During the twentieth century, the pharmaceutical industry experienced a series of dramatic changes as developments in science and technology generated new opportunities for innovation. Each of these transitions forced existing firms to develop new capabilities. The authors examine the most recent such transition, the shift to molecular genetics and recombinant DNA technology (1970 to the present), and explain how and why this transformation differed from the previous ones in pharmaceuticals. Small biotech startups played an important role in this transition, and the large pharmaceutical firms that began to enter the field had to develop new strategies for innovation. Two major strategies were adopted by the early movers, all of which created various kinds of alliances with the small biotech businesses. By the mid-1990s, the leading pharmaceutical manufacturers had established significant capabilities in the new field, but they were continuing to work with specialized biotechs in order to innovate across a broad range of therapeutic categories.
Two parallel, intellectual strands that seldom intersect have emerged in our evolving understanding of health and health systems over the past couple of decades. First is the growing appreciation of the role that social and economic factors play in shaping health. These so-called social determinants of health are now widely accepted to be core contributors to the health of populations, as indicated by a substantial body of empirical work. We know, for example, that income and education fundamentally shape health through the life course, that disparities by sex and ethnicity affect health outcomes, that characteristics of place (including the built environment) determine opportunities for health-promoting behavior and access to healthcare resources, and that public policies, market incentives, and commercial forces are inextricably linked with the conditions that ultimately generate health [1][2][3][4]. This has led to recognition of the centrality of these concepts by public health scholars and governmental organizations at all levels. The 2008 report of WHO Commission on Social Determinants of Health, chaired by Michael Marmot, was a landmark study in this area [5]. The United States Department of Health and Human Services has advocated for Public Health 3.0, which urges thinking beyond clinical settings to include complementary perspectives from community institutions to link prevention and treatment with social, economic, and environmental factors that help explain patterns of disease in given populations. Several books have translated these ideas for the general public [6,7], and slowly, the political-and private-sector conversation is also beginning to recognize the role that social determinants play in health.A second strand has followed the emergence of technologies that can collect data that characterize our biology, how we live, and the forces with which we intersect with far greater granularity than was ever possible before. These "big data" approaches (characterized typically by large volumes of data, collected quickly, and varied across levels of human organization [e.g., from the biological to the social]) have paved the way for unprecedented, new opportunities for measuring, analyzing, and documenting individual and population health. In particular, these approaches (enabled by new data-analytic tools from artificial intelligence and machine learning) have deployed new data sources and new technologies that can improve health and improve decision-making at the individual and community level. The potential of big data to improve health is becoming apparent both in the genomic revolution that has created an enormous growth in precision medicine approaches to health and in the digital revolution more broadly. These technological advances have made it possible to obtain more data about aspects of human activity, behavior, and context. Recent developments in genomics, big data, and artificial intelligence offer intriguing prospects for the development of a new discipline of
Purpose -There is growing awareness that global public health problems are so complex, and require such major resources, that neither states nor other stakeholders can tackle them and achieve the millennium development goals (MDGs) on their own. This paper aims to examine the relevance of the MDGs to the pharmaceutical sector and summarizes the industry's contributions to helping achieve the MDGs in the context of its business goals.Design/methodology/approach -The paper reviews the MDGs for which industry has made significant contributions, particularly goal 4: reduce child mortality; goal 5: improve maternal health; goal 6: combat HIV/AIDS, malaria and other diseases; and goal 8: develop a global partnership for development. The paper focuses on two public-private partnerships (PPPs) in particular -the Merck MECTIZAN w Donation Program, for the elimination of river blindness as a public health problem, and the African Comprehensive HIV/AIDS Partnerships to address the HIV/AIDS epidemic in Botswana -and outlines some lessons learned. The paper also offers some considerations for PPPs to contribute further to public health and the MDGS in the future.Findings -The pharmaceutical industry has made some major contributions to addressing public health challenges. Along the way, companies such as Merck & Co., Inc. (Whitehouse Station, New Jersey; Merck operates in most countries outside the USA as Merck Sharp & Dohme) have learned useful lessons that can be shared to inform the approach and practices of other PPPs in global health.Originality/value -Relatively few overviews document the industry's contributions to public health, especially in relation to the MDGs. This paper provides a first step to fill that gap at a time when interest in PPPs is increasing.
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