Gates Foundation Health Chief on Coaxing Pharma to Do Good (Part 2)

Yesterday, I ran the first installment of an interview with Trevor Mundel, the president of global health at the Seattle-based Bill & Melinda Gates Foundation. He talked about his personal reasons for leaving the pharmaceutical industry to work on global health problems, and how the foundation makes decisions on how to spend its money.

Today, Mundel is talking more about how the foundation interacts with pharma and biotech companies. He shares some lessons learned here that I think could be useful for every patient advocacy group that wants to see the industry do bigger, and better things for patients.

Xconomy: I want to ask about the biotech industry and how you interact with them. You know a lot of these folks and have interacted with them in your past life. I asked your predecessor, Tachi Yamada, a couple years ago about this, and he thought pharma was doing a pretty good job of engaging with the foundation. How would you say pharma and biotech are doing in terms of working with you on these problems?

Trevor Mundel: When I came in, I think we had a strong emphasis on pharma. I’d say we have developed that even further since Tachi left. We’ve had some significant events. The London conference was a huge highlight for the pharma group. The CEO roundtable that we do with Bill (Gates) and the pharma executives is an oversubscribed and enormously popular event. It has led to a lot of buy-in, and very strong top-down endorsement of what we do.

Trevor Mundel, president of global health at the Bill & Melinda Gates Foundation.
Trevor Mundel, president of global health at the Bill & Melinda Gates Foundation.

What I found is that within companies, you need to reach down a bit deeper than just the CEO. The CEO can be hugely supportive, but our teams engage deeper in those organizations. Critical people are often the heads of R&D. So I’ve been doing quite a bit of work with the heads of R&D. It’s quite effective. If you can get the CEO on board, and the head of R&D at the pharma company on board, then you’ve really got things locked down. If you just have the CEO, then things can take a long time when our teams try to engage deep within those organizations. But I’d say pharma is an important partner for us.

What we need to be clear about, though, is what each of the partners gets. A lot of our partners like to engage from a CSR (corporate social responsibility) perspective, in global health. I think it’s very positive for pharma companies to be engaged with us. We also determine we get value from the interaction as well. We bring a lot to the table, whether it be this [global burden of disease report]—which is helpful to them too, because it’s worldwide. To the extent we are hugely subsidizing that, they derive value from it, too. They derive value from our work to improve regulatory systems in developing countries. We work with the FDA and the EMA quite closely on this. It’s driving thinking on the global regulatory structure. Many things that we do give them value.

X: More than just PR?

TM: Yes, more than just PR. We expect really deep commitments. We don’t want a sort of ‘storefront’ team on a project. If you’re going to do drug discovery in malaria, don’t put three people on the team. We want a fully powered team, and a real partner. We want to access the deep capabilities. That kind of relationship has matured with a number of pharma companies, but not all of them.

X: What about biotech? Biotech and venture capital seem to be missing in action here.

TM: Yes, I did find they were missing in action. We already had some ideas around PRIs (program-related investments). They aren’t something new. We’ve been doing developing country vaccine manufacturing loans. We have volume commitments, and AMC (advanced market commitments) to give preferential pricing, either in volume guarantees or post-market commitments. It’s so we can lock in affordable prices.

X: You’re correcting a market failure, and giving them an incentive to develop these things.

TM: Exactly.

X: That was going on before you got here.

TM: Yes, that was going on. But as I was coming on, we did the Liquidia Technologies deal. (The first Gates Foundation equity investment in a biotech).

X: Why have you personally shown interest in going that route, through equity investments in biotech companies?

TM: I love the energy and the drive of biotech. I’ve seen it

Author: Luke Timmerman

Luke is an award-winning journalist specializing in life sciences. He has served as national biotechnology editor for Xconomy and national biotechnology reporter for Bloomberg News. Luke got started covering life sciences at The Seattle Times, where he was the lead reporter on an investigation of doctors who leaked confidential information about clinical trials to investors. The story won the Scripps Howard National Journalism Award and several other national prizes. Luke holds a bachelor’s degree in journalism from the University of Wisconsin-Madison, and during the 2005-2006 academic year, he was a Knight Science Journalism Fellow at MIT.