It is estimated that more than a billion people around the world suffer from neglected diseases. Those affected the most are the poorest, living in conflict zones, urban fringes or isolated rural areas. According to DNDi Africa (2018), their needs are not a priority for policymakers, pharmaceutical organizations, or research and development (R&D) establishments. Consequently, there is a significant unmet need for treatment of many neglected diseases, as well as for patient groups impacted by these.
Luckily, in the second half of the 1990s, there was an expansion of the Public-Private Partnerships (PPPs) in the area of health care. Designed to overcome policy and market failures, such cooperations mobilized new financial resources and offered innovatory solutions to demanding global health issues (Taylor and Smith, 2020). Sub-categories of PPPs, among others, include PDP – product development-based partnerships – one of which is Drugs for Neglected Diseases initiative. As per DNDi Africa (2018), DNDi is a collaborative, patient-oriented, non-profit organization working on delivery of treatments for neglected diseases. These include human African trypanosomiasis, mycetoma, leishmaniasis, and Chagas disease.
Since its inception, DNDi has sought to provide public leadership for neglected-disease-related R&D, including their conducting and financing. According to DNDi‘s (2019) report, the development agents that contributed to the company’s success are public and private institutions, as well as innovative financing mechanisms, non-governmental and philanthropic partners, and separate generous individuals. With the help of their donor support, several important milestones have been reached. For instance, five disease-specific platforms for clinical research were created in Africa and Latin America, affordable and field-adapted treatments were delivered, and a number of R&D projects were launched across various disease areas.
Nowadays, there is an arising consensus that the essential market model for funding and stimulating R&D in medical technology is becoming extremely problematic. On account of this, DNDi’s development management addresses key development challenges by continuously adapting its responses to changing R&D gaps and needs. According to DNDi (2019), organization has initiated new approaches for cases such as neglected populations being affected, innovative solutions being out of reach due to high prices, and global market failures influencing all countries. As a result, DNDi has been able to deliver new and improved treatments for neglected patients; the company hopes that their development management policy will help them continue to overcome obstacles that arise on the way.
In general, interventions in provisions of health care and health sector in its entirety can and should play a major role in the process of successful state-building. According to Organization for Economic Co-Operation and Development (2011), state-building is defined as “an endogenous process to enhance capacity, institutions and legitimacy of the state driven by statesociety relations” (p. 20). This process is to be seen against the background of structural and historical factors contributing to shaping state formation and the relationship between the state and society. Additionally, it has to be understood in the light of the current situation in the country concerned. In terms of African contexts, it means addressing certain challenges of conflict-affected or fragile circumstances. States in such circumstances are those which have little capacity to perform the basic functions of regulating their populations and territories and are unable to develop mutually beneficial and reinforcing society relations.
History has shown time and time again that conflicts entail not only indeterminable human suffering but also very determinable economic and social costs. According to Peace Building Initiative (n.d.), investment and economic growth are impeded by the consequences of conflict: loss of life, annihilation of infrastructure, institutions, and human capital, political unrest, and overall uncertainty connected to conflicts. Conflicts tend to compound public finances by reducing revenue due to the destruction of the tax base’s part while increasing military spending. As a result, public debt and fiscal deficits increase and resources divert from social and development spendings, further exacerbating the pernicious effects of conflict. Moreover, the inability to escape the so-called ‘conflict trap’ – the increased likelihood of the conflict re-occurrence after the first incident – becomes the metaphorical death penalty for many countries.
At the heart of the most of the current world’s alarming events – including conflicts, terrorism, forced displacement, poverty, hunger, and disasters – is fragility. Fragility is ubiquitously recognized as the key development challenge and all of the world’s biggest development agencies have issued reports confirming that. Fragility not only affects the citizens of the fragile states but also has significant negative consequences at the regional and global levels. According to Organization for Economic Co-operation and Development (2018), fragility may be the biggest obstacle to achieving the Sustainable Development Goals (SDGs) and the supporting of peace prioritizing. Thus, both of these agendas’ success depends on whether numerous manifestations and drivers of fragility can be better addressed.
When it comes to state-building in a new global environment, the challenges of today’s world have complex inferences for conflict-affected and fragile states. The global debate on human rights and human development is currently grounded in international relations more solidly than ever before, and this, according to Organization for Economic Co-Operation and Development (2011), justifies international collective action. Simultaneously, there is a view that the so-called West should not inflict its norms and models other world parts and that state-building should be understood as a both political and context-driven process. Moreover, the policy of being at war with terrorism has given rise to security concerns posed by fragility, which has significantly increased the emphasis on the link between security and development. Additionally, it is important to note that some aspects of globalization – contrary to the popular belief – have negatively impacted the incentive structures for behavior of elites in poor countries, undermining the motivation to facilitate national state-building efforts.
Evidently, there is a need to resort to a unifying concept that defines implementable ideas to better support the evolvement of a peace vision that encompasses the areas of security, political and developmental domains. McCandless (2018) argues that a perfect example of such concept is the social contract. The social contract perspective can serve both as a conceptual incentive for a vision that can bring together national stakeholders and provide the elements of a comprehensive practical framework of escaping conflict and fragility. The early stages of negotiating for peace offer opportunities to redefine parameters of inclusion and exclusion, as well as identify positioning of various groups and issues. Additionally, over time or within previous frameworks no effective action has been taken against the core conflict issues, directly undermining the political settlement’s inclusiveness, which can be changed with the help of social contracts. Moreover, spheres and mechanisms of social contracting can be made to contribute more sufficiently to the effective implementation of peace agreements.
Finally, the development agenda is to be set resting on Sustainable Development Goals (SDG). According to United Nations (2015), these are universally applicative and global in nature: they take into account various national realities and development levels, considering national priorities and policies. Each government is able to set its own targets, based on a global level of ambition and national circumstances. A nation also decides on their own how these goals should be integrated into particular planning processes and strategies. It is essential to recognize the relationship between sustainable development policy and other important processes in the social, economic, and environmental areas.
References
DNDi. (2019). 15 years of needs-driven innovation for access: Key lessons, challenges, and oppoRtunities for the future. [PDF Document]. Web.
DNDi Africa (2018). Strengthening regional partnerships to respond to the needs of neglected patients. [PDF Document]. Web.
McCandless, E. (2018). Does the key to sustaining peace lie in resilient social contracts? IPI Global Observatory. Web.
Organization for Economic Co-Operation and Development. Development Assistance Committee. (2011). DAC guidelines and reference series supporting statebuilding in situations of conflict and fragility: Policy guidance. OECD Publishing.
Organization for Economic Co-operation and Development. Development Assistance Committee. (2018). States of fragility 2018. OECD Publishing.
Peace Building Initiative. (n.d.). Introduction: Economic recovery strategies: Key debates & implementation challenges. Web.
Taylor, E. M., & Smith, J. (2020). Product development partnerships: Delivering innovation for the elimination of African trypanosomiasis?. Tropical Medicine and Infectious Disease, 5(1), 11. Web.
United Nations. (2015). Transforming our world: The 2030 agenda for sustainable development. Web.