Health Biotechnology Innovation on a Global Stage

Halla Thorsteinsdóttir

Cinvestav, Mexico City

2. June 2014

Overview

1. The changing global  scene in S&T in general2. Increased role of emerging economies in health 

biotechnology3. Study on South‐South collaboration in health y

biotechnology4. Key messages on how to promote health 

biotechnology innovation on the global stagebiotechnology innovation on the global stage

Steinunn Thórarinsdóttir Territory

Changing landscape in S&TChanging landscape in S&T 

Source: OECD 2010

Increased funding for R&D byE i E iEmerging Economies

GERD as a % of GDPGERD (‘000, PPPs$), 2009 or latest available year GERD as a % of GDP

Increasing in emerging economies (most in (China) but stagnated or reducing in some high income countries

As emerging economies are experiencing growth thi lt ithis results in considerably more resources for  R&D

Source UNESCO, 2011

Changes in health biotechnology knowledge d i iproduction over time

50000

60000

rs

Japan

30000

40000

otechn

ology Pa

per Germany

United Kingdom

China

France

Italy

20000

30000

umbe

r of H

ealth Bi

Italy

Canada

Spain

Netherlands

Rep. of Korea

0

10000

1998‐2001 2002‐2005 2006‐2009

Nu

India

Brazil

Mexico compared with other low/middle i i i h A iincome countries in the Americas

9,000

6 000

7,000

8,000

,

ogy Pa

pers

Brazil

3 000

4,000

5,000

6,000

f Health Biotechn

ol Brazil

Mexico

Argentina

Chile

Colombia

0

1,000

2,000

3,000

Num

ber o

f

Cuba

Venezuela

01998‐2001 2002‐2005 2006‐2009

Years

Mexico’s relative status seems to be slippingMexico s relative status seems to be slipping

Mexico ranked:25th in 1996 with 264 papers30th in 2008 with 635 papersp p

Countries such as Greece, Czech RepublicTurkey and Portugal have moved aheadTurkey and Portugal have moved ahead

Increased collaboration in health biotechnology ld idworld wide

25,000

20,000

,bo

ration

10,000

15,000

s of pap

ers in colla

0

5,000Num

ber

01996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

C ll b ti t i d f 17 5% i 1996 t 22% i 2008Collaboration rate increased from 17.5% in 1996 to 22% in 2008 

Most networks reflect north‐north collaborationMost networks reflect north north collaboration 

Almost all, or 99%, of international collaborations involves north‐north linkages whereas 27% involve north‐south or south‐south linkages

Developing countries participation in international health biotechnology networks is  increasing from gy g f19% in 1996 to 34% in 2008

South‐South cooperation in health pbiotechnology

As there is increasing capacity in health biotechnology in emergingbiotechnology in emerging economies/developing countries we wanted to examine to what extent developing countries and emerging economies are working together and h t th k i t f th iwhat are the key impacts of their 

collaboration

The collaboration teamThe collaboration team

Brazil ‐ Maria Carlota de Souza Paula and Tirso Sáenz (Center for Sustainable Development, University of Brasilia)  

China ‐ Wen Ke (Institute of Policy and Management, Chinese Academy of Sciences)   Egypt‐ Magdy Madkour (Library of Alexandria)  India ‐ Sachin Chaturvedi (Research and Information System for the Developing 

Countries)    South Africa ‐ Victor Konde (University of Zambia) 

Historical contextHistorical context

With independence from colonial powers there were political and economic incentives to find alternatives to relations with Northern countrieswith Northern countries

Terms of trade with former colonial powers had been unfavourable

The Bandung conference between Asian and African countries in 1955 marked the beginning of formal South‐South relationsbeginning of formal South South relations between developing countries

Further developments includedFurther developments included

The Non‐Aligned Movement g(1961) and the Group of 77 (1964)

United Nation’s involvement through, for example, UNDP’s  Special Unit for South‐South ll b ticollaboration.

Institutional infrastructure for South‐South collaboration

Different formats of South‐South ll b icollaboration

Bilateral collaboration between countries.

China and India have e.g. bilateral collaboration involving technical cooperation with African countries since the 1960s

i l ll b i Regional collaboration

For example, ASEAN (the Association of Southeast Asian Nations). Typically target both economic and political relationsNations). Typically target both economic and political relations

Mercosur, COMESA. Many have later incorporated co‐operation programmes in science and technology

Multilateral initiativesSuch as IBSA (India, Brazil, South Africa) initiativeSouth Africa) initiative (2003)

Drivers of South‐South collaboration

Diversification of economies – wanted to create alternatives to ties with former colonial powers

Political force ‐ to stick together to counteract political influence of Northern countriesof Northern countries– Influence international agenda, e.g. at the World Trade Organizations 

rounds

– IBSA’s role to strengthen voice of developing countries

Increasingly reference to common needs or clusters of common Increasingly reference to common needs or clusters of common interest– Developing countries have many environmental, health and climate‐

i d d bl h N h i d hinduced problems that Northern countries do not share

– Strong need to develop low cost solutions

Developing countries are not a homogenous grouphomogenous group

Concerns about increasing South‐South divide

At the same time differences provide scope for increased trade and learning between developing countries

South‐South exports account for 46% of developing countries’ exports

S h S h F i Di I South‐South Foreign Direct Investment accounts for 35% of FDI from developing countries

Study on South‐South collaboration in health biotechnologyhealth biotechnology

Main Research Objectives

① Map the levels, geographic distributions and key characteristics of South‐South health bi h l ll b ibiotechnology collaboration 

② Identify the opportunities, drivers, challenges, and impacts of the collaborations and examineand impacts of the collaborations and examine the factors and conditions that shape the collaborations

ScopeEntrepreneurialcollaboration

Researchcollaboration

DefinitionDefinition

We consider partnerships between research groups and firms in low/middle income countries as South‐South collaboration

Relied on the World Bank’sRelied on the World Bank s classification of countries

What did we do?What did we do? Methodology

Mapping exercises

Used co‐publications (Scopus database) as a proxy for  p ( p ) p yresearch collaboration and a survey administered to biotech firms in Brazil, China, Cuba, Egypt, India and S‐Africa to map entrepreneurial collaboration

Case studies of bilateral collaboration projects

Interviewed different health biotech collaborators, and Interviewed different health biotech collaborators, and other relevant experts in the innovation systems of the participating countries

What countries did we focus on?What countries did we focus on?

Case Study Countries

348 interviewees in 13 countries

Conceptual framework: Innovation systemsConceptual framework: Innovation systems

Scholars studying North‐South collaboration emphasize theScholars studying North South collaboration emphasize the importance of perceiving and promoting collaborations as part of innovation systems of the Southern countries, in order to be able to have impacts in developing countries (Velho 2002;able to have impacts in developing countries (Velho 2002; Oyelaran‐Oyeyink 2005; Chataway et al 2005)

Innovation is the result of complex relationships and knowledge flow between various actors in the system,between various actors in the system, which include firms, universities, government and user groups.

Very simplified scheme of innovation systems 

A broad definition of innovationA broad definition of innovation

Innovation is not only new to the world innovation Innovation is not only new‐to‐the‐world innovation

“processes that impro e people’s li es b transforming “processes that improve people’s lives by transforming knowledge into new or improved ways of doing things in a place where (or by people for whom) they have notin a place where (or by people for whom) they have not been used before” (IDRC, 2011)

What are innovation systems?What are innovation systems?

Defined as: “an open, evolving and complex system that l ti hi ithi d b t i tiencompasses relationships within and between organizations, 

institutions and socio‐economic structures which determine the rate and direction of innovation and competence‐building 

ti f f i b d d i b demanating from processes of science‐based and experience based learning” (Lundvall et al 2009)

Include formal organisations such as firms universities research Include formal organisations such as firms, universities, research centres and government (consciously created and have an explicit purpose)

Also institutions which are sets of common habits, social norms, routines, and laws. 

Vary according to scale: Can be supranational, national or subnational. 

More on the innovation systems’ concepty p

Has been evolving since mid 1980s. Original architects are Bengt

Lundvall, Chris Freeman and Richard Nelson 

Origins are in evolutionary economics research on technological 

change, to understand how and why nations differ in their mode of 

innovation

Innovation is complex and requires a systemic perspective

Learning is a central concept It can be carried out both at the firmLearning is a central concept. It can be carried out both at the firm 

level and at the whole system level

Interactions are crucial for learning Interactions are crucial for learning

A range of factors and conditions influence innovation

What does it mean to perceive and promote ll b i f i i ?collaboration as a part of an innovation system?

Goes beyond producing ‘check‐lists’ for good collaboration practices and delves deeper into what makes collaboration have impacts on sustainable development

Collaboration is not perceived to be only between individuals Collaboration is not perceived to be only between individuals but must be aligned with and involve interactions among larger sets of institutions that contribute to innovation and development

A focus on local institutional competencies and dynamics in the participating countriesparticipating countries

Highlights that all kinds of knowledge are important for innovation to take place

Looking at South‐South research collaborationLooking at South South research collaboration

To what extent are developing countries p gconducting research in health biotechnology gytogether?

Extent of South‐South vs South‐North h ll b iresearch collaboration 

South‐South research collaboration of l iselect countries

30

25ll internationa

l 

15

20

h collabo

ration

 of a

labo

ration

Brazil

China

Egypt

Mexico

5

10

tion

 of Sou

th‐Sou

th col Mexico

India

South Africa

0

5

1998‐2001 2002‐2005 2006‐2009

Prop

ort

Geography of South‐South research ll b icollaboration

South‐South Research Collaboration in Health Biotechnology, 1996‐2009South South Research Collaboration in Health Biotechnology, 1996 2009

South‐South collaboration in HIV/AIDs hresearch, 1996‐2009

South‐South collaboration in malaria h 1996 2009research, 1996‐2009

Mexico’s key collaborators in research, 1996 20091996‐2009

80

100

red 

0

20

40

60

80

umbe

r of co‐au

thor

pape

rsNu

Southern Collaborators

600800

1,0001,2001,400

utho

red 

0200400

Num

ber o

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pape

rs

Northern Collaborators

Drivers for the research collaboration

1. Shared health problems necessitate South‐S th ll b ti F lSouth collaboration. For example:

a) Chagas disease diagnostic in Brazil‐Argentina collaboration

b) Cholera vaccine in India Bangladesh collaborationb) Cholera vaccine in India‐Bangladesh collaborationc) Malaria in sub‐Saharan Africa collaborationd) Meningitis in China‐Thailand collaboration

Drivers for the research collaboration ( ’d)(cont’d)

2. Developing countries collaborate in order to access each others’ ti /t h l iexpertise/technologies

a) Capacity building effortsSmaller technological gaps, e.g., between Egypt and the leading developing countries has facilitated collaborationleading developing countries has facilitated collaboration and made possible appropriate capacity building

b) Complementary expertise drive, e.g., China‐India collaboration on mitochondrial DNA where India gains access to China’s sequencing infrastructure and expertise. 

Sometimes there are pockets of expertise in smaller developing countries important for collaboration e g expertise on Beta Thalasemia research in Thailand wasfor collaboration, e.g., expertise on Beta‐Thalasemia research in Thailand was important for China

Drivers for the research collaboration ( ’d)(cont’d)3. Access to clinical samples/biodiversity is an important 

d i f th th ll b ti F ldriver for south‐south collaboration. For example: 

Chinese researchers needed samples of the parasite p pAngiosrongulus cantonensis from Thailand when dealing with increasing incidence of meningitis

Indian malaria researchers needed access to parasite and phuman population samples from Amazonia that are resistant to malaria

When cholera re‐occurred in Brazil access to Indian samples pwas of paramount importance

Since there was no repository kept for strains ... there was no way work related to the identification of strains could be initiated in Brazil (Brazilian researcher)identification of strains could be initiated in Brazil (Brazilian researcher) 

Challenges for the research collaborationsg

Lack of funding

Few dedicated funds for South‐South research collaboration. Exception: CBAB (Centre Brasileiro Argentino de Biotecnologia 

Long times and costs to move samples across international borders

Misalignment of new South‐South collaboration initiatives with gexisting collaborations

Capacity building efforts won’t contribute to research and healthCapacity building efforts won t contribute to research and health promotion efforts because of lack of local infrastructure

Systemic misalignment hampers collaborationSystemic misalignment hampers collaboration

Impacts of the research collaborationImpacts of the research collaboration

Gains in health biotechnology knowledge creation seen in co‐publications

Capacity building in health biotechnology

Building of South‐South networks in the health biotechnology field

Limited impacts on development of products or services

Chagas diagnosticsChagas diagnostics

Network of researchers in 19 Latin American Network of researchers in 19 Latin American countries have been carrying out research on a rapid  ELISA diagnostic test for Chagas disease, to be used in l ilow resources settings.

Funding from Brazil, Argentina, Spain and WHO

Results showed high sensitivity and specificity of the Results showed high sensitivity and specificity of the diagnostics they developed that by‐passes the cold chain

Chagas STAT‐PAK Assay is now being commercialised by Chembio Diagnostic Systems, a biotechnology firm from the United Statesfrom the United States

Contribution to Global HealthContribution to Global Health

Developing countries can contribute towards imrovingp g ghealth through South‐South research collaboration in health biotechnology

Still, the South‐South collaboration levels are low and funding to support the collaboration is seriously lackingg pp y g

Misalignments between the participating countries have limited the impacts of the South South researchhave limited the impacts of the South‐South research collaboration on innovation and thus lead to limited contributions to global health.contributions to global health.

Looking at South‐South entrepreneurial ll b icollaboration

To what extent are firms working together in South‐Southtogether in South‐South entrepreneurial collaboration in health biotechnology?health biotechnology?

Extent of international collaboration of h lth bi t h l fi ihealth biotechnology firms in 

developing countries 

Percentages of firms surveyed that engage in S th S th h lth bi t h l ll b tiSouth‐South health biotechnology collaboration

Geography of entrepreneurial collaborationGeography of entrepreneurial collaboration

Activities in South‐South entrepreneurial ll b icollaboration

Drivers for the entrepreneurial ll b icollaboration 

1 Access to new suppliers and markets1. Access to new suppliers and marketsThe most important driver for all the countries surveyed. Features centrally in China’s and India’s collaboration both with each other and also with far away countries such as Brazilalso with far away countries such as Brazil

2. Transfer of technology.

S ll h l i l d ibl i iSmaller technological gaps made possible appropriate capacity building. Example the Chinese company Dongbao transferred 

technology for  recombinant insulin to the Egyptian firm Vacsera

“When Egypt faced a problem with imported insulin from the developed countries, there was only the door of China p , y fopen to overcome the insulin deficiency crisis” (Egyptian entrepreneur)

Drivers for the entrepreneurial collaboration ( ’d)(cont’d)

3 Complementary expertise3. Complementary expertiseDifferent expertise in demand, technological, regulatory, 

knowledge of markets

4. Co‐research and development of traditional di imedicine

Traditional medicine is seen as a resource in many developing countries and there is a demand to learndeveloping countries and there is a demand to learn particularly from China and India’s  experiences.

Example: Nigeria and India collaborate in traditional medicine where Nigeria learns from India how to harness its resources

Challenges for the collaborationsChallenges for the collaborations

1 Immature and differences between1. Immature and differences between regulatory systems

2. Long times and costs to move products i t ti l b dacross international borders

1. Communication difficulties between firms

Systemic misalignments hamper South‐South collaboration

Impacts of the entrepreneurial collaborationImpacts of the entrepreneurial collaboration

1. Affordable health products in developing countries’ markets“If we collaborate with Southern partners it makes a lot of sense for us, I mean without Shantha vaccines if we had to buy, the hepatitis vaccine from GSK for example, you can imagine p f f p y gwhat people will pay” (Nigerian Interviewee)

2. Increased capacity to meet local health needs“if l i bl f th t th ld h b“if malaria was a problem of the west, there would have been a vaccine on the market now, but it’s not their problem, so we are the ones that have to engineer that research and find a l i ” ( i )solution.” (Kenyan Interviewee)

Impacts of the entrepreneurial collaborationImpacts of the entrepreneurial collaboration

3. Ability to leverage on traditional medicine y gas traditional medicine products are reaching the products pipelinesg p p p

4 Increased availability of vaccines in poor4. Increased availability of vaccines in poor countries

Example Meningitis A vaccineExample Meningitis A vaccine

Reduced costs of health products produced by complementarities

• Brazil and Cuba cooperate to solve a health problem of a third party i.e. of  the meningitis belt in Africa

• Finlay Institute in Cuba contributes the main vaccine technology

• Biomanguinhos of Brazil contributes effective scale up and• Biomanguinhos of Brazil contributes effective scale up and manufacturing technology

• The price of the vaccine produced through this partnership p p g p pis much lower than that on the international market

• WHO initiated the collaboration and to support  the ll b i h l i i b h ilcollaboration, the regulatory agencies in both Brazil 

(ANVISA) and Cuba (CECMED) started to work together

Contribution to Global HealthContribution to Global Health

Developing countries can contribute towards improving health through South‐South entrepreneurial collaboration in health biotechnology. They share similar health problems and the need to be cost effectivebe cost effective

South‐South entrepreneurial collaboration can both expand p ptechnology transfer and rely on complementary expertise that can lead to increased availability of cost effective health products

Still, production of health products does not equal increased availability of health products for low income populationsy p p p

What the research on South‐South collaboration i h l h bi h l h h ?in health biotechnology has shown?

1 Great potential for South South collaboration in health biotech1. Great potential for South‐South collaboration in health biotech, particularly to address shared health problems and reduce costsof health products 

2. South‐South cooperation is an underutilised resource and to harness it there is a need for greater investment in South‐South cooperation by governments in developing countries the privatecooperation by governments in developing countries , the private sector, multilateral organisations etc.

1 Firms are active in South South cooperation and focused efforts1. Firms are active in South‐South cooperation and focused efforts on their cooperation should be considered Potential actions include: support for joint R&D or 

hpurchasing arrangements

What the research … has shown?

4. Systemic misalignment limits the impacts of the cooperationp

In order to have more impacts there is a need for better alignments between the countries involved In international cooperationthe countries involved In international cooperation

For example: Capacity building efforts won’t contribute to research, innovation and health promotion efforts because of lack of local infrastructure and planning coordination.

Immature and differences between regulatory systems hamper the Immature and differences between regulatory systems hamper the cooperation

How can South‐South collaboration be l d ib h l h?leveraged to contribute to health?

① Increase resources for South‐South collaboration①

e.g. national and bi‐lateral funds for technological cooperation

② Prioritise research on joint health problemse.g. through dedicated institutional mechanisms like bilateral councils

③ Consider South‐South‐North trilateral collaborationcollaboration

How (cont’d)How (cont d)

④ Include support for entrepreneurial collaboration e.g. through support for joint R&D or purchasing arrangementsg g pp f j p g g

⑤ Integrate South‐South collaboration Integrate research and innovation activities

Integrate training and research and include e.g. seed grants

Integrate science, technology, innovation with health systems and health promotion plans.

Call for a paradigm shiftCall for a paradigm shift

“Fundamentally a paradigm shift will be requiredFundamentally a paradigm shift will be required for decision‐makers to better integrate trade, investment, aid and technology policies into ainvestment, aid and technology policies into a seamless activity” (Dufour, 2002)

A systemic perspective helps cultivate this di hiftparadigm shift

Key messages on promoting health y g p gbiotechnology on the global stage

Systemic misalignment limits the impacts of the cooperationof the cooperation

In order to have more impacts there is aIn order to have more impacts there is a need for better alignmentsWithin countries to incorporate the 

ll b i ffi i lcollaboration more efficientlyBetween the countries involved international cooperation

Conceptualization of international collaboration

We need to look at international collaboration as interaction of finnovation systems and focus on their alignments

Very simplified scheme of interacting  innovation systems 

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