Open Source Model in Healthcare can Create Shared Value Last weekend, I (Salil) visited my parents who liv e in Hyderabad, a city in South India. During the trip, I initiated a conversation with an old family friend named Gh uraan Bi by simply ask ing how she wa s doing. A slight lady in her 60s, the inno cuous question seemed to trigger a barrage of emotions. Ghuraan Bi settled down on the floor and unbundled a small bag in which she stored betel leaves (paan) and betel nuts (supari). This was an indication that she was preparing for a long conversation, and then, she said something that immediately caught my attention. She narrated a story about how she had to loan her home out as collateral to the local money-lender in order to pay for her husband’s medicines. Tears welled up into her eyes as she spoke about how expensive medicines took her home away from her. “Why do medicines have to cost so much?”, she asked! Why, indeed! It is well known that sections of society are driven below the poverty line due to unbearable costs ofhealthcare and medicine in India. This is largelybecause millions of people pay out-of-pocket in the absence of social security guaranteeing health as a fundamental right. Some hold the pharmaceutical industry r esponsible for this “evil” despite k nowingthat the cost of medicines is only approximately 15% of overall healthcare costs. This is not to say that cost of medicines should not be reduced. The intention is just the opposite. It is to explore how healthcare can be made more accessible to the people through innovative partnerships, effectively leveragingtechnology and building innovative distribution models between different stakeholders. It is about thinking how to achieve this by getting the public and private sectors to work together to develop a wide range of innovative tools, partnerships, and approaches to improve healthcare delivery to the underprivileged. Andrew Witty, Chief Executive Officer of pharma major GlaxoSmithKline, in the January 2011 issue ofHealthAffairs, wrote that pharmaceutical companies are drivingcrucial research into new medicines in a way that can benefit the life of the poor. The pharmaceutical industryand the public sector are thinking differently than before about how to improve access to medicines and advance research and development. Witty writes that diseases disproportionately affecting developing countries play a large role in stalling economic and social development. Pharmaceutical companies are driving crucial research into new vaccines and medicines; however, although there is an imperative for industry to research newtherapies for diseases of the poor, the financial returns are often seen as limited. What if financial returns do not become the constrainingfactor? Would companies be more open and willing to create innovative models? Take for instance a not-for- profit arm of the business. In a publicly held company, pressure from investors is likely to deter the Board ofDirectors and top management from considering anymodel that does not generate profit or financial return. Such innovation is likely to happen in smaller, privatelyheld start-up companies such as the Institute for One World Health (iOWH), which became the first nonprofit pharmaceutical company in the United States. Since its inception, iOWH has recei ved mor e than $200 millio n from the Bill & Melinda Gates Foundation, as well as funds from other philanthropic donors. It’s a brillia nt start! But, the ‘down-side’ is that excell ent initiatives such as iOWH are simply not large enough to create an impact of the size that can simultaneouslybenefit the lives of the two billion people who do not have access to medicines and healthcare across the world. 1 https://twitter.com/salilkallianpurwww.salilkallianpur.wordpress.com www.chipress.org
