discoveries with the potential to address such pandemic diseases as AIDS, tuberculosis and malaria.

Chiron and a few other firms, including Celera, have licensed these experimental drugs to a handful of nonprofit development organizations such as the Global Alliance for TB Drug Development, headed by Dr. Maria Freire.

Think of these nonprofit developers as "virtual companies" with tiny staffs and no labs or factories. What they do have is support from foundations led by the Bill & Melinda Gates organization and the Rockefeller Foundation.

Using foundation cash, the nonprofits will contract out the clinical trial work needed to prove new drugs safe and effective.

Under the terms of these new licensing deals, the nonprofits have the right to sell -- or give away -- new medicines in the developing world. The for- profit firms retain options to sell the drug in affluent nations.

"This industry is really thinking about doing things a little differently," Byers said.

In a-better-late-than-never way, I'm proud that local biotech leaders are taking the lead in trying to change the grim statistics of global health.

Every 15 seconds someone dies of TB. Malaria kills 2,800 children a day in Africa alone. AIDS claimed 3 million lives in 2001. Lesser-known diseases needlessly kill millions more.

In the past, for-profit drug firms turned a blind eye toward these needs and followed the money -- treating the ailments of affluence, such as heart disease, diabetes, impotence, baldness and depression.

Of course, there have always been exceptions. In the late 1980s, Merck took a heartworm drug for dogs, amended it to treat river blindness in humans, and then gave the new medicine away when no government or international agency stepped up to buy it.

But such corporate altruism is uncommon and, I'd argue, as unlikely as trying to solve homelessness by letting the indigent sleep on our couches.

In recent years, many biotech leaders have quietly tested business models that might make it possible to develop drugs for the 1.2 billion people who live on a dollar a day or less.

Chiron Chief Executive Officer Sean Lance nudged the process along two years ago, when he joined a vaccine development conference organized by the Institute for Global Health in San Francisco.

Earlier this year, biotech licensing expert Mark Edwards held a workshop in San Francisco on how to put together north-south deals to channel money and know-how from the affluent nations to treat pandemics.

This budding global health movement moved into high gear in June, when Carl Feldbaum, president of the Biotechnology Industry Organization, pledged it would take the lead on the issue.

BIO will start to deliver on that promise in Washington, D.C., next month at its first Partnering for Global Health Forum, (

Let's not be naive. The drug industry has been beaten up in recent years for hiding behind patents to price AIDS drugs out of reach of the poor. Without getting into that debate, industry leaders understand they must balance their patent rights against human rights, or risk losing their patents.

So there's a large element of what might be called enlightened self- interest fueling this movement. Cynics might dismiss the whole affair as window dressing. But if being a reporter has taught me anything, it's spotting PR ploys, and this strikes me as the real McCoy.

So far, all I've focused on is drug development. Remember how Merck had to give away its pills? Foundations can fund clinical trials, but they can't buy and deliver the pills without help.

Anticipating the need for an international agency to do that job, U.N. Secretary General Kofi Annan last year helped create the Global Fund to Fight Aids, Tuberculosis and Malaria.

The new fund is headed by UCSF Professor Richard Feachem, one of the folks who helped start this movement. Feachem is already in Geneva, raising billions of dollars from the United States, Italy and other nations. Wish him luck. Better yet, send him money ( When he goes panhandling among the high and mighty, it'd be nice to have some coins from hoi polloi jingling in his cup.

Corruption is a stumbling block for the global health movement. After all the fury about free AIDS drugs to Africa, when GlaxoSmithKline shipped 9 million doses of Combovir to West Africa for next to nothing, health officials discovered to their dismay that profiteers had sold a third of pills back into Europe.

We'll learn from such setbacks. Drugmakers are changing the packaging and shape of subsidized pills to make diversion tougher. As new challenges arise, we'll have to think outside the box, because accepting the status quo is unacceptable.

The global health movement is trying to establish a new human right -- that every person deserves a minimum standard of medical care. This is not a movement organized by governments or parties. It won't have rallies or speeches. We're too busy. We're going to change the world by knitting together like-minded people by e-mail and cell phones. We're going to create an international conspiracy of compassion.

And we know we'll win, because we've seen this movie. Actually, two movies fused into one.

The global health movement is where "Alice's Restaurant" meets "Wall Street." It's Arlo Guthrie crossbred with Gordon Gecko. It's a movement that grows stronger every time someone in the biotech industry says, "Surely this isn't only about money."

If it was only one person, well, the prevailing wisdom would suggest they were depressed and prescribe Prozac. But when a card-carrying capitalist like Brook Byers gets up at investment conference and says, "Surely, this isn't only about money," you can't write him off as a commie.

Imagine ten thousand people throughout the industry, ten thousand people standing up and saying, "Surely this isn't only about money."