A Conversation with Karl Hofmann

Looking back and looking forward with the outgoing president of TB Alliance's Stakeholders Association

April 25, 2019

We spoke with Karl Hofmann, president and CEO of Population Services International (PSI), to hear about his time serving as the president of the TB Alliance Stakeholders Association (SHA). The SHA is an association of organizations that form a group of supporters and advisors. Find out more from our most recent SHA annual meeting



TB Alliance: After six years as SHA President, how have you seen TB Alliance and the SHA change?

Karl Hofmann: The Stakeholder's Association has been around for almost twenty years, and I think it's been an important part of the support group for the work of the TB Alliance. During my period here I was privileged to see the Alliance really start to move into a phase from research through clinical trials and, now, right into patients. And this is an exciting period in TB after many decades where there just wasn’t much of a breakthrough at all in terms of new therapies.

I think the SHA has to play a role that is informed, supportive, but also when necessary, constructively critical of the decisions that the TB Alliance is making. I think the whole concept behind the SHA from the beginning was a wise one on the part of the Alliance, to make sure they had an organized way to get feedback from the broader stakeholder community. So as the Alliance moves forward now with new therapies, getting closer to patients, making real breakthroughs in the approach to treating the disease – this is where we encounter the need for lots of feedback.


TBA: Any highlights from your time serving as SHA president you'd like to share?

KH: One of the really exciting chapters during my time at the TB Alliance was the breakthrough in terms of children's therapies. There had not been a precise, fixed-dose response to the needs of children [with TB]. I mean people were required to literally cut pills in half or in thirds and hope for the best and hope to get them down the mouths of their kids. So TB Alliance worked with partners to bring to the market new therapies designed precisely for children. I think at this point there have been almost one million doses ordered in a number of different countries, just a few years after this formulation was introduced. And that's very exciting, because it's a way to turn what was already a very painful, difficult process—certainly for the mother and the child struggling against a TB infection—into something that's a little bit easier to tolerate, designed for the child, and therefore more likely to achieve its result, which is cure.


TBA: Do you have any advice for TB Alliance moving forward?

KH: The world is awash in health solutions that we know are beneficial to patients or consumers, but that for one reason or another don't get into their mouths, don’t get into their arms, don't get into their bodies, don't make a difference in their lives. I think TB Alliance is rightly focused on bringing a full spectrum response to that set of challenges so that breakthrough therapies can reach the patients and the consumers as they should.

The fight against TB, like so many other great challenges of our time, is never won and will not be won by single actors. The fantasy that there's one thing that will solve a problem is just that – a fantasy. Because even the best intervention, the most effective new therapy, for example, if you can't get it into the hands of people who need it, when they need it, where they need it, it's ineffective. And the global health landscape is littered with examples of this. So, this requires a very collaborative approach to problem solving. I think this is one of the reasons why the SHA is important to the TB Alliance.

The skill set that leads to research and science breakthroughs is not necessarily the same skill set required to orchestrate the interests of a lot of different parties and try and mitigate conflict and move toward a shared vision of success. And successful organizations embrace all those different skills sets. Collaboration is critically important to achieving progress, even when we have the best possible new therapy, we're not going to get it done just by delivering a product. We have to think about the full experience.


TBA: Any closing thoughts to leave us with?

KH: I think TB has felt for so long like a disease area that was a little bit frozen in time. We had very old approaches, very old therapies, old concepts about how to deal with this age-old affliction. The breakthroughs that TB Alliance is working on represent an ability to understand that the best science in the world doesn't matter if we're not getting those drugs to the patients who need them.


TB Alliance is grateful to Karl Hofmann for his service as President of the Stakeholders Association and welcomes PSI's continued membership in the SHA.