Bill & Melinda Gates Foundation

The Not So Funny Truth About Innovation

March 09, 2014

If a joke began with “a scientist, an engineer, a marketer and a banker walk into a bar,” you probably wouldn’t think the punch line would have much to do with innovations in healthcare. Truth be told, you probably wouldn’t think it was likely to be a good joke. And perhaps it’s because, well, a joke about innovation is not all that funny.

Innovation is neither a word we kid about here at the Gates Foundation, nor is it a value we take for granted. We are certain innovation is one of the most important tools we have to make the world a better place and, as Bill said recently, we believe “more innovation equals faster progress.” But how do we translate innovation into action?

I just returned from the Global Vaccine and Immunization Research Forum (GVIRF) in Bethesda, Maryland– where, over a few days, we debated that very question. Experts from science, academia, government, public health, the private sector and philanthropy came together to share learnings and exchange ideas about actionable innovation and its role in ensuring every single person has access to vaccines by the year 2020.

Innovation is likely to be the vehicle to full immunization worldwide. We know that because it has already helped us achieve great milestones in closing the gaps that exist in the developing world. When the Developing Country Vaccine Manufacturer’s Network (DCVMN) was created in 2000, for example, it was quite a novel proposition: developing country vaccine manufacturers would join together and form a network to share training, technology and findings. Not too long after, this unique formation is delivering outstanding results. More children than ever are getting vaccines – 370 million more than in 2001, to be precise. And vaccines themselves cost less than they ever have, as the price envelope for a full suite of pentavalent, pneumococcal, and rotavirus vaccines has dropped 36% just in the last three years.

But to ensure we keep building on the successes brought on by innovation, we actually need to broaden our concept of it, and think outside the box to overcome challenges in four important areas. These areas are perhaps more traditionally associated with that scientist, engineer, marketer or banker.

Enter the scientist. Scientific challenges are inherent to worldwide vaccine coverage because people in the most remote areas are often without access to proper hygiene and sanitation, and live too far away from health clinics. This means innovation is needed to develop drugs for weakened immune systems, and drugs that can be taken less frequently, because they are longer lasting.

Next, cue the engineer to help ensure we innovate to overcome infrastructure limitations. For places where there is limited cold chain storage, we have to think about heat-resistant vaccines or innovative, multi-dose packaging that allows us to reduce volume in limited storage space. For places where electricity is a challenge, we have to think about creating battery-operated diagnostic tools.

It’s now time to bring in the marketer who will ensure we address affordability of solutions. No matter how sound our science, vaccines are nothing if they are not affordable. Most of the people who are not able to receive immunization are living in the poorest countries of the world, so the right price point is fundamental to ensuring they have access to vaccines.

Lastly, bring in the banker, so she can make us consider market failures and adapt to our learnings. This also means providing financial support to industry through a variety of instruments to de-risk investment in global health products.

Here’s the punch line, as unfunny as it is: when we speak about innovation, we have to broaden our definition. Because the scientist, the supply chain manager, the marketer and the banker already know that vaccines are one of the most cost-effective, evidence-based public health measures to reduce infectious disease mortality and morbidity. But if they really put their heads together, they’ll quickly realize that the answers to getting the entire world vaccinated require taking science, infrastructure, pricing and market failures into account. Most of all, though, they’ll conclude that the only way to find solutions to address the most pressing issue of all – that every 20 seconds, a child still dies from a vaccine-preventable disease – is to innovate. And that’s no joke.

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