To head off the gap in public health between North and South, the world, specifically public health actors, must rally. The pharmaceutical industry has a recognized know-how in innovation, development of new compounds, and preparation of registration files, as well as in distribution and quality industrial production at a large scale, and particularly in information, education, and communication.
Sanofi-aventis has decided to play a role to fill the North - South gap.
For the past two years, we have benefited from a fully dedicated department in charge of the access to medicines. We have decided to work in seven fields: malaria, tuberculosis, sleeping sickness, leishmaniasis, epilepsy, mental health, and vaccines.
For each of them we have a R&D approach, follow-up of WHO recommendations, information, education and communication policy, and a specific economical approach: going from tiered pricing according to the patient's income to a no-profit, no-loss price. To carry out this type of policy we need partnerships. We are, for example, currently partnered with DNDi on malaria, for development of a fixed dose combination of artesunate – amodiaquine. In the works are partnerships with MMV, also on malaria, with WHO on sleeping sickness, leishmaniasis, buruli ulcer and Chagas disease, with IOWH (Institute for One World Health) on production of semi-synthetic artemisinin, as well as another project on sleeping sickness with DNDi.
After two years we can evaluate these partnerships. Using the example of our partnership with DNDi, our first signed agreement took place in 2004. It included three main aims: Common development, affordable price, and no patent for this fixed dose combination.

A new economical approach
Through this partnership we have learned how people from very different entities can work together. This experience has shown to be very fruitful for both sides. This partnership has allowed for the emergence of a new economical approach but has also generated a new business model for a "big pharma" in dealing with some specific diseases such as, but not limited to, malaria. Even so, we have decided to come back to a discovery phase for new compounds and new vaccines against malaria. This new type of approach permits us to enhance our response to the needs of the most underprivileged patients. Times have changed; the age of polemics is over. A new era of collaboration for public health actors has arrived to confront the big challenge of access to health.