Global Health Innovators


Dr. Philippe Douste-Blazy with African children on a UNITAID visit to South Africa

Dr. Philippe Douste-Blazy, "Douste" to his friends, is the United Nations Under-Secretary-General in charge of Innovative Financing for Development and the unpaid Chair of UNITAID

Dr. Douste-Blazy occupies a starkly modest office at the World Health Organization (WHO), and the modesty of the premises belies the immense scale and limitless scope of the story of innovation in financing a crucially important Global Health project that has been executed from here for the past seven years.

Back in 2004 Douste was the French Minister of Social Affairs when he conceived a unique project after a visit to Africa where he was told that in undeveloped countries one child dies every three seconds and one mother per minute succumbs to preventable or curable diseases. On his return to France he remarked to a colleague that "humanity was bathed in a cloak of shame" and would forever remain that way in the event it continued to turn a blind eye to these totally senseless and tragic deaths that in many cases could be prevented for just a few dollars per person.

Douste's plan is based on the observation that even if we put pressure on governments to increase the official development assistance (ODA), the Global economic and financial crisis, responsible for unprecedented debt in what would normally be donor countries forces us to invent new sources of funding to help the poorest countries. Dr. Douste-Blazy recognizes that while developed countries pay for their economic woes in higher unemployment and reduced consumer spending, underdeveloped and developing countries pay for their economic woes and indeed for the lack of aid from economically constrained developed countries with a massive amount of preventable deaths. He likes to recall that while the last two decades have seen unprecedented levels of economic globalization and a revolution in communication that our world of today could not have imagined just 20 years ago, the globalization of solidarity in caring for those less fortunate simply does not exist. To make matters worse there is a "scissor effect" with increased needs being accompanied by a reduction in ODA that has resulted in a humanitarian crisis of epidemic proportions.

Despite significant progress the international community has failed to mobilize sufficient resources and coordinate efforts as required by the United Nations (UN) Millennium Development Goals (MDGs) and scant progress has been made towards achieving the MDG's to date. The Global Financial crisis that started in 2008, climate issues, global warming and food crises in underdeveloped countries around the world, has further delayed and complicated efforts to provide finances for adequate healthcare in those areas that need it most and according to Dr. Douste-Blazy this scissor-effect between public resources and the need to fund international solidarity and indeed assist in the quest for dignity for every human being is a major international challenge. Say's Douste-Blazy "We have to fulfill a historical responsibility and in doing so revisit our approach to solidarity as human beings".

His idea is simple: Take activities that benefit the most from globalization, such as air travel, internet, mobile phones or financial transactions and get Governments initially to mandate a painless "micro tax" on airplane tickets or to agree to include the possibility of a minimal voluntary solidarity contribution at the point of payment and pass that money along to UNITAID who quite simply put promote peace and save countless lives in funding medication and programs that are helping to fight Pediatric HIV as well as Malaria and Tuberculosis in areas that otherwise could not afford to fight against these diseases. Thanks to the support of former French President Jacques Chirac and former Brazilian President Lula Ignacio Da Silva laws were passed establishing a. UNITAID's life-saving adventure began with a one euro per airline ticket micro charge mandated under the leadership of then President Jacques Chirac in 2006 and Philippe Douste-Blazy as its Founder and Chairman had just volunteered without pay for one of the world's toughest jobs with a grueling travel schedule and long hours that would take an unimaginable toll on his personal life but give him more satisfaction than any challenge that he had ever before faced. Soon 14 other countries followed, introducing for the first time, the concept of an international solidarity tax. The idea was so innovative to be almost revolutionary: a micro tax -- with little or no impact on the taxpayer and mandated at the national level -- would be managed at the supranational level.

Philippe Douste-Blazy is a medical doctor, a highly respected Professor of Public Health, and his goal for UNITAID was to wage war against three of the most dangerous and devastating epidemics in the history of mankind. Why AIDS, tuberculosis and malaria I asked Douste as he is called? "Because I wanted to show conclusively that the quantifiable, sustainable and predictive nature of such funding could and would achieve tangible, effective and measurable results in the preservation of human life" he answers.

Five years on, UNITAID has collected 2.2 billion USD, proving that a micro solidarity contribution, which by its very nature is absolutely painless for the air-traveler or the state which participates, can raise huge amounts of money simply by the scale of it.

Overseen and hosted by the WHO in Geneva, the governance of UNITAID is totally unique, combining the governments of the founding countries (Brazil, Chile, Norway, the UK and France), an African Union representative, the Bill and Melinda Gates Foundation (representing private sector donors) the United Nations via the WHO and civil society. The presence of Non- Governmental Organizations on the UNITAID board reflects the will of Dr. Douste to associate all the links in the chain of solidarity with the decisions taken on what programs to fund. UNITAID is thus a very special Public-Private Partnership where admin costs very little and the vast majority of its funding is spent on medication for those who most need it to stay alive.

UNITAID's major successes include game changing programs to deliver medicines in poor countries. "The example of pediatric AIDS treatments shows how the capitalistic world in which we live could and should be better regulated," says Douste. Indeed, because antiretroviral treatments are effective in HIV-Positive pregnant women, today there are virtually no infected newborns in Western countries' maternity hospitals. Thus, because of the "lack of market" in developed countries, pharmaceutical companies did not spend the time or research dollars to develop HIV medicines for children. That said we should not forget that over 1000 children are born each day with HIV, 98% of them in Sub Saharan Africa!

It is UNITAID under Douste which funded the research and development for pediatric medicines against AIDS and today 8 out of 10 pediatric AIDS treatments are funded via UNITAID. Many of these programs are funded and implemented on the ground by the Clinton Foundation and former US President Bill Clinton last week awarded Doustewith The Clinton global Citizens Award in New York during the UN Meeting.

UNITAID has also funded UNICEF programs to provide antiretroviral treatment to over 500,000 pregnant women in developing countries. Say's Douste, "UNITAID treats women and more particularly women in countries where armed conflict is going on or has already occurred. A large number of these women have been raped at gunpoint and infected with HIV. The least we can do as caring human beings is to allow the children of these physically and mentally scarred women to be born HIV free and to give them a chance at the dignity that has been denied their mothers by war criminal fathers they will never know. This action by UNITAID says Douste will promote peace and ultimately enhance the future stability of the post-conflict regions where they live while helping to promote world peace.

Finally, UNITAID with the "Stop TB partnership" is the leading global player in the treatment of tuberculosis and also funds the largest program for the elimination of malaria which was developed by the Global Fund and has to date saved literally millions of lives.

Douste says UNITAID has shown the international community that innovative financing can greatly help us to achieve the MDGs.

It is due to UNITAID's example that many Heads of State have now agreed to champion innovative new financing methods so that healthcare can be made available to the poorest of the poor.

According to Douste UNITAID is only paving the way. What has been done with airline tickets could be done tomorrow in other economic sectors directly affected by globalization such as mobile telephony, the internet and the financial exchanges.

It is an open, highly topical debate. Indeed, given the success of UNITAID, it seems necessary to broaden the scale by providing in particular a Financial Transaction Tax (FTT) which Douste proposes could be a single dollar on transfers of 10,000 dollars or more. Although Douste has proposed such a tax informally to a number of world leaders for a number of years most have rejected the idea outright until this fall when French President Nicolas Sarkozy and German Chancellor Angela Merkel launched a joint proposal for a FTT in the EU. Douste hopes that the FTT will be prominent on the agenda when the G20 countries' Heads of State and government hosted by President Sarkozy gather for a summit November 3rd and 4th in Cannes. Says Douste "Momentum is gathering for the FTT with an EU Parliament resolution in March being followed by a positive vote in the French Parliament in June and an EC Directive on September 28 of this year. Now the question is whether there is enough collective will power to pass a FTT resolution. It would be a huge contribution to restoring confidence in international processes and institutions insofar as their commitment to global health initiatives is concerned. "The very framework of our efforts for peace, security and development through caring is at stake", says Douste who met with the finance ministers and development ministers of the G20 in Washington DC on Friday September 23 to discuss the FTTas part of the preparatory work for the Cannes summit.

Introduction of such financial tax could provide from 40 to 200 billion U.S. dollars per year, depending on the types of transactions covered. In comparison global ODA totals approximately 120 billion dollars a year.

Last week Bill Gates who Douste regards as "arguably the greatest humanitarian the world has ever known" presented his report commissioned by the French Presidency of the G20 about financing for development, noting that a tax on financial transactions represents an extraordinary opportunity to help Developing Countries and save countless lives in the process while promoting world peace.

"But a new battle begins" Ph.Douste-Blazy said. "The most important one because while all the Ministries of Finance have been arguing so far that such an FTT was technically impossible, it suddenly becomes possible! Their countries are in debt, and for some politicians the FTT is seen as a way to cut deficits. We need more than ever to involve the general public to make sure that the proceeds of this tax are fully or at least in large measure devoted to helping poor countries with healthcare. Let us join together to help each human being to benefit from the most essential Human Rights... good health, human dignity and the inalienable Right to Live.

Dr. Douste-Blazy believes in the power of good deeds and prays that 2011 will be a decisive year for political decision makers who have taken up the cause in favor of the FTT.

"This is the last opportunity to rebalance the world. Otherwise, the 21st century will be a century of war between the poor, humiliated and angry who will surely rise up against the inequity and injustice of the selfish, the greedy, those of us that are rich but care not and despotic rulers and dictators of the type whose actions have given rise to the Arab Spring.Inward-looking rich countries are no exception. The gap between rich and poor countries continues to grow and is is all the more dangerous now the internet allows those who live in extreme poverty to compare the situation they are in with that of Western countries, breeding feelings of despair and humiliation. Put simply, the globalization of the economy without the globalization of solidarity is a certain way to court disaster. This is not simply about being generous, but it is also in the best interest of the most advanced countries. We cannot accept the trampling of Human Rights in developing countries for want of aid."Douste cites the much quoted, oh so French example of Marie Antoinette who, when told that the people had no bread said "Let them eat cake". We all know the result of that he says pragmatically.

But Philippe Douste-Blazy also initiated the opening of a second innovative approach for poor countries, The Patent Pool. A third of the medicines we use for the prevention and treatment of HIV-AIDS in the developed world are not available to children in developing countries.

UNITAID's goal includes defining new rules for the global market for medication. The method is is based on a win-win cooperation between research laboratories and the industry of generic drugs -- those that create "copy medicines".

Why? Because due to current regulations and methods for protecting patent rights, people in developing countries must often wait 15-20 years to gain affordable access to medicines that are available in our part of the world!

A patent pool for medicines establishing a pool arrangement for patents drives down prices of medicines, and contributes to the development of treatments that are better adapted to conditions in developing countries. This is done by allowing more access to patented material, through a negligible license fee. These licenses may only be used for markets in developing countries. Thus, patent owners share the risk of product development with the generic manufacturers. Meanwhile, patent owners receive a small license revenue per unit from sales in a much bigger market.

Despite the fact that this too is a simple idea, it is still a formidable challenge. For the first time in history people in need of treatment in poor countries are gaining access to the same drugs at the same time as those in rich countries. It is a globalization of solidarity that enables equal opportunity for all.

The lead of UNITAID for access to medicines can be applied to other MDGs. Indeed, the same methods UNITAID has demonstrated for fair trade in medicines should be used also for other important purposes -- such as the development and distribution of restorative climate technologies which reduce environmental harm and global warming. It is the reason why Ban Ki Moon chose Dr.Douste-Blazy as Under Secretary General of the UN in charge of Innovative Financing for Development.

"We have no time to lose. The international community cannot afford another failed summit, like those on climate change in Copenhagen and Cancun, or the endless WTO negotiations on more equitable terms for international trade" Dr.Douste-Blazy says.

"We all need to get together and write a new page for the benefit of humanity."

When you ask Douste why he, a two time Minister of Health, former Minister of Culture and former Minister of Foreign Affairs has put his political career on hold to work away from the cameras in devoting his life to find funding to alleviate suffering amongst the poorest of the poor in our world, he laughs heartily and says, "At UNITAID and in my work on Innovative Financing I feel so useful and effective while essentially having the privilege of being able to write a new chapter on Human Rights. There are probably at least a hundred people who if they wanted to serve could potentially be a better Government minister than me!" He ends our conversation with a dire warning: "If we don't want the global economic crisis to deepen and degenerate into a global humanitarian and social crisis, with unpredictable consequences to political stability and international peace, we need to act now."