Description: A fund for R&D into neglected diseases which awards remuneration to innovators provided that their drugs are sold affordably.
Start date: Proposed in 2009.
FRiND is a pooled fund proposed by Novartis to fund late-stage research into neglected diseases. The proposal was submitted to the Expert Working Group (EWG) on R&D Financing and Coordination in 2009 and the Consultative Expert Working Group (CEWG) on Research and Development: Financing and Coordination in 2011.1
Initially the fund would focus on attracting funds from governments without the capacity for portfolio management. This is meant to enable smaller donors to direct their funds to the most promising opportunities.
The fund would use portfolio management techniques to select the most promising compounds with the help of a scientific advisory committee.
Applicants to the pool would have to ensure that drugs developed using FRiND funding were affordable. FRiND proposed a possible mechanism whereby exclusive licensing rights would be granted to FRiND itself, which would thereby create a kind of neglected Diseases patent pool.
In the original proposal, FRiND was envisaged as becoming the dominant funder of neglected diseases research. Due to lack of enthusiasm from donors, the second proposal was scaled back. The fund would start with \$50-100 million, and then increase up to double that amount if successful. In 2012, \$200 million was less than 10% of non-HIV/AIDS neglected diseases research.2
Scope: FRiND focuses on neglected diseases, which are likely to be among the most cost-effective funding opportunities (though this also means that FRiND would not directly impact the wider R&D funding landscape). Unlike similar funds, FRiND proposes to fund all kinds of research organisation, rather than only Product Development Partnerships (PDPs).3 FRiND focuses on late stage research only.
Access: As FRiND subsidises research, it delinks to a certain extent. FRiND also envisages some kind of commitment to affordability on the part of fundees, so drug prices would reduce at least somewhat. However, FRiND does not include any incentive for distribution.
Innovation: Incentives are not directly linked to health impact, although the focus on NDs and on portfolio management might well lead to an increase in health impact. The incentives for new innovation would be fairly weak, as the fund targets only late-stage research which is more likely to be undertaken anyway, if at a later date.
Efficiency: FRiND is a relatively cheap proposal: \$50-100m to begin with. However, this also means that FRiND would be a small funding player with limited reach.4 FRiND might look market based depending on the licensing approach taken and so the amount of competition stimulated in manufacture and sale.
Governability: FRiND proposes a scientific advisory board as the main mechanism of governance. This seems feasible. Prioritising between different compounds as part of portfolio management would be difficult but again seems feasible. The selection process would need to be robust against political interference.
Political Feasibility: A lack of enthusiasm among large donors led the FRiND proposal to be scaled down. It also seems unlikely that smaller governments would be willing to cede control over funding decisions to FRiND, as this would require a high degree of value alignment. However, it is true that FRiND is backed by a pharmaceutical company, and so may be in a better position to generate industry support.
The PDP+ Fund (Product Development Partnership) is the most similar to the FRiND proposal, except that it would only be used to fund PDPs.5
The 3P-Project and FRiND share the idea of raising funds which are disbursed for the late-stage creation of neglected drugs on condition of affordability. The 3P-Project has a more composite mechanism and a more targeted disease area than FRiND.
The Health Product Research and Development Fund would also be a voluntary pooled fund, and would target Type II and III diseases. Both funds would use portfolio management techniques and a scientific advisory board to select projects. Unlike FRiND, this fund would target early and late stage research.
If FRiND were implemented with exclusive licensing to FRiND itself, it would become a patent pool as well as a fund, like the Medical Patent Pool (MPP), the 3P Project, and the Chagas Disease Prize Fund and Tuberculosis Prizes.6
Other pooled funding mechanisms (on a much larger scale) are the proposals from the WHO health R&D discussions, the Australian Democrats Prize Proposal and the Health Impact Fund (HIF).7
FRiND is a fund which awards grants conditional on some commitment to access. HIF and the Medical Innovation Prize Fund (MIPF) are similar, but rather than awarding funds conditionally in advance, they award remuneration retrospectively based on health impact (which has an obvious relation to access). HIF and MIPF are both comprehensive proposals, rather than focusing on a neglected diseases. The Australian Democrats Prize Proposal is similar to HIF and MIPF in these respects.
The Cancer Innovation Fund and FRiND are both disease specific international funds. The Cancer Innovation Fund (CIF) is aimed explicitly at comprehensive delinkage, and remunerates rather than funding up front.
GAVI, the vaccine alliance is partially funded through contributions from developing countries. This is similar to FRiND’s funding model of contributions from countries without the capacity for portfolio management.
Stakeholders on board:
EWG submission: “The Fund for R&D in Neglected Diseases (FRiND).” EWG submission, 2009. http://www.who.int/phi/Novartis.pdf.
CEWG submission: “FUND FOR RESEARCH AND DEVELOPMENT IN NEGLECTED DISEASES.” CEWG submission, 2011. http://www.who.int/phi/news/phi_20_cewg_FRiND_en.pdf.
Cheri Grace, Mark Pearson, and Janis Lazdins. “Pooled Funds: Assessing New Models for Financing Global Health R&D.” CENTER FOR GLOBAL HEALTH R&D POLICY ASSESSMENT, 2011.http://www.resultsfordevelopment.org/sites/resultsfordevelopment.org/files/Pooled Funding Technical Background Paper.pdf.
“Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination.” Report of the Consultative Expert Working Group on Research and Development: Financing and Coordination. World Health Organisation, 2012. http://apps.who.int/iris/bitstream/10665/254706/1/9789241503457-eng.pdf?ua=1.