GlaxoSmithKline Case Study Company Sector Programme
1. The Millennium Development Goals Please select 1. Eradicate extreme poverty and hunger which of the 2. Achieve universal primary education MDGs your 3. Promote gender equality and empower women programme or 4. Reduce child mortality strategy is 5. Improve maternal health impacting 6. Combat HIV, AIDS, malaria & other diseases 7. Ensure environmental sustainability 8. Develop a global partnership for development
2. Geography Please indicate Central America where in the Central Asia world your Europe programme or Middle East strategy is North Africa impacting North America Pacific Nations South America South Asia South East Asia Sub-Saharan Africa If you prefer to name specific countries please name up to a maximum of three where your programme or strategy is having the most impact. 1. 2. 3.
3. Context Please describe Lymphatic Filariasis (LF, often called elephantiasis) is recognised by the the background World Health Organization (WHO) as one of the world’s most disabling to your and stigmatising diseases. The disease is caused by a parasitic worm programme or infection spread by mosquitoes that can lead to massive swelling of strategy; the limbs, breasts and genitals. Considered a neglected tropical disease, LF situation on the almost exclusively affects the world’s poorest people. The disease is ground or in the found is more than 80 countries throughout the global tropics. Some 120 market in which million people are affected with over one billion -- approximately one- they are sixth of the world's population -- at risk of acquiring the infection. operating
GSK has pledged to manufacture and donate the anti-parasitic medicine, albendazole, to all endemic countries for as long as necessary. In 2009, the global programmed reached 496 million people in 51 countries. GlaxoSmithKline (GSK) is a founder member of the Global Alliance to
Eliminate LF whose goal is to eliminate the disease as a public health problem.
4. Rationale Please state the GSK has a long history and presence in much of the developing world. reasons for The LF programme is one of a series of initiatives targeted at further initiating the transforming the company’s approach to diseases that disproportionately project or affect the world’s poorest countries. In addition to our ongoing strategy community programmes such as African Malaria Partnerships and
PHASE (our hand washing and hygiene programme), we are reinvesting 20% of our profits from medicines sold in the Least Developed Countries back into those countries. This profit funds community-based projects to improve health infrastructure. As a healthcare company, we play a critical role in helping to achieve the MDGs, particularly in combating HIV/AIDs, malaria and other diseases. Prevention of future suffering from LF is wholly aligned to GSK's mission to enable people to do more, feel better and live longer. GSK has supported the LF elimination programme since 1998. Subsequent to research findings that albendazole could play a key role in helping eliminate the disease, GSK pledged to donate albendazole treatments to the World Health Organization (WHO) for as long as necessary to eliminate LF. With full commitment from GSK senior management and employees, community programmes that help achieve the MDGs foster a supportive business environment, develop our relationships with key stakeholders, and assist in attracting and retaining employees who want to work for a company that is committed to making a positive impact on the world. GSK’s involvement in the fight against LF provides inspiration and affirmation to the company’s leadership and employees.
5. Objectives Please indicate The LF elimination programme is a pro-poor health initiative that targets the objectives whole communities in the poorest sectors of society. The principle for the project objectives are to: or strategy •
prevent disability and suffering of those already afflicted by LF.
The cycle of LF transmission can be interrupted in five years by treating the entire at-risk population annually with two co-administered antiparasitic medicines: albendazole (donated by GSK globally) plus diethylcarbamazine (DEC), or albendazole plus ivermectin. To interrupt transmission of the disease, more than 80% of each at-risk community must be treated. This requires reaching out to the most remote areas to ensure compliance. A comprehensive information and education programme is delivered by health staff and volunteers to recipient communities.
6. Mechanics Please give a GSK partners with the World Health Organization, the Ministries of Health description of of the 80 LF-endemic countries and 40 international organisations in the how the project Global Alliance to Eliminate Lymphatic Filariasis. It is an extensive and or strategy diverse partnership of key international stakeholders that has created a functions and new paradigm for disease control. GSK has moved away from the was/ is traditional donor relationship to a true partnership where medicines, implemented resources and planning are shared.
GSK and partners support the Ministries of Health; and it is the Ministry of Health of each country who owns and implements the LF programme and makes decisions on who to treat, by what means and when. GSK has already contributed almost £10 million in cash grants since the programme’s inception, and over 1.4 billion albendazole treatments have been donated to 50 countries in Africa, Asia, the Caribbean and the Pacific Islands. To ensure production capacity for albendazole, GSK has just completed construction of a new albendazole manufacturing facility in Nashik, India. The facility complements production of our factory in Cape Town, South Africa. Over the course of this 20+ year elimination programme, best estimates have put the scale of GSK’s commitment at over five billion albendazole treatments.
7. Business Benefits Please provide Community investments like the LF programme support GSK’s reputation details of how and helps us earn the trust of society. Our strategic focus on health and the business education supports the broad reputation of GSK, and stakeholders has benefited realise that the company is a committed partner in dealing with complex from the project health challenges. It is broadly accepted that the most sustainable or strategy programmes are those where there is a mutual benefit for both donor and
recipient. Dr LEE Jong-wook, former WHO Director-General said, ‘The continued contribution of GSK over the past several years is helping us in our efforts to achieve the goal of eliminating LF and could serve as a model for others.’ The LF programme has made contributions to GSK’s commitment to an inclusive, diverse environment for employees, customers and stakeholders. For employees, the programme creates an understanding and awareness of GSK’s commitment to health in the developing world. For customers, our partnership with the LF programme reinforces our ability to respond to diverse customer needs, building confidence in our company and our products. For stakeholders, the LF programme enables the company to collaborate with the increasingly diverse communities where we live and work. We build trust with our stakeholders when they see what GSK is doing in the community. The LF programme and its global collaboration provide a human face to the company. Because lymphatic filariasis is a disease ‘at the end of the road’, GSK’s name is reaching even the most remote of communities through this programme. In the countries with LF programmes, GSK’s local operating companies find that this programme has helped them engage more effectively with the Ministries of Health and other international partners, ‘I’m a huge supporter of the LF programme,’ said a former General
Manager of GSK’s Tanzania office, ‘A commitment of this scale builds a groundswell of support for the type of company that GSK aspires to be and creates an enormous amount of goodwill in-country.’ Involvement with LF elimination is an important source of motivation and pride for GSK employees and helps with the recruitment of talented people who seek to work for companies that demonstrate social responsibility.
8. Society Benefits Please provide The LF programme will leave a lasting and permanent benefit for the details of the world -- elimination of one of the world's most disabling tropical diseases. social and It is broadly recognised that disease specific initiatives such as the LF community programme contribute to the strengthening of health systems and to the benefits of the promotion of the principles of primary healthcare: equity of access and project or community involvement in healthcare delivery. By adopting the strategy strategy of community-directed treatment, where village appointed volunteers
deliver medicines to their neighbours, the LF programme empowers communities to actively engage in the planning and delivery of their own healthcare. This inclusive process contributes directly to the empowerment of women as healthcare providers at the village level and provides entry points for other interventions, thereby enhancing local human resource capacity. Dr Margaret Chan, WHO Director-General said, 'The large scale donation of medicines through public-private sector partnerships such as the GSK donation of albendazole for LF has been of great assistance to arrive at these impressive global figures. Through its donation, GSK is helping to contribute not only to LF elimination but also to providing other ancillary benefits to poor people, such as treating intestinal worm infections.' Mass drug administration (MDA) of annual treatments has expanded rapidly with spectacular results. WHO reports that over 50 countries have active programmes and some 496 million people were treated in 2008. The total number of LF treatments delivered now exceeds 2 billion. Several countries and regions—Egypt, Zanzibar, Sri Lanka, Togo, Vanuatu and other Pacific Island nations—have now completed MDA and moved into a post MDA surveillance phase. In the meanwhile, evaluation of programmes in China, Republic of Korea, Suriname, Costa Rica, Trinidad and Tobago and the Solomon Islands show that previous interventions have successfully reached a stage where elimination has been permanently achieved. The LF Elimination Programme helps achieve six of the MDGs: (1)
Eradicate extreme poverty and hunger: LF is a disabling disease
that contributes to poverty. As a founder member of the Global Alliance to Eliminate LF, GSK has committed to donate as much albendazole as will be required–over 5 billion treatments over 20 years. LF causes several billion pounds sterling in productivity losses each year. It occurs primarily in poor communities, and exacerbates poverty, physically incapacitating people; thus preventing them from having a normal working life. The fight against LF is also a fight against poverty. (2)
Achieve universal primary education: LF elimination will increase
the capacity of poor families to access education through increased income, reduced caring for afflicted parents by children, and increased school attendance and performance due to the impact of albendazole on intestinal worms. (4)
Reduce child mortality: LF infection typically occurs during early
childhood. By interrupting the cycle of transmission, the LF programme significantly reduces the risk that chidren will ever become infected In addition, regular treatment with albendazole significantly reduces the physical and cognitive consequences of helminth infections in children. A recent analysis of the health impact of the Global Programme indicates that the 1.9 billion treatments delivered to the end of 2007 resulted in some 56.6 million children having been treated with albendazole and 66 million babies having been born into areas protected fromLF transmission as a result of the ongoing mass drug administration programmes. (5)
Improve maternal health: Every year, 100,000 women die during
child-birth because of iron deficiency - often a result of hookworm infection. GSK’s donated albendazole has a significant impact on reducing hookworm related anaemia and consequently on mortality in women of child bearing age. Over 45 million women of childbearing age have been treated for intestinal worms, most multiple times. (6)
Combat HIV/AIDS, malaria and other diseases: LF and malaria
are spread by the same species of mosquitoes. Control of both diseases can be interlinked by insecticide-treated bednets. In addition, albendazole alleviates anaemia, a severe symptom of malaria. LF elimination activities can be integrated with other community-based prevention programs such as river blindness, school-based deworming programmes, schistosomiasis and trachoma control. (8)
Develop a global partnership for development: GSK was
instrumental in the creation of the Global Alliance to Eliminate LF. The Alliance is a free, non-restrictive partnership forum for the exchange of ideas and coordination of activities. Membership is open to all interested
particularly the LF endemic countries of the world, including the
80 endemic countries, WHO, academic and other research centers. Alliance functions include sharing of information on progress and challenges, and coordination of activities such as operational research, fund-raising and advocacy. The individual strengths and comparative advantages of each partner are harmonized towards the goal of lymphatic filariasis elimination.
9. Lessons Learned Please provide Most significantly, GSK has learned that partnership is essential for a summary of implementation, resource mobilisation, planning, education, patient care the key insights and community mobilisation. In particular each Ministry of Health must and lessons play the lead role and own the implementation of the programme in their learned through country. GSK helped build a global coalition that now includes the the project or Ministries of Health of the LF countries, the World Health Organization strategy and over 40 partner organizations that include private sector companies,
international development agencies, academic institutions, foundations and local communities. GSK has also learned that it's important to play a more active role in partnership than just donating medicines, that's why GSK also provides cash grants to partner organisations and contributes management expertise for strategic planning, logistics and communications.
Measuring impact -- Each endemic country collects data on prevalence of infection at baseline and during the years of treatment measuring the impact of mass drug administration from sentinel sites and spot check sites. These data show that after five to six rounds of annual treatment, infection rates have been decreasing signficantly. There is considerable geographical overlap where people suffer from multiple parasitic diseases such as river blindness, trachoma, soil transmitted helminths and schistosomiasis. Endemic countries and partners are now collaborating with other disease programmes to coordinate interventions for multiple neglected tropical diseases usine the same delivery mechanisms for the medicines. Tackling the diseases in an integrated way opens up new efficiencies and broadens the reach of each health programme.
10. External endorsement and available data/sources of information Please list any Awards: awards that the - World Business Award in support of the Millennium Development programme has Goals (2006), presented by UNDP, International Chamber of Commerce received and and the Prince of Wales International Business Leaders Forum any supporting resources to - Scrip Award for Corporate Social Responsibility (2005) accompany this case study - Short-listed: Oracle International Award, 2005 Business in the
Community Awards - Short-listed: Fourth Annual Pharmaceutical Achievement Awards Supporting documentation/materials: - WHO Weekly Epidemiological Records and WHO Annual Reports between 2000 and 2008 - Ottesen EA, Hooper PJ, Bradley M and Gautam Biswas (2008), 'The Global Programme to Eliminate Lymphatic Filariasis: Health Impact after 8 Years', PLoS NTDs 2:10 e317. - Lymphatic Filariasis: produced by Rockhopper Production for BBC World - 'One Day in Sri Lanka' produced by The Edge Picture Company for GSK Further information is available on GSK's website: www.gsk.com/filariasis
VI Seminario Nazionale per Dottorandi in Farmacologia e Scienze Affini Siena, Certosa di Pontignano, 23 - 26 Settembre 2002 IN VITRO STUDIES ON THE MECHANISM OF ACTION OF TWO COMPOUNDS WITH ANTIPLASMODIAL ACTIVITY: ELLAGIC ACID AND 3,4,5-TRIMETHOXYPHENYL-(6’-O- GALLOYL)-O-β-D-GLUCOPYRANOSIDE Dell’Agli M. , 2° anno di corso del Dottorato in Scienze Farmacotossicologiche,
Dasgupta Memorial Lecture Gustaaf Van Tendeloo, University of C. Barry Carter, University of Connecticut, USA. Rafal Dunin-Borkowski, Ernst Ruska Centre for Microscopy, Juelich, Germany. Pavia G, Zeiss Energy filtered precession electron diffraction: the enhanced way to kinematical electron diffraction Afternoon First Session (2 PM – 3:35 PM) Atom Probe Tomography Studies on Advanced Struct
GlaxoSmithKline Case Study 
Eliminate LF whose goal is to eliminate the disease as a public health problem.
or strategy diverse partnership of key international stakeholders that has created a 
Manager of GSK’s Tanzania office, ‘A commitment of this scale builds a groundswell of support for the type of company that GSK aspires to be and creates an enormous amount of goodwill in-country.’ Involvement with LF elimination is an important source of motivation and pride for GSK employees and helps with the recruitment of talented people who seek to work for companies that demonstrate social responsibility.
the capacity of poor families to access education through increased income, reduced caring for afflicted parents by children, and increased school attendance and performance due to the impact of albendazole on intestinal worms. (4)
Reduce child mortality: LF infection typically occurs during early
childhood. By interrupting the cycle of transmission, the LF programme significantly reduces the risk that chidren will ever become infected In addition, regular treatment with albendazole significantly reduces the physical and cognitive consequences of helminth infections in children. A recent analysis of the health impact of the Global Programme indicates that the 1.9 billion treatments delivered to the end of 2007 resulted in some 56.6 million children having been treated with albendazole and 66 million babies having been born into areas protected fromLF transmission as a result of the ongoing mass drug administration programmes. (5)
Improve maternal health: Every year, 100,000 women die during
child-birth because of iron deficiency - often a result of hookworm infection. GSK’s donated albendazole has a significant impact on reducing hookworm related anaemia and consequently on mortality in women of child bearing age. Over 45 million women of childbearing age have been treated for intestinal worms, most multiple times. (6)
Combat HIV/AIDS, malaria and other diseases: LF and malaria
are spread by the same species of mosquitoes. Control of both diseases can be interlinked by insecticide-treated bednets. In addition, albendazole alleviates anaemia, a severe symptom of malaria. LF elimination activities can be integrated with other community-based prevention programs such as river blindness, school-based deworming programmes, schistosomiasis and trachoma control. (8)
Develop a global partnership for development: GSK was
instrumental in the creation of the Global Alliance to Eliminate LF. The Alliance is a free, non-restrictive partnership forum for the exchange of ideas and coordination of activities. Membership is open to all interested
particularly the LF endemic countries of the world, including the
80 endemic countries, WHO, academic and other research centers. Alliance functions include sharing of information on progress and challenges, and coordination of activities such as operational research, fund-raising and advocacy. The individual strengths and comparative advantages of each partner are harmonized towards the goal of lymphatic filariasis elimination.
Measuring impact -- Each endemic country collects data on prevalence of infection at baseline and during the years of treatment measuring the impact of mass drug administration from sentinel sites and spot check sites. These data show that after five to six rounds of annual treatment, infection rates have been decreasing signficantly. There is considerable geographical overlap where people suffer from multiple parasitic diseases such as river blindness, trachoma, soil transmitted helminths and schistosomiasis. Endemic countries and partners are now collaborating with other disease programmes to coordinate interventions for multiple neglected tropical diseases usine the same delivery mechanisms for the medicines. Tackling the diseases in an integrated way opens up new efficiencies and broadens the reach of each health programme.
10. External endorsement and available data/sources of information