This post originally appeared here on Impatient Optimists, the blog of the Bill & Melinda Gates Foundation. Reposted with permission. Written by Laneta Dorflinger, Distinguished Scientist, Director of Contraceptive Technology Innovation, Kate Rademacher, Technical Advisor, Contraceptive Technology Innovation, and Lucy Wilson, Monitoring and Evaluation Advisor, Contraceptive Technology Innovation, FHI 360.
To optimize opportunities to make groundbreaking advances in contraceptive research and development (R&D), the global health community must help connect the dots to facilitate new partnerships between groups that often work in silos. For example, there is the company in the U.S. that is developing a promising drug delivery platform but hasn’t yet considered applying the research to contraceptive products. There is the university scientist who has an idea for a new contraceptive product but is unsure whether similar investments are being made in the private sector. There is the small company based in the global South that wants to enter the international market but lacks experience registering its contraceptive products in sub-Saharan Africa.
For all of these groups, the financial and regulatory barriers to advancing new contraceptive methods through the pipeline can be substantial. In recent years, funding for contraceptive R&D has sharply declined in both the private and public sectors. A new report recently issued by Policy Cures indicates that in 2013, only US$63 million was invested in developing new contraceptive products that would meet the needs of women in low- and middle-income countries. In comparison, US$580 million and US$549 million were invested in R&D for prevention and treatment of tuberculosis and malaria respectively. Another challenge is that organizations may lack the skills and capacity in-house that are needed to take a product from the discovery phase through to introduction. In addition, companies often do not have financial incentives to develop new contraceptives designed to address the needs of women in low-resource settings if there is little potential for a commercial market in developing countries. Finally, some organizations — particularly small manufacturers located in emerging markets — often have difficulty navigating the complex international regulatory environment.
The result is that the range of available contraceptive methods has remained largely unchanged over the past several decades. The consequences of this lack of innovation are sobering. There are over 200 million women in developing countries who want to avoid pregnancy but are not using an effective family planning method. If all women with unmet need received contraceptive services, it is estimated that 52 million unintended pregnancies, 24 million abortions and 70,000 maternal deaths would be avoided. We need innovative solutions — including better products — to reach vulnerable groups with high unmet need for family planning, such as adolescents, postpartum women and individuals living in rural settings.
In order to advance new contraceptive methods through the research pipeline, it is critical to promote knowledge sharing and expand partnerships between private industry, academia, the donor community and the nongovernmental organization (NGO) sector. This will enable the leveraging of not only financial resources, but also capacity and know-how. For example, FHI 360 is partnering with for-profit companies, universities and international research centers to support the development a new longer-acting injectable contraceptive and a biodegradable implant. Some of the most exciting elements of this work have been creating linkages with groups that hadn’t previously applied their research to contraceptive R&D, and initiating interactions between for-profit and non-for-profit organizations committed to contraceptive R&D.
In order to promote collaboration and knowledge sharing between these types of groups, a new website has been recently launched with funding from the Bill & Melinda Gates Foundation — the Contraceptive Technology Innovation (CTI) Exchange. This is a unique “one-stop-shop” for individuals to find and share resources that support contraceptive research, development, registration and introduction. The information is relevant for scientists, product developers, funders, manufacturers, distributors, procurement agencies and service delivery groups. The site is geared for the experienced researcher as well as for organizations or individuals that have little experience with contraceptive R&D or with developing products for low-resource settings. The site includes a new blog, Exchanges, that provides a platform for partners to share and discuss timely news, events and ideas.
One new resource that is housed on the CTI Exchange website is Calliope, the Contraceptive Pipeline Database. It includes information about more than 170 contraceptive leads and products that are in development or are marketed on a limited basis. This database contains information about leads intended for use by men and women as well as hormonal and nonhormonal regimens. In addition to leads that are in active development, the database also includes information regarding leads for which development has been discontinued, and products that are only available in certain markets. Our hope is that increased access to this information will spur innovation and create new opportunities for strategic partnerships. Researchers can learn more about what has been tried in the past, potential funders can identify opportunities for future investments, and procurement agencies, policymakers and program managers can learn about products that are close to market.
The Institute of Medicine’s landmark report, New Frontiers in Contraceptive Research: A Blueprint for Action, included 13 recommendations to advance the field of contraceptive R&D. One of those highlighted the need for “a clearinghouse for information on contraceptive research” as well as “an up-to-date database showing the progress of all current lead compounds through the research and development pipeline.” With the launch of the CTI Exchange and Calliope, we are excited to help connect the dots so that a range of diverse partners can share knowledge and move the field of contraceptive innovation forward.
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