Dr. Louis J. Currat, former Executive Secretary of the Global Forum for Health Research, insisted on the problems regarding health products for the poor, stating that there were "very little new products for the diseases in the LDC's". A "structural disconnection" between the private and public sector explains this lack of interest and engagement for neglected diseases. The two have specific failures, e.g. high costs for the private sector and a lack of expertise for the public sector, but also complementary capacities which they do not use. Dr. Louis J. Currat suggested that in order to "reconnect the private-public pipeline", you needed a "multi drug therapy" made of an increase in resources in the international agencies, "push and pull" interventions by national governments and the development of PPP's. The latter, not being a "panacea", should pass the cost/benefit calculus and be certain that no other more sufficient way to deal with the "reconnecting of the pipeline" process exists. This will allow us to know "when and where PPP's are useful but also when they should be stopped".
Eduardo Missoni from the Faculty of Sociology at Bicocca University in Milan, Italy, insisted on the controversial meaning of the "partnership" concept which has been value-laden and sometimes misleading. Hence, he stressed that during the definition process of the concept of PPP's, many have forgotten that it implies equal partners and that it has become a key word in political discussions, but most of the time there is a lack of reflexion and sufficient understanding. Emphasizing on Global PPP's (GPPP's), Eduardo Missoni pointed out the growing influence of Western private donors (such as the Bill and Melinda Gates Foundation) in the PPP's agenda setting, thus revealing the inequality among the so-called "partners". This phenomenon has led to the fragmentation and disempowerment of the WHO at the global level and to the one of the countries at the national level, thus questioning the alleged positive elements of GPPP's: What accountability, but more importantly what sustainability? To tackle these issues, Dr. Eduardo Missoni stated that the WHO should regain its legitimate leading role in global health governance (i.e. keeping a "democratic platform" which does not mean excluding the corporate sector from the whole picture but leaving the governing function to the WHO), more transparency among the international agencies and the necessity to develop a country level approach so that local players are re-empowered.
Eighty percent of the world population represent only twenty percent of the pharmaceuticals market and over the last thirty years, only twenty-one of the 1500 new marketed drugs were for the neglected diseases treatment. This is why Dr. Bernard Pécoul, Executive Director of the Drugs for Neglected Diseases Initiative (DNDI), presented the numerous gaps in the neglected diseases R&D chain where basic existing knowledge is not translated into clinically trialled and therefore never reaches the needing patients. In order to bridge these gaps, his NGO strongly believes in building partnerships and pushing governments to assume their responsibility. DNDI wishes to involve and commit the public sector through political leadership, sustained financial support and setting rules to respect intellectual property rights.
Comments from the floor brought stimulating reactions to Dr. Missoni's presentation. Some agreed that PPP's were fragmenting global health solutions, proving that they were "going down the wrong path". Jean François Martin, President of Parteurop, declared that one should make a difference between principles of PPP's and actual management of PPP's. Principles are good even tough the management needs improvement. Reacting to Dr. Pécoul's assumption, a spokesperson of a pharmaceutical company stated that R&D is costly for governments who should really concentrate on providing rather than developing the needed drugs.
The symposium's chair, Roy Widdus from the Global Health Futures Network, concluded by saying that "no one believes that PPP's are useless nor that they are deliberately harmful, making criticism addressed to PPP's very broad and not specific".
