Creating global health commons

The specter of a swine flu pandemic has driven home the urgent need for more rapid and effective responses to a wide range of public health threats. But in order to respond more effectively, we need to create a more open system for the exchange of vital health information and research across sectors, disciplines, geographic, economic and cultural boundaries.

Pioneers in medical and scientific research are now laying the foundations for a global health commons, a medical information and innovation exchange system that could greatly accelerate the pace and enhance the effectiveness of crucial discoveries.

Based largely online for global reach, access, and affordability, they believe such a common resource could serve as a meeting place and clearinghouse where stakeholders in diverse dimensions of public and personal health could find one another, share the results of their experiments, identify common challenges, and collaborate in designing solutions to them.

The concept of an open source health commons orginates in part with Internet commerce pioneer Marty Tenenbaum. In 1998 he was at the peak of success as a Silicon Valley entrepreneur, launching the first commercial Internet transactions and web-based auctions, when he was struck by a rare form of melanoma.

Frustrated by the lack of drug treatments for his illness, he launched an online patient-researcher alliance called CollabRx (www.collabRx.com ) that facilitates the creation of virtual biotech companies to speed the research process to develop treatments for diseases that wouldn’t otherwise receive the attention of major pharmaceutical companies.

On average, says Tenenbaum, the development of a major new drug takes 17 years and a billion dollars. With numbers like these, most pharmaceutical companies focus on so-called ‘blockbuster drugs’ with millions of potential customers. Some of these drugs address widely felt needs but many cater more to affluent consumers ready to spend lavishly for enhanced beauty or pleasure. This system of skewed incentives neglects the vast majority of ‘orphaned’ diseases that kill or disable millions of mostly poor people worldwide but won’t generate the profits drug companies are looking for.

A related experiment in open source science has already proven remarkably successful. The Public Library of Science (www.plos.org) was launched in 2000 by Nobel prize-winning scientist Harold Varmus and other eminent medical researchers. Their goal is to ‘open the doors to the world’s library of scientific knowledge by giving any scientist, physician, patient, or student anywhere in the world unlimited access to the latest scientific research.’

Now it has launched PLoS One, a unique experiment in rapid, researcher-financed publication of a huge volume of peer-reviewed scientific papers. Morever, PLoS One is equipped with innovative user tools that enable readers to comment on and rate papers in open dialogue with their authors. The genius of crowd-sourced creativity is out of the bottle, and in the view of many in the open innovation movement that’s all to the good.
In the silo-ed world of medical and scientific research, doctors speak primarily to doctors, researchers to researchers, patients to doctors and sometimes to each other. But in the kind of world where pandemics spread with stunning speed, we need to peer over the walls of the institutional and cultural compartments that separate us, to compare experiences and collaborate in devising solutions to common threats.

Exchange information

Global emergencies like swine flu illustrate the need to more freely exchange information about what's working and what's not, so we can quickly and efficiently adapt, adopt, and share the results of our experiments. In the case of health, both public and personal, we need to bring millions more people and many more constituencies into the innovation process.

 Patients, victims of diseases who can’t obtain care, traditional and alternative healers, innovators not housed within existing institutions and therefore sometimes freer to think anew: the experience of all these and more are essential to effectively address the increasingly complex challenges we now face.

The greater challenge will be to overcome deep-seated structural barriers and longstanding patterns of competition and isolation. Competitive relationships and institutional imperatives are not innately counterproductive, but they’ve too often prevented much needed cooperation. Now we’re forced by necessity to collaborate as never before because the challenges we face require a diversity of skills and perspectives. (IPS)