Early on, WHO/TDR worked with WRAIR and pharmaceutical companies to develop mefloquine and halofantrine. More recently, it has collaborated with pharmaceutical partners to develop injectable artemether and injectable arteether for the treatment of severe malaria. WHO/TDR also sponsored the application for U.S. Food and Drug Administration approval of rectal artesunate in severe malaria (application pending). Other recent accomplishments and ongoing work include:

• Gaining regulatory approval of chlorproguanil-dapsone in collaboration with GlaxoSmithKline (GSK) in 2003

• Developing a fixed-dose combination of chlorproguanil-dapsone plus artesunate with GSK and MMV

• Working with Novartis to extend Coartem use in children down to 5 kg and to develop appropriate, user-friendly, and informative packaging

Public-private partnerships for drug development are relatively new. While they are still few, and not exclusively focused on neglected diseases of poor countries (some have formed around rare, or orphan, diseases), such collaborations are becoming very important, reviving R&D in areas that have lain fallow too long. A number of administrative arrangements are possible, but the key is tapping into a variety of skills and resources from institutions in the public and private sectors, often in a “virtual” organization. One of the most successful public-private partnerships involved in neglected diseases is the Medicines for Malaria Venture (MMV), begun in 1999, and profiled below. A new public-private partnership, the Drugs for Neglected Diseases Initiative (DNDi) has taken on late-stage development of two artemisinin coformulations as pilot projects (although the long-term focus of the DNDi will be on diseases other than malaria, e.g., African sleeping sickness).

MMV is among the first public-private partnership established to tackle a major global disease. The initiative arose from discussions between WHO (primarily through WHO/TDR), a number of other partners, and the International Federation of Pharmaceutical Manufacturers Associations (IFPMA). Early partners in these exploratory discussions were the Global Forum for Health Research, the Rockefeller Foundation, the World Bank, the Swiss Agency for Development and Cooperation, the Association of the British Pharmaceutical Industry, and the Wellcome Trust. The idea was to combine the expertise of the pharmaceutical industry in drug discovery and development, and the public sector, with its depth of expertise in basic biology, clinical medicine, field experience, and above all, its responsibility